Contrast-enhanced transcranial Doppler sonography in patients with acute cerebrovascular diseases

The aim of the study was to evaluate the diagnostic potential of galactose-based microbubble suspension (Levovist) in patients with acute cerebrovascular disease and inadequate transtemporal acoustic window, when examined by transcranial Doppler (TCD). We studied 10 patients with either transient ischemic attack (no. = 3) or stroke (no. = 7). Inadequate transtemporal acoustic window was unilateral in 3 patients and bilateral in the remaining 7 patients. Signals from middle, anterior, and posterior cerebral arteries (MCA, ACA, PCA) were recorded after injecting Levovist 300 mg/ml. Six patients needed 3 injections of Levovist, 1 patient two, and 3 patients one. Mean +/- SD duration of optimal signal enhancement was 175.2 +/- 53.2 s, range 70-290 s. Doppler waveform analysis was possible in 14 (82.3%) MCA, 11 (65%) ACA, and 9 (53%) PCA. Levovist improved the reliability of TCD in patients with acute cerebrovascular disease and insufficient transtemporal insonation.