DIAGNOSTIC-VALUE OF 3-DIMENSIONAL TRANSCRANIAL CONTRAST DUPLEX SONOGRAPHY

This study evaluated intracranial cerebral arteries using a new data a cquisition system for transcranial three-dimensional (3D) ultrasonogra phy with and without an echo contrast agent, with confirmation by cere bral angiography. Ten patients, studied with diagnostic cerebral angio graphy, were examined without knowledge of the angiographic results. D ata acquisition through the transtemporal acoustic window was performe d using a magnetic sensor system to track the spatial orientation of t he ultrasound probe while scanning the volume of interest. A color tra nscranial duplex system with a power Doppler mode was used, and 3D dat a sets were acquired before and after the injection of transpulmonary- stable ultrasound contrast medium. Ipsilateral to the transducer, the anterior cerebral artery (ACA) in 90%, middle cerebral artery (MCA) in 60%, all three or more branches of the MCA in 60%, posterior cerebral artery (PCA) in 60%, and posterior communicating artery (PCoA) in 60% were successfully imaged without the echo contrast agent. With the co ntrast agent, the ACA, MCA, three or more branches of the MCA, PCA, an d PCoA were visible in 100%. The anterior communicating artery was vis ualized in 40% without contrast enhancement and in 90% with contrast e nhancement. Contralateral to the transducer, the ACA (60%), MCA (30%), all three or more branches of the MCA (10%), PCA (20%), and PCoA (20% ) were successfully imaged without contrast. Contrast enhancement impr oved the imaging success rate for the ACA (90%), MCA (80%), three or m ore branches of the MCA (80%), PCA (100%), and PCoA (100%). A transpul monary-stable ultrasound contrast agent used in combination with 3D tr anscranial duplex ultrasonography can significantly improve the succes s rate for transcranial color duplex imaging of intracranial arteries.