Success rate of transcranial color-coded duplex ultrasonography in visualizing the basal cerebral arteries in vascular patients over 60 years of age

Background and Purpose-Clinically important atherosclerotic cerebrovascular disease is mainly found in patients aged >60 years. Transcranial color-cod ed duplex ultrasonography (TCCD) is a relatively new technique for investig ating the basal cerebral arteries; however, it is often hampered by impenet rable ultrasound windows. The aim of this study was to ascertain the as yet unknown success rate of TCCD regarding visualization of the basal cerebral arteries in patients >60 years, to provide reference data, and to compare any possible male/female differences. Methods-In 112 atherosclerotic white patients >60 years of age, the anterior, middle, and posterior cerebral art eries and the vertebral and basilar arteries were insonated. Results-In men, 99% of the temporal and 94% of the suboccipital windows cou ld be penetrated by ultrasound compared with 77% and 95%, respectively, in women. The male versus female vessel detection rates were 91% versus 58% fo r the anterior cerebral artery, 97% versus 73% for the middle cerebral arte ry, 97% versus 68% for the posterior cerebral artery, 94% versus 93% for th e vertebral artery, and 91% versus 79% for the basilar artery. In 77% of me n but only 33% of women could all vascular segments be investigated. All in tracranial arteries were insonated at a deeper level in men. The women show ed significantly higher blood flow velocities than the men. Conclusions-In elderly white men the vessel detection rate is >90%. In wome n there is a much lower detection rate, due to impenetrable temporal window s. Visualization of all major intracranial arteries is possible in only one third of female patients >60 years of age.