COMPARISON OF TRANSCRANIAL POWER DOPPLER AND CONTRAST-ENHANCED COLOR-CODED SONOGRAPHY IN THE IDENTIFICATION OF INTRACRANIAL-ARTERIES

Power-based transcranial color-coded sonography and contrast-enhanced transcranial color-coded sonography are ultrasonographic techniques th at allow improved visualization of vascular structures. The present st udy was designed to investigate and compare the diagnostic capacity an d applicability of both methods in the assessment of intracranial vess els of the circle of Willis (33 patients) and the vertebrobasilar syst em (21 patients). Compared to conventional transcranial color-coded so nography, both power-based and contrast-enhanced transcranial color-co ded sonography improved the diagnostic sensitivity in identifying peri pheral segments and small vessels of the circle of Willis. Contrast-en hanced transcranial color-coded sonography was significantly superior to power-based transcranial color-coded ultrasonography in the depicti on of the second segment of the middle cerebral artery (66 of 66 versu s 60 of 66, P < 0.005), both segments of the anterior cerebral artery (66 of 66 versus 56 of 66 for the Al segment, P < 0.005; 61 of 66 vers us 44 of 66 for the A2 segment, P < 0.005), the first segment of the p osterior cerebral artery (66 of 66 versus 55 of 66, P < 0.005), and th e 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 re solution of the vertebrobasilar system compared to power Doppler sonog raphy. Ln conclusion, contrast-enhanced transcranial color-coded real- time sonography further improves the diagnostic potential of power Dop pler sonography in the identification of vascular structures of the ci rcle of Willis. Contrast-enhanced transcranial color coded sonography and power Doppler sonography are equally effective in visualizing the vertebrobasilar system with branches.