Journal of Ultrasound in Medicine, Vol 17, Issue 2 91-96, Copyright © 1998 by American Institute of Ultrasound in Medicine
Comparison of transcranial power Doppler and contrast-enhanced color-coded sonography in the identification of intracranial arteries
T. Postert, J. Federlein, H. Przuntek and T. Buttner
Department of Neurology, Ruhr-University Bochum, Germany.
Power-based transcranial color-coded sonography and contrast-enhanced
transcranial color-coded sonography are ultrasonographic techniques that
allow improved visualization of vascular structures. The present study was
designed to investigate and compare the diagnostic capacity and
applicability of both methods in the assessment of intracranial vessels of
the circle of Willis (33 patients) and the vertebrobasilar system (21
patients). Compared to conventional transcranial color-coded sonography,
both power-based and contrast-enhanced transcranial color-coded sonography
improved the diagnostic sensitivity in identifying peripheral segments and
small vessels of the circle of Willis. Contrast-enhanced transcranial
color-coded sonography was significantly superior to power-based
transcranial color-coded ultrasonography in the depiction of the second
segment of the middle cerebral artery (66 of 66 versus 60 of 66, P <
0.005), both segments of the anterior cerebral artery (66 of 66 versus 56
of 66 for the A1 segment, P < 0.005; 61 of 66 versus 44 of 66 for the A2
segment, P < 0.005), the first segment of the posterior cerebral artery
(66 of 66 versus 55 of 66, P < 0.005), and the basilar artery using the
transtemporal approach (21 of 21 versus 15 of 21, P < 0.05). Using the
transforaminal approach contrast-enhanced transcranial color-coded
real-time sonography did not increase fine resolution of the
vertebrobasilar system compared to power Doppler sonography. In conclusion,
contrast-enhanced transcranial color-coded real-time sonography further
improves the diagnostic potential of power Doppler sonography in the
identification of vascular structures of the circle of Willis.
Contrast-enhanced transcranial color-coded sonography and power Doppler
sonography are equally effective in visualizing the vertebrobasilar system
with branches.