Feasibility and validity of transcranial duplex sonography in patients with acute stroke

• Published in: Journal of neurology, neurosurgery and psychiatry neurosurgery and psychiatry, 2002-07, Vol.73 (1), p.17-20
• Main Authors: Gerriets, T, Goertler, M, Stolz, E, Postert, T, Sliwka, U, Schlachetzki, F, Seidel, G, Weber, S, Kaps, M
• Format: Article
• Language: English
• Subjects: ACA; Acute Disease; Adult; Aged; angiography; anterior cerebral artery; Biological and medical sciences; Carotid arteries; Cerebral arteries; cerebral infarction; computed tomography angiography; Contrast Media; CTA; Diagnosis; digital subtraction angiography; Doppler effect; DSA; Duplex ultrasonography; Feasibility Studies; Female; Flow velocity; Hemodynamics; Humans; ICA; internal carotid artery; Investigative techniques, diagnostic techniques (general aspects); magnetic resonance angiography; Male; MCA; Medical imaging; Medical sciences; Middle Aged; middle cerebral artery; MRA; Nervous system; Neurology; Patients; PCA; Polysaccharides; posterior cerebral artery; Reproducibility of Results; Stroke; Stroke (Disease); Stroke - diagnostic imaging; TCCS; Tomography; transcranial colour coded duplex sonography; Ultrasonic imaging; Ultrasonic investigative techniques; Ultrasonography, Doppler, Transcranial - methods; ultrasound; Ultrasound imaging; Vascular diseases and vascular malformations of the nervous system; Veins & arteries
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.73.1.17

Objectives: To evaluate in a prospective multicentre setting the feasibility of transcranial colour coded duplex sonography (TCCS) for examination of the middle cerebral artery (MCA) in patients with acute hemispheric stroke, and to assess the validity of sonographic findings in a subgroup of patients who also had a correlative angiographic examination. Methods: TCCS was performed in 58 consecutive patients within six hours of the onset of a moderate to severe hemispheric stroke. Ultrasound contrast agent (Levovist) was applied if necessary. Thirty two patients also had computed tomography angiography (n=13), magnetic resonance angiography (n=18), or digital subtraction angiography (n=1). In 14 of these patients, both the sonographic and corresponding angiographic examination were performed within six hours of stroke onset (mean time difference between TCCS and angiography 0.8 hours). Eighteen patients, in whom angiography was carried out more than 24 hours after stroke onset, had a follow up TCCS for method comparison (mean time difference 6.1 hours). Results: Initial unenhanced TCCS performed 3.4 (SD 1.2) hours after the onset of symptoms depicted the symptomatic MCA mainstem in 32 patients (55%) (13 occlusions, one stenosis, 18 patent arteries). After signal enhancement, MCA status could be determined in 54 patients (93%) (p