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Transcranial power mode Doppler duplex sonography of intracranial aneurysms
1Department of Neurology, Ernst Moritz Arndt University of Greifswald, Germany.
Insights
Different color-coding techniques in transcranial color-coded duplex sonography (TCCD) improve the detection of intracranial aneurysms. Adding contrast agents like Levovist enhances aneurysm visualization and size measurement accuracy with power Doppler imaging (PDI).
Area of Science:
- Neurology
- Medical Imaging
- Radiology
Background:
- Intracranial aneurysms pose significant health risks.
- Accurate detection and measurement are crucial for treatment planning.
- Transcranial color-coded duplex sonography (TCCD) is a non-invasive imaging modality.
Purpose of the Study:
- To evaluate different color-coding techniques in TCCD for detecting and measuring intracranial aneurysms.
- To assess the impact of contrast enhancement on TCCD performance.
- To compare TCCD measurements with angiographic findings.
Main Methods:
- Thirty-two patients with 36 cerebral aneurysms underwent TCCD using color Doppler flow imaging (CDFI) and power Doppler imaging (PDI).
- Both methods were tested with and without the contrast agent Levovist.
- Aneurysm diameters were measured and compared with angiography.
Main Results:
- TCCD with CDFI detected 75% of aneurysms, while PDI detected 80%.
- Contrast enhancement with Levovist increased detection rates by two (CFD) and three (PD) aneurysms.
- PDI with contrast enhancement showed higher correlation with angiographic measurements than PDI alone.
Conclusions:
- Alternative color-coding techniques, particularly PDI with contrast agents, improve the detection of intracranial aneurysms.
- Contrast-enhanced TCCD enhances the visualization and accurate measurement of non-thrombosed intracranial aneurysms.
- TCCD with contrast agents offers a valuable improvement for diagnosing cerebral aneurysms.
Abstract:
The application of different color-coding techniques in transcranial color-coded duplex sonography (TCCD) was assessed for detection and measurement of the size of intracranial aneurysms. Thirty-two consecutively examined patients with 36 angiographically verified cerebral aneurysms underwent TCCD with color Doppler flow imaging (CDFI), power Doppler imaging (PDI), and both methods with contrast enhancement. The diameters of the aneurysms were measured in comparable planes by means of angiography and TCCD-PD with and without 400 mg/ml of the monosaccharide microparticle contrast agent Levovist. TCCD with CFD enabled detection of 27 of 36 aneurysms (75%), and PD depicted 29 aneurysms (80%). After administration of Levovist, an additional two aneurysms were detected with CFD and three with PD color coding. Measurements of aneurysm size obtained by means of PD with contrast enhancement corresponded more highly with angiographic findings than did measurements obtained with PD alone. Use of alternative color-coding techniques with the addition of contrast agents increases the number of intracranial nonthrombosed aneurysms detectable with TCCD.