Abstract:
Purpose: To determine the intra- and interrater agreement of mean flow velocity (MFV)
and pulsatility index (PI) measurement in middle cerebral arteries, assessed by transcranial
Doppler (TCD) with M-mode.
Methods: Masked experienced neurosonologists performed TCD with M-mode using
handheld probe in healthy adult volunteers. The Bland–Altman method for concordance and
intraclass correlation coefficient were used.
Results: Seventy-seven healthy volunteers and seven raters participated (3 on regular TCD shift and
4 off-shift). The intrarater absolute mean difference between measurements was 5.5 cm/s [95%
confidence interval (CI), 4.7–6.3] for MVF and 0.073 (95% CI, 0.063–0.083) for PI. The difference
between MFV measurements was significantly higher in off-shift raters (p = 0.015). The interrater
absolute mean difference between measurements was 6.5 cm/s (95% CI, 5.5–7.5) for MVF and 0.065
(95% CI, 0.059–0.071) for PI. No influence was found for the middle cerebral artery side, volunteer's
sex, or age, and there was no significant difference between raters. The intraclass correlation
coefficient was 82.2% (95% CI 77.8–85.6) and 72.9% (95% CI 67.4–77.6) for MFV and PI, respectively.
Conclusions: There exists good intra- and interrater agreement in MFV and PI measurements using
M-mode TCD. These results support the use of this noninvasive tool and are important for clinical
and investigational purposes.
