title: Benefit of echocontrast-enhanced transcranial arterial color-coded duplex ultrasound.
abstract: OBJECTIVE
  Proper assessment of the intracranial arteries by transcranial color-coded duplex sonography (TCCD) is occasionally made difficult by an insufficient temporal bone window, an unfavorable insonation angle, or low flow velocity or volume. In these cases, echocontrast could be helpful to increase the diagnostic confidence or to make the diagnosis at all.
  
  
  METHODS
  We investigated 67 temporal windows of 47 patients with insufficient native transtemporal insonation conditions before and after the application of the second-generation (gas-filled) microbubble contrast agent Sonovue (in 20 patients out of these 47, both temporal windows were insufficient, in the remaining 27 only one side).
  
  
  RESULTS
  As compared to the precontrast scans, echocontrast allowed for more segments to be evaluated by pulsed Doppler sonography (p < 0.0001) and for longer lumen segments to be displayed on color mode (p < 0.0001). With the help of contrast medium, flow velocity in the middle cerebral artery could be measured through 65 windows as compared to only 26 windows before contrast was applied (p < 0.0001).
  
  
  CONCLUSIONS
  In patients with poor precontrast visualization of intracranial arteries, echocontrast-enhanced TCCD is very helpful.
authors.affiliation: Department of Neurology, University of Munster, Germany. droste.dirk@chl.lu
authors.forename: Dirk W
authors.initials: DW
authors.lastname: Droste
authors.forename: Thomas
authors.initials: T
authors.lastname: Boehm
authors.forename: Martin A
authors.initials: MA
authors.lastname: Ritter
authors.forename: Ralf
authors.initials: R
authors.lastname: Dittrich
authors.forename: E Bernd
authors.initials: EB
authors.lastname: Ringelstein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000000981:diagnostic imaging*; D002560:Cerebrovascular Circulation; D003097:Collateral Circulation; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010743:Phospholipids; D020521:Stroke / Q000000981:diagnostic imaging*; D013459:Sulfur Hexafluoride; D013701:Temporal Bone / Q000000981:diagnostic imaging; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride