title: Teleneurosonology: a novel application of transcranial and carotid ultrasound.
abstract: BACKGROUND
  To demonstrate the technical feasibility of interfacing transcranial Doppler (TCD) and carotid "duplex" ultrasonography (CUS) peripherals with telemedicine end points to provide real-time spectral waveform and duplex imaging data for remote review and interpretation.
  
  
  METHODS
  We performed remote TCD and CUS examinations on a healthy, volunteer employee from our institution without known cerebrovascular disease. The telemedicine end point was stationed in our institution's hospital where the neurosonology examinations took place and the control station was in a dedicated telemedicine room in a separate building. The examinations were performed by a postgraduate level neurohospitalist trainee (M.N.R.) and interpreted by an attending vascular neurologist, both with experience in the performance and interpretation of TCD and CUS.
  
  
  RESULTS
  Spectral waveform and duplex ultrasound data were successfully transmitted from TCD and CUS instruments through a telemedicine end point to a remote reviewer at a control station. Image quality was preserved in all cases, and technical failures were not encountered.
  
  
  CONCLUSIONS
  This proof-of-concept study demonstrates the technical feasibility of interfacing TCD and CUS peripherals with a telemedicine end point to provide real-time spectral waveform and duplex imaging data for remote review and interpretation. Medical diagnostic and telemedicine devices should be equipped with interfaces that allow simple transmission of high-quality audio and video information from the medical devices to the telemedicine technology. Further study is encouraged to determine the clinical impact of teleneurosonology.
authors.affiliation: Mayo Clinic Department of Neurology, Scottsdale, Arizona. Electronic address: Rubin.Mark@Mayo.edu.
authors.forename: Mark N
authors.initials: MN
authors.lastname: Rubin
authors.affiliation: Mayo Clinic Department of Neurology, Jacksonville, Florida.
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Barrett
authors.affiliation: Mayo Clinic Department of Neurology, Jacksonville, Florida.
authors.forename: W David
authors.initials: WD
authors.lastname: Freeman
authors.affiliation: Mayo Clinic Department of Neurology, Scottsdale, Arizona.
authors.forename: Joyce K
authors.initials: JK
authors.lastname: Lee Iannotti
authors.affiliation: Mayo Clinic Department of Neurology, Scottsdale, Arizona.
authors.forename: Dwight D
authors.initials: DD
authors.lastname: Channer
authors.affiliation: Mayo Clinic Department of Neurology, Rochester, Minnesota.
authors.forename: Alejandro A
authors.initials: AA
authors.lastname: Rabinstein
authors.affiliation: Mayo Clinic Department of Neurology, Scottsdale, Arizona.
authors.forename: Bart M
authors.initials: BM
authors.lastname: Demaerschalk
mesh_terms: D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D005240:Feasibility Studies; D064368:Healthy Volunteers; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D017216:Telemedicine / Q000379:methods*; D017585:Ultrasonography, Doppler, Transcranial; D014584:User-Computer Interface
keywords: Telestroke; acute stroke; carotid ultrasound; sonology; telemedicine; transcranial Doppler