THE STROKE OUTCOMES AND NEUROIMAGING OF INTRACRANIAL ATHEROSCLEROSIS (SONIA) TRIAL

摘要: Background: Transcranial Doppler ultrasound (TCD) and magnetic resonance angiography (MRA) can identify intracranial atherosclerosis but have not been rigorously validated against the gold standard, catheter angiography. The WASID trial (Warfarin Aspirin Symptomatic Intracranial Disease) required performance of to verify presence stenosis, allowing for prospective evaluation TCD MRA. aims Stroke Outcomes Neuroimaging Atherosclerosis (SONIA) were define abnormalities on TCD/MRA see how well they 50 99% stenosis large proximal arteries Study Design: SONIA standardized interpretation TCD, MRA, Study-wide cutpoints defining positive used. Hard copy centrally read, blind results Results: enrolled 407 patients at 46 sites in United States. For prospectively tested noninvasive test cutpoints, predictive values (PPVs) negative (NPVs) PPV 36% (95% CI: 27 46); NPV, 86% 81 89); 59% 54 65); 91% 89 93). modified maximize PPV, 50% 36 64), NPV 85% 88); MRA 66% 58 73), 87% 85 89). each test, a characteristic curve showing vary with changing cutpoint was obtained. Conclusions: Both transcranial noninvasively vessel stenoses substantial value. methods allow reliably exclude stenosis. Abnormal findings or require confirmatory such as