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Updated: Jul 11, 2026
Point of Care Transcranial Color-Coded Duplex Ultrasound of the Middle Cerebral Artery
Published on: August 9, 2024
Power-based versus conventional transcranial color-coded duplex sonography in the assessment of the
Background:
Power Doppler (PD) is a new ultrasonic technique that allows improved visualization of vascular structures. The aim of our study was to compare the ability of power-based transcranial color-coded duplex sonography (p-TCCS) to conventional transcranial color-coded duplex sonography (TCCS) and contrast-enhanced transcranial color-coded duplex sonography (CE-TCCS) in the visualization of the vertebrobasilar system.
Methods:
In 41 patients without cerebrovascular diseases, we evaluated and compared identification rates of major vessels of the vertebrobasilar system and branches using both ultrasound (US) techniques. In 9 patients we performed additional CE-TCCS studies. Furthermore, the possibility of visualization of the basilar artery (BA) and the vertebral arteries (VA) over the long course was investigated.
Results:
TCCS and p-TCCS were equally effective at showing the VAs (74 of 82 v 80 of 82), proximal segments of the BA (37 of 41 v 41 of 41) and P1 segments of the posterior cerebral artery (PCA) (72 of 82 v 82 of 82). However, the diagnostic sensitivity of p-TCCS was significantly better for peripheral segments of the PCA (34 of 82 v 68 of 82 for P2 and 2 of 82 v 24 of 82 for P3 segments, P<.001), distal parts of the BA (25 of 41 v 38 of 41, P<.01), the anterior inferior cerebellar artery (AICA) (0 of 82 v 8 of 82, P<.0001) and the posterior inferior cerebellar artery (PICA) (13 of 82 v 34 of 82, P<.001). Furthermore, using transtemporal coronal sections, p-TCCS allowed visualization of the BA over the complete course in connection with one or both VAs in half of the patients. Except P2 and P3 segments, CE-TCCS did not increase resolution compared with p-TCCS.
Conclusions:
PD offers significant advantages over color-coded sonography in imaging the BA and small-calibre vessels like the PICA, AICA, and peripheral segments of the PCA. P-TCCS in combination with TCCS increases the diagnostic sensitivity to identify vascular structures of the vertebrobasilar system.