Comparison of Transcranial Doppler Ultrasound with Computational Fluid Dynamics: Responses to Physiological Stimuli

Few studies have compared transcranial Doppler (TCD) ultrasound with independent techniques such as computational fluid dynamics (CFD) simulations, particularly in response to stimuli. We compared TCD cerebral blood flow velocity in healthy participants with subject-specific CFD simulations to determine differences in techniques. Twelve participants underwent head and neck imaging with 3 Tesla magnetic resonance angiography. Velocity waveforms in the middle cerebral artery (MCA) were measured with TCD while velocity and diameter in the neck arteries were measured with duplex ultrasound at rest, hypercapnia and exercise. Subject-specific CFD simulations were developed for each condition, with velocity waveforms extracted in the same region as TCD. We found that absolute TCD velocities were significantly higher than CFD data, and non-significantly correlated across all conditions (r range 0.030-0.377, all P>0.05). However, relative changes from rest to hypercapnia and exercise generally exhibited significant positive correlations (r range 0.448-0.770), with the strongest correlation being average velocity change from rest to exercise (r=0.770, P<0.01). We have found that although absolute MCA velocity measurements from different sources vary, relative velocity changes yield stronger correlations regardless of source. Our findings indicate relative responses to physiological stimuli, along with absolute data, should be considered for analyzing cerebral blood flow velocity.