Power motion-mode doppler signature: A useful tool for assessing middle cerebral artery stenosis

Purpose: To identify power motion-mode Doppler (PMD) patterns and assess their diagnostic value for the diagnosis of middle cerebral artery (MCA) stenosis. Methods: Retrospective analyses of PMD data were performed for the identification of specific patterns related to MCA stenosis. The interrater reliability and the validity of these patterns were studied, using magnetic resonance angiography and conventional transcranial Doppler sonography as gold standards. Results: Three PMD patterns were identified: the so-called black-hole, the white-hole, and the diastolic-band patterns in 58 among 178 MCAs. The mean flow velocity was significantly higher in arterial segments with the black-hole patterns and lower in segments with the diastolic-band pattern compared with the segments with normal patterns. The interrater reliability was good for each pattern. The black-hole pattern or its combination with the white-hole pattern showed the highest validity. Conclusion: Despite some limitations, the black-hole PMD pattern or its combination with the white-hole pattern appeared as a reliable and valid marker for the diagnosis of MCA stenosis.