Factors associated with temporal window failure in transcranial Doppler sonography
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ORIGINAL ARTICLE
Factors associated with temporal window failure in transcranial Doppler sonography Chan-Hyuk Lee 1 & Seung-Ho Jeon 1 & Su-Jung Wang 1 & Byoung-Soo Shin 1,2 & Hyun Goo Kang 1,2 Received: 21 February 2020 / Accepted: 7 May 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Background Temporal window failure (TWF) is found in 8–20% of subjects. There are still insufficient studies about the factors affecting TWF. We aimed to elucidate the underlying causes of TWF. Methods We analyzed 376 patients who underwent both transcranial Doppler sonography and cerebral angiographic imaging. They were divided into two groups: with and without TWF. Demographics, cardiovascular factors, degree of stenosis from the proximal intracranial artery to the middle cerebral artery (MCA), MCA diameter, and skull features were examined. Results The subjects were 314 TWF-negative patients and 62 TWF-positive patients. The TWF-negative group was younger than that of the TWF-positive group (67.0 ± 12.1 vs. 75.2 ± 9.4, p < 0.001). The proportion of men in the TWF-negative group was higher than in the TWF-positive group (71% vs. 29%; p < 0.001). The TWF-negative group had a higher smoking rate than the TWF-positive group (34.4% vs. 12.9%; p = 0.001). In multivariate logistic regression analysis, age (odds ratio (OR), 1.05; p = 0.019), sex (OR, 4.64; p = 0.002), temporal bone thickness (OR, 6.03; p < 0.001), temporal bone density (OR, 0.996; p = 0.002), and soft tissue thickness (OR, 1.31; p = 0.004) significantly affected TWF. Conclusions In addition to age, sex, temporal bone thickness, and temporal bone density which were previously reported as variables associated with TWF, we confirmed that soft tissue thickness of the temporal area is a new associated factor of TWF. Measuring soft tissue thickness of the temporal area for patients with suspected TWF could be useful in identifying measurement error due to technical problems. Keywords Cerebral blood flow . Risk factor . Soft tissue . Temporal bone . Transcranial Doppler Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10072-020-04459-6) contains supplementary material, which is available to authorized users. * Hyun Goo Kang [email protected] Chan-Hyuk Lee [email protected] Seung-Ho Jeon [email protected] Su-Jung Wang [email protected] Byoung-Soo Shin [email protected] 1
Department of Neurology, Jeonbuk National University Hospital, Jeonju, South Korea
2
Department of Neurology, Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju-si, Jeonbuk-do, Jeonju 54907, South Korea
Introduction Transcranial Doppler (TCD) sonography is a test that examines cerebral blood flow noninvasively through the temporal bone. TCD can examine the hemodynamic changes of cerebral blood flow in real time and can be conducted repeatedly. Therefore, it is useful for monitoring the progression of cerebrovasc
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