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Value of transcranial color-code Doppler in evaluating intracranial atherosclerotic stenosis in patients with diabetes mellitus type 2: a comparison of transcranial Doppler and computed tomography angiography.

BACKGROUND
There are several imaging assessment methods for intracranial atherosclerotic stenosis (ICAS). This study investigated the most efficient method by which to diagnose ICAS in patients with diabetes mellitus.


METHODS
One hundred seven patients with type 2 diabetes mellitus were enrolled as the experimental group and 68 healthy subjects were designated as the control group. The experimental group was examined with transcranial color-code Doppler (TCCD) and transcranial Doppler (TCD). Sixty-five patients in the experimental group were diagnosed by computed tomography angiography (CTA) on a voluntary basis. The 68 subjects in the control group were examined by TCCD alone.


RESULTS
Based on TCCD examinations, the ICAS positivity rate was 71.0% (76/107) in the experimental group, which was greater than the 42.6% (29/68) in the control group (χ2 = 13.954, P＜0.001). The middle cerebral artery was most frequently affected by ICAS (χ2 = 4.684，P=0.030), with a higher incidence of moderate and severe stenosis (χ2 =4.510，P=0.034). The ICAS positivity rate was 64.6% (42/65) by TCCD, 75.4% (49/65) by CTA, and 53.8% (35/30) by TCD. There was a statistically significant difference between the TCCD and CTA (χ2=1.795, P=0.180) and between the TCD and CTA (χ2=6.594, P=0.010) positivity rates.


CONCLUSIONS
ICAS is expected to occur in patients with diabetes mellitus more often than healthy subjects, and to involve the middle cerebral artery with moderate-to-severe stenosis. The ICAS positivity rate evaluated by TCCD was lower than CTA and higher than TCD.