Related Experiment Video
Updated: Jul 11, 2026
Point of Care Transcranial Color-Coded Duplex Ultrasound of the Middle Cerebral Artery
Published on: August 9, 2024
Suitability of temporal bone acoustic window: conventional TCD versus transcranial color-coded duplex sonography
Jaroslaw Krejza1, Maciej Swiat, Mikolaj A Pawlak
1Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. jaroslaw.krejza@uphs.upenn.edu
Purpose And Background:
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.
Subjects And 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.
