Assessment of intracranial blood flow velocities using a computer controlled vasoactive stimulus: a comparison between phase contrast magnetic resonance angiography and transcranial Doppler ultrasonography.

PURPOSE To compare measurements of blood flow velocity (BFV) and BFV changes in the middle cerebral arteries (MCA) acquired from phase contrast magnetic resonance angiography (PCMRA) and transcranial Doppler ultrasound (TCD) during controlled manipulation of end-tidal partial pressure of carbon dioxide (PetCO2 ). MATERIALS AND METHODS In vivo TCD and PCMRA velocity data from the M1 segment in the MCA of nine healthy adult volunteers were acquired during precise targeting of PetCO2 induced by a computer-controlled gas delivery system. Doppler spectra and phase contrast data were processed into time-averaged peak-velocity (TAPV) values for comparison. Changes in velocity between baseline and hypercapnia were analyzed in terms of velocity-based cerebrovascular reactivity (CVR). RESULTS Good correlation between the pairs of velocity measurements acquired from the two modalities were found (ρ = 0.81), but Bland-Altman analysis indicates a significant bias error. There was relatively weak agreement between the pairs of computed CVR values (ρ = -0.26). CONCLUSION Under precise PetCO2 control, PCMRA proves to be more consistent than TCD. Despite issues with variability, TCD is qualitatively comparable to PCMRA measures of velocity in the MCA. However, PCMRA velocity results are better suited for analyses that require quantitative values, such as CVR.