AJDRAJNR - American Journal of Neuroradiology

Published ahead of print on November 16, 2007
doi: 10.3174/ajnr.A0789
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Transcranial Color-Coded Duplex Sonography for Detection of Distal Internal Carotid Artery Stenosis

J. Valaikienea, G. Schuiererb, B. Ziemusc, J. Dietrichd, U. Bogdahnc and F. Schlachetzkic

a Department of Neurology, Vilnius University Hospital, Santariskiu Klinikos, Vilnius, Lithuania
b Institute for Neuroradiology, Bezirksklinikum Regensburg, Regensburg, Germany
c Department of Neurology, University of Regensburg, Bezirksklinikum Regensburg, Regensburg, Germany
d Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass


Figure 1
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  		Fig 1. Normal anatomy of the carotid siphon, lateral view DSA (A) and anterior coronal imaging plane TCCS (B) A, C5 (precavernous/ganglionic segment), C4 (inferior carotid siphon), C3 (carotid knee), C2 (upper carotid siphon), and C1 (terminal ICA segment). B, Color coding showing flow toward (red) and away (blue) from the transducer. M1 indicates the first segment of the MCA; A1, the precommunicating segment of the ACA; A2, the postcommunicating segment of the ACA; cA1, the contralateral A1 segment, ICA segments C3/4 and C4/5.


Figure 2
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  		Fig 2. High-grade stenosis extending from the C1 segment into the C2 and C3 segments. A, DSA. Note the torturous and elongated course of the intracranial ICA. B, TCCS with a coronal imaging plane and aliasing phenomenon in the C1 and C2 segments.





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