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(Stroke. 1995;26:1123.)
© 1995 American Heart Association, Inc.

Articles

Basic Identification Criteria of Doppler Microembolic Signals

Consensus Committee of the Ninth International Cerebral Hemodynamic Symposium

Correspondence to V.L. Babikian, MD, Department of Neurology, Boston University School of Medicine and Boston Veterans Administration Medical Center, 150 S Huntington Ave, Boston, MA 02130.


Key Words: embolism • hemodynamics • signal interpretation, computer-assisted • ultrasonics


*    Introduction
 
Selected high-intensity transient signals detected by transcranial Doppler ultrasonography have been shown to correspond to microemboli made of air, platelet, fibrinogen, or atheromatous material in laboratory models.1 2 They have also been detected in various clinical settings.3 4 5 6 7 8 Recent studies of their occurrence in comparable patient populations have revealed variable findings among centers. Reasons for this discrepancy include differences in signal identification criteria by various investigators and in the display on various instrument screens, as signal characteristics depend on equipment settings at the time of recording and use different ultrasonic carrier frequencies. To address this problem, the Consensus Committee recommends that an individual Doppler microembolic signal must always have the following basic features.

1. A Doppler microembolic signal is transient, usually lasting less than 300 milliseconds. Its duration depends on its time of passage through the Doppler sample volume.

2. The amplitude of a Doppler microembolic signal is usually at least 3 dB higher than that of the background blood flow signal and depends on the characteristics of the individual microembolus.

3. Within the appropriate dynamic range of bidirectional Doppler equipment, a signal is unidirectional within the Doppler velocity spectrum.

4. Depending on the equipment used and its own velocity, a microembolic signal is accompanied by a "snap," "chirp," or "moan" on the audible output.

The preceding criteria are not meant to be definitive or complete. They are proposed as minimal features that should constitute a useful reference for investigators and physicians. Investigators who select different criteria for their studies are urged . . . [Full Text of this Article]




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Transcranial Doppler Monitoring and Causes of Stroke From Carotid Endarterectomy
Stroke, April 1, 1997; 28(4): 685 - 691.
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D. W. Droste, G. Hagedorn, A. Notzold, H.-J. Siemens, H. H. Sievers, and M. Kaps
Bigated Transcranial Doppler for the Detection of Clinically Silent Circulating Emboli in Normal Persons and Patients With Prosthetic Cardiac Valves
Stroke, March 1, 1997; 28(3): 588 - 592.
[Abstract] [Full Text]

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H.-C. Koennecke, H. Mast, S. S. Trocio Jr, R. L. Sacco, J. L. P. Thompson, and J. P. Mohr
Microemboli in Patients With Vertebrobasilar Ischemia : Association With Vertebrobasilar and Cardiac Lesions
Stroke, March 1, 1997; 28(3): 593 - 596.
[Abstract] [Full Text]

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M. Kaps, J. Hansen, M. Weiher, K. Tiffert, I. Kayser, and D. W. Droste
Clinically Silent Microemboli in Patients With Artificial Prosthetic Aortic Valves Are Predominantly Gaseous and Not Solid
Stroke, February 1, 1997; 28(2): 322 - 325.
[Abstract] [Full Text]

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U. Sliwka, A. Lingnau, W.-D. Stohlmann, P. Schmidt, M. Mull, R. R. Diehl, and J. Noth
Prevalence and Time Course of Microembolic Signals in Patients With Acute Stroke: A Prospective Study
Stroke, February 1, 1997; 28(2): 358 - 363.
[Abstract] [Full Text]

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J. P. Slater, E. A. Rose, H. R. Levin, O. H. Frazier, J. K. Roberts, A. D. Weinberg, and M. C. Oz
Low Thromboembolic Risk Without Anticoagulation Using Advanced-Design Left Ventricular Assist Devices
Ann. Thorac. Surg., November 1, 1996; 62(5): 1321 - 1327.
[Abstract] [Full Text]

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E. V. Van Zuilen, W. H. Mess, C. Jansen, I. Van Der Tweel, J. Van Gijn, and R. G.A. Ackerstaff
Automatic Embolus Detection Compared With Human Experts: A Doppler Ultrasound Study
Stroke, October 1, 1996; 27(10): 1840 - 1843.
[Abstract] [Full Text]

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M. Daffertshofer, S. Ries, U. Schminke, and M. Hennerici
High-Intensity Transient Signals in Patients With Cerebral Ischemia
Stroke, October 1, 1996; 27(10): 1844 - 1849.
[Abstract] [Full Text]

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R. P. Gerraty, D. N. Bowser, B. Infeld, P. J. Mitchell, and S. M. Davis
Microemboli During Carotid Angiography: Association With Stroke Risk Factors or Subsequent Magnetic Resonance Imaging Changes?
Stroke, September 1, 1996; 27(9): 1543 - 1547.
[Abstract] [Full Text]

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D. G. Nabavi, D. Georgiadis, T. Mumme, P. Zunker, and E. B. Ringelstein
Detection of Microembolic Signals in Patients With Middle Cerebral Artery Stenosis by Means of a Bigate Probe: A Pilot Study
Stroke, August 1, 1996; 27(8): 1347 - 1349.
[Abstract] [Full Text]

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J. Srinivasan, D. W. Newell, M. Sturzenegger, M. R. Mayberg, and H.R. Winn
Transcranial Doppler in the Evaluation of Internal Carotid Artery Dissection
Stroke, July 1, 1996; 27(7): 1226 - 1230.
[Abstract] [Full Text]

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D.G. Nabavi, D. Georgiadis, T. Mumme, C. Schmid, T.G. Mackay, H.H. Scheld, and E.B. Ringelstein
Clinical Relevance of Intracranial Microembolic Signals in Patients With Left Ventricular Assist Devices : A Prospective Study
Stroke, May 1, 1996; 27(5): 891 - 896.
[Abstract] [Full Text]

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A.M. Forteza, V.L. Babikian, C. Hyde, M. Winter, and V. Pochay
Effect of Time and Cerebrovascular Symptoms on the Prevalence of Microembolic Signals in Patients With Cervical Carotid Stenosis
Stroke, April 1, 1996; 27(4): 687 - 690.
[Abstract] [Full Text]

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C. Gymnopoulos and N. M. Ramadan
Low Pulsatility Signals Through the Orbits
Stroke, February 1, 1996; 27(2): 300 - 302.
[Abstract] [Full Text]


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