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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 26:730-735, April 2005
© 2005 American Society of Neuroradiology

BRAIN

Age and Sex Variability and Normal Reference Values for the V_MCA/V_ICA Index

Jaroslaw Krejza^a,c, Piotr Szydlik^c, David S. Liebeskind^b, Jan Kochanowicz^a,c, Oleg Bronov^a, Zenon Mariak^c and Elias R. Melhem^a

^a Department of Radiology, University of Pennsylvania, Philadelphia
^b Department of Neurology, University of Pennsylvania, Philadelphia
^c Department of Radiology, Bialystok Medical Academy, Poland
^d Department of Neurosurgery, Bialystok Medical Academy, Poland

Address reprint requests to Jaroslaw Krejza, MD, PhD, Department of Radiology, Division of Neuroradiology, University of Pennsylvania, 3600 Market St, Science Building Ste 370, Phialdelphia, PA 19104

BACKGROUND AND PURPOSE: The index of mean blood flow velocity (V) in the middle cerebral artery (MCA) divided by respective velocity in the ipsilateral internal carotid artery (ICA), or V_MCA/V_ICA index, is commonly used as a marker of vasospasm, although reference values are not established. We sought to provide reference data for these velocities and index.

METHODS: Transcranial color-coded duplex and carotid duplex sonography was performed in 335 healthy volunteers (211 women, 124 men; mean age ± SD, 42 ± 18 years; range, 18–86 years). Age analyses were based on three groups: I, <40; II, 40–60; and III, >60 years. The V_MCA/V_ICA index was calculated based on angle-corrected blood flow velocities determined in the MCA and extracranial ICA.

RESULTS: Mean flow velocities in the MCA and ICA diminished with increasing age, most pronounced in those subjects >40 years. The V_MCA/V_ICA index increased significantly (1.67 + 0.005 [age]; P < .05) with age in women, but not in men. In women, reference values and ranges for the V_MCA/V_ICA index were as follows, by group: I, 1.82 (range, 0.88–2.68); II, 1.91 (range, 0.94–2.88); and III, 2.06 (range, 0.59–3.53). Respective values for men were as follows, by group: I, 2.10 (range, 0.96–3.24); II, 2.04 (range, 0.71–3.37); and III, 1.78 (range, 0.81–2.75). In subjects <40 years, the V_MCA/V_ICA index was significantly higher in men than in women.

CONCLUSION: The V_MCA/V_ICA index significantly varies with age and sex. Sonographic diagnosis of cerebral vasospasm should be based on age- and sex-adjusted reference values of the V_MCA/V_ICA index.

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