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 (x(2)=13.954, P<0.001). The middle cerebral artery was most frequently affected by ICAS (x(2)=4.684, P=0.030), with a higher incidence of moderate and severe stenosis (x(2)=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 (x(2)=1.795, P=0.180) and between the TCD and CTA (x(2)=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.