Comparison of transcranial color-coded duplex sonography and cranial CT measurements for determining third ventricle midline shift in space-occupyingstroke

BACKGROUND AND PURPOSE: Transcranial color-coded duplex sonography (TCCS) a llows the noninvasive, easily reproducible measurement of midline dislocati on (MLD) of the third ventricle in space-occupying stroke, even in critical ly ill patients. However, the method has been validated only in a small num ber of subjects. The aim of this study was to test the method under clinica l conditions. METHODS: In 61 prospectively recruited patients (mean age, 62 +/- 15 years) with supratentorial ischemic infarction or intracranial hemorrhage, the so nographic measurement of MLD was compared with cranial CT data in a 12-hour time window. Subgroup analysis was also undertaken for comparing TCCS and cranial CT measurements within a 3-hour time window. RESULTS: One hundred twenty-two data pairs of TCCS and cranial CT MLD measu rements were correlated within the 12-hour time window. TCCS and cranial CT measurements of MLD correlated both in the total patient group and in the different subgroups with coefficients of over 0.9. The 2-SD confidence inte rval of the difference between the TCCS measurements and the respective mea ns of both methods in the total patient collective was +/-1.78 mm. CONCLUSION: TCCS provides a noninvasive, easily reproducible and reliable m ethod for monitoring MLD of the third ventricle in stroke patients. It is p articularly suitable for critically ill patients who are not fit for transp ortation.