Power Transcranial Doppler Ultrasound in the Detection of Intracranial Aneurysms

White, Phil; Wardlaw, Joanna M.; Teasdale, E.; Sloss, Stuart; Cannon, James C.; Easton, Valerie

doi:10.1161/01.str.32.6.1291

Cited by 27 publications

(13 citation statements)

References 22 publications

(28 reference statements)

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“…Studies using transcranial color-coded duplex sonography (TCCS) compared to TCD have reported better rates of transtemporal window presence (81-92%) [24][25][26][27][28][29] . However, Krejza et al [16] did not notice any clear difference in the prevalence of transtemporal windows between TCCS and TCD.…”

Section: Prevalence Of Acoustic Windowsmentioning

confidence: 99%

Estimated Prevalence of Acoustic Cranial Windows and Intracranial Stenosis in the US Elderly Population: Ultrasound Screening in Adults for Intracranial Disease Study

et al. 2011

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Background: Intracranial atherosclerosis is an important etiology of stroke in the USA, but its prevalence in the general population remains unknown. This study was performed to determine the feasibility of transcranial Doppler ultrasound (TCD) for general population screening and to estimate the prevalence of intracranial stenosis in the USA. Methods: We used a public database to randomly select 99 subjects aged 65–84 years residing in a well-defined geographic area. For all subjects clinical history was reviewed, blood pressure was recorded and TCD examination was performed to identify intracranial stenosis. Results: The mean age of subjects was 72 years, 42 were men, and 17 were African-Americans. All acoustic windows were present in 77 subjects. After multivariate adjustment, the odds of absence of a bone window were higher in African-Americans [odds ratio (OR) 6.0, 95% confidence interval (CI) 1.8–2.0], nonsmokers (OR 3.1, 95% CI 1.0–9) and those with a high BMI (9% higher odds per index point). Among 77 subjects who had all acoustic windows present, intracranial stenosis of >50% was identified in 6.5%, and intracranial stenosis of any severity was identified in 16% of the persons. Intracranial stenosis was most prevalent in the middle cerebral artery (6%). Conclusion: Presence of acoustic windows is associated with vascular risk factors. Based on the high prevalence of significant intracranial stenosis in the US elderly population, it is feasible and important to perform a large-scale population-based study for this disease entity.

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Section: Prevalence Of Acoustic Windowsmentioning

confidence: 99%

Estimated Prevalence of Acoustic Cranial Windows and Intracranial Stenosis in the US Elderly Population: Ultrasound Screening in Adults for Intracranial Disease Study

et al. 2011

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“…This places high demands on the frame rate and processing capacity of the duplex scanner. TCDI should not be used as a screening test for cerebral aneurysms [23,24]. Furthermore, fewer diagnostic criteria are available for the detection and grading of intracranial disease with TCDI [25,26] Although TCDI allows the assessment of intracranial veins, thrombosis and arterio-venous malformations [27][28][29], the reliability and clinical utility of TCDI in this setting are still unknown.…”

Section: Limitations Of Tcdimentioning

confidence: 99%

Intracranial Cerebrovascular Ultrasound Examination Techniques

Alexandrov

Rubiera

Palazzo

et al. 2011

Cerebrovascular Ultrasound in Stroke Prevention and Treatment

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“…22,23 Contrast enhancement, in conjunction with power Doppler, allows the imaging of low-flow signals and decreases the dependence of the angle of insonation. 12 This can assist in the detection of low-velocity flow around and within the coil nidus. Indeed, we found the greatest increase in detection with contrast was in aneurysms with minor refilling.…”

Section: Turner Et Al Ultrasound-assessed Coiled Intracranial Aneurysmentioning

confidence: 99%

“…A criticism of TCCS imaging of the intracranial vasculature is the degree of operator expertise required. Although it is accepted that TCCS requires experience, particularly when using contrast agents, White et al 12 conducted a study comparing the performance of experienced and inexperienced operators. They found very little difference in the detection of aneurysms between the 2 groups (sensitivity 5%, specificity 2%).…”

Section: Turner Et Al Ultrasound-assessed Coiled Intracranial Aneurysmentioning

confidence: 99%

Intracranial Aneurysms Treated With Endovascular Coils

Turner

Higgins²,

Gholkar³

et al. 2005

Stroke

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Background and Purpose-Because neck recurrence after endovascular treatment of intracranial aneurysms (IAs) is not uncommon, surveillance to assess long-term stability of occlusion is clearly important. This study evaluated unenhanced and contrast-enhanced transcranial color-coded duplex sonography (TCCS) in detecting refilling of IAs treated with detachable coils. Methods-Patients with coiled IAs were imaged before and after contrast enhancement. The results were compared with those of a surveillance digital subtraction angiogram (DSA). The operator was blinded to the results of the DSA. Aneurysms were classed as either occluded or with residual flow and quantified as minor, moderate, or extensive. There were 208 studies performed in 4 neurosurgical centers. Of those, 141 studies received ultrasonic contrast enhancement with Levovist, and 68 had an additional enhanced study with SonoVue. Results-We excluded 44 studies. Of the 164 unenhanced studies, TCCS correctly identified 52 of 67 cases defined as completely occluded by DSA (sensitivity 78%; specificity 77%), 13 of 50 aneurysms with minor refilling (sensitivity 26%; specificity 88%), 15 of 27 aneurysms with moderate refilling (sensitivity 56%; specificity 95%), and 9 of 20 aneurysms with extensive refilling (sensitivity 45%; specificity 100%). TCCS correctly identified an additional 10 aneurysms with minor refilling after Levovist enhancement and 3 with SonoVue. Both SonoVue and Levovist enhancement identified an additional 1 aneurysm with moderate refilling and 3 with extensive refilling. Conclusions-TCCS could be used to selectively monitor IAs, which would reduce the requirement for long-term invasive monitoring.

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Power Transcranial Doppler Ultrasound in the Detection of Intracranial Aneurysms

Cited by 27 publications

References 22 publications

Estimated Prevalence of Acoustic Cranial Windows and Intracranial Stenosis in the US Elderly Population: Ultrasound Screening in Adults for Intracranial Disease Study

Estimated Prevalence of Acoustic Cranial Windows and Intracranial Stenosis in the US Elderly Population: Ultrasound Screening in Adults for Intracranial Disease Study

Intracranial Cerebrovascular Ultrasound Examination Techniques

Intracranial Aneurysms Treated With Endovascular Coils

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