Use of transcranial doppler ultrasonography (tcd)‎ to screen for cerebral micro angiopathy in type 2 diabetes mellitus

Abstract EN

Objective: To assess the value of using transcranial Doppler ultrasonography (TCD) for screening of silent cerebral microangiopathy.

Methods: This study involved 60 patients with type 2 diabetes mellitus and 20 healthy controls .The diabetic patients were classified according to fundus examination into two groups .Group(I):20 patients with no diabetic retinopathy (NDR).Group(II):40 patients with retinopathy and this group was further subclassified into two subgroups ;20 patients with early stage or background retinopathy (BDR)and 20 patients with advanced stage or proliferative retinopathy (PDR).

Transcranial Doppler Ultrasonography (TCD )was performed to all patients and controls measuring peak systolic velocity(PS),end diastole ( ED), systolic/diastolic ratio( S/D) ,pulsatility Index (PI) as well as resisitivity Index (RI) at the middle cerebral artery( MCA),anterior cerebral artery (ACA),posterior cerebral artery (PCA),vertebral and basilar arteries..

Results: TCD parameters; PI ,RI and S/D ratio were significantly higher in diabetics than controls.

which are also significantly and positively correlated to diabetes duration and presence of retinopathy.

The microcirculation studies ; laser Doppler flowmetry parameters revealed higher maximum and mean perfusion at room tempetature and at postocclusive reactive hyperemia with decrease in percent change in diabetics compared to controls.Dynamic capillaroscopy revealed significant higher grades of capillary morphology with positive correlation to presence to retinopathy.On the other hand , there was positive correlation between peripheral microangiopathy and its grade and the presence of silent cerebral microangiopathy as evidenced by high PI value.