Image guidance for transcranial Doppler ultrasonography

Area of Science:

• Neurology
• Medical Imaging
• Ultrasound Technology

Background:

• Transcranial Doppler (TCD) ultrasonography is crucial for noninvasively detecting intracranial vascular pathologies like vasospasm.
• Accurate identification and monitoring of these conditions are vital for patient management.

Purpose of the Study:

• To demonstrate the efficacy of image-guided TCD in rapidly identifying and analyzing blood flow in specific intracranial vascular segments.
• To showcase its capability in providing excellent anatomical orientation for diagnostic procedures on pathological vascular structures.

Main Methods:

• Neuronavigated image-guided TCD was employed on three patients previously scanned with computed tomographic angiography.
• A Kolibri image guidance system tracked the TCD probe, which was equipped with reflective markers.

Main Results:

• Image-guided TCD successfully identified all major intracranial vessels.
• Examination time was significantly reduced from 14 ± 6 minutes to 8 ± 2 minutes with neuronavigation, and further to 4 ± 1 minutes with navigational pilot software for repetitive scans.
• Navigational pilot software ensured consistent examination angles and locations for repeat assessments.

Conclusions:

• Image guidance is an efficient and easily applicable tool for TCD.
• It enhances anatomical orientation, aids in standardizing protocols, and defines pathological areas for follow-up, reducing inter-observer variability.
• Image-guided TCD can be extended to cases with abnormal or variant vascular anatomy.