Suitability of temporal bone acoustic window: conventional TCD versus transcranial color-coded duplex sonography.
OBJECTIVE
To determine whether the proportion of patients with suitable temporal bone acoustic windows is different for conventional transcranial Doppler sonography (TCD) and transcranial color-coded duplex sonography (TCCS), based on a head-to-head comparison in the same population of patients.


METHODS
Ninety patients, age 22-88 years (mean 57.1 +/- 11.7 years), 46 women and 44 men, 66 Caucasian, 19 African-American, and five Hispanic, underwent routine conventional TCD and the TCCS examination close in time to each other. Suitability of temporal bone acoustic window was defined by ability to insonate the middle and posterior and/or anterior cerebral arteries, while partial suitability was defined by ability to detect the posterior cerebral artery but not the middle cerebral artery. To compare proportions of suitable temporal bone windows for both sonographic methods, exact sign test by Liddell was used.


RESULTS
Bilateral absence of temporal bone acoustic window was reported in six patients when studied with both conventional TCD and TCCS, whereas at least unilateral absence was reported in 10 patients. Partial, at least unilateral, suitability was reported in 11 patients with conventional TCD, and in 7 with TCCS. All differences in proportions were not significant (two-sided P>0.05).


CONCLUSIONS
This study suggests that success rate of insonating the intracranial vessels through the temporal bone acoustic window is the same for conventional TCD and imaging TCCS.
Krejza
Jaroslaw
J
Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. jaroslaw.krejza@uphs.upenn.edu
Swiat
Maciej
M
Pawlak
Mikolaj A
MA
Oszkinis
Grzegorz
G
Weigele
John
J
Hurst
Robert W
RW
Kasner
Scott
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013701:Temporal Bone / Q000000981:diagnostic imaging*; D018615:Ultrasonography, Doppler, Color; D017585:Ultrasonography, Doppler, Transcranial