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Abstract

Transcranial color-coded duplex sonography in the evaluation of collateral flow through the circle of Willis.

R W Baumgartner, I Baumgartner, H P Mattle and G Schroth
American Journal of Neuroradiology January 1997, 18 (1) 127-133;
R W Baumgartner
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I Baumgartner
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H P Mattle
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G Schroth
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Abstract

PURPOSE To determine the sensitivity, specificity, and positive and negative predictive values of transcranial color-coded duplex sonographic (TCCD) evaluation of cross flow through the anterior (ACoA) and posterior (PCoA) communicating arteries in patients with occlusive cerebrovascular disease.

METHODS We studied prospectively 132 patients (37 women, 95 men; mean age, 60 years) with stenoses of more than 69% reduction in vessel diameter (n = 93) and occlusions (n = 52) of the internal carotid artery, and three occlusions of the basilar artery. The sonographer was aware of extracranial sonographic findings but was blinded to the results of cerebral angiography.

RESULTS Nine patients (7%) with thick bones preventing transtemporal insonation and three patients (3%) with occlusions of the middle (n = 3) and anterior (n = 1) cerebral arteries were excluded. Sensitivity of TCCD for detection of collateral flow through the ACoA in patients with occlusive carotid artery disease was 98%, specificity was 100%, positive predictive value was 100%, and negative predictive value was 98%. The corresponding values for the PCoA were 84%, 94%, 94%, and 84%, respectively. All three functional PCoAs were identified in patients with occluded basilar arteries.

CONCLUSION TCCD is a valuable method for noninvasive evaluation of cross flow through the ACoA in patients with adequate sonographic windows. However, TCCD evaluation of cross flow through the PCoA is less reliable, because hemodynamic criteria may cause falsely positive and falsely negative results.

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American Journal of Neuroradiology
Vol. 18, Issue 1
1 Jan 1997
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Transcranial color-coded duplex sonography in the evaluation of collateral flow through the circle of Willis.
R W Baumgartner, I Baumgartner, H P Mattle, G Schroth
American Journal of Neuroradiology Jan 1997, 18 (1) 127-133;

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Transcranial color-coded duplex sonography in the evaluation of collateral flow through the circle of Willis.
R W Baumgartner, I Baumgartner, H P Mattle, G Schroth
American Journal of Neuroradiology Jan 1997, 18 (1) 127-133;
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Cited By...

  • Recanalization of Spontaneous Carotid Artery Dissection
  • Assessment of Intracranial Collateral Flow by Using Dynamic Arterial Spin Labeling MRA and Transcranial Color-Coded Duplex Ultrasound
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  • Prognosis of asymptomatic stenosis of the middle cerebral artery
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  • Ischemic Lacunar Stroke in Patients With and Without Potential Mechanism Other Than Small-Artery Disease * Editorial Comment
  • Color Velocity Imaging Quantification in the Detection of Intracranial Collateral Flow
  • Carotid dissection with and without ischemic events: Local symptoms and cerebral artery findings
  • Effect of Collateral Blood Flow and Cerebral Vasomotor Reactivity on the Outcome of Carotid Artery Occlusion
  • Collateral Variations in Circle of Willis in Atherosclerotic Population Assessed by Means of Transcranial Color-Coded Duplex Ultrasonography
  • Collateral Configuration of the Circle of Willis : Transcranial Color-Coded Duplex Ultrasonography and Comparison With Postmortem Anatomy
  • Benefit of Echocontrast-Enhanced Transcranial Color-Coded Duplex Ultrasound in the Assessment of Intracranial Collateral Pathways
  • Angiographically Defined Collateral Circulation and Risk of Stroke in Patients With Severe Carotid Artery Stenosis
  • Circle of Willis Collateral Flow Investigated by Magnetic Resonance Angiography
  • Contrast-Enhanced Transcranial Color-Coded Sonography in Acute Hemispheric Brain Infarction
  • Success Rate of Transcranial Color-Coded Duplex Ultrasonography in Visualizing the Basal Cerebral Arteries in Vascular Patients Over 60 Years of Age
  • Assessment of >=50% and <50% Intracranial Stenoses by Transcranial Color-Coded Duplex Sonography
  • Contrast-Enhanced Transcranial Color-Coded Duplex Sonography in Ischemic Cerebrovascular Disease
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