Value of transcranial Doppler combined with digital subtraction angiography in evaluation of intracranial vessels in patients with cerebral watershed infarction

Objective To study the value of transcranial Doppler (TCD) combined with digital subtraction angiography (DSA) in the evaluation of intracranial vessels in patients with cerebral watershed infarction. Methods The clinical and imaging data of 97 patients with cerebral watershed infarction, admitted to our hospital from June 2008 to June 2011, were retrospectively analyzed. All patients underwent TCD and DSA examination. Comparative analysis of TCD and DSA for intracranial stenosis diagnosis and compensatory collateral circulation in these patients was performed, and the advantages and disadvantages of TCD and DSA in these cases were compared. Results Eight hundred and seventy-three intracranial vessels of the 97 patients were analyzed. TCD and DSA showed no significant differences in evaluation of vascular stenosis or occlusion (P=0.503). As to the collateral circulation, no significant differences between TCD and DSA were shown in the evaluation of anterior communicating artery compensatory (P=0.754), while TCD was more sensitive than DSA in the evaluation of ophthalmic artery compensatory (P=0.039), and DSA was more sensitive in evaluating the posterior communicating artery and pial artery compensatory (P=0.035 and P=0.000). The internal watershed infarction and cortical watershed infarction had significant differences in intracranial vascular stenosis or occlusion and collateral circulation (χ2=9.762, P=0.002;χ2=24.708, P=0.000). Conclusion Combining TCD and DSA can contribute to judge the intracranial vascular lesions and collateral circulation correctly. Key words: Watershed infarction; Transcranial Doppler; Digital subtraction angiography