Benefit of Echocontrast-Enhanced Transcranial Color-Coded Duplex Ultrasound in the Assessment of Intracranial Collateral Pathways

Publisher Website
Google Scholar
Abstract
Background and Purpose —Although clinically important, proper assessment of intracranial arterial collateral pathways by transcranial color-coded duplex sonography (TCCD) in patients with internal carotid artery (ICA) high-grade stenosis or occlusion is occasionally made difficult by an insufficient temporal bone window, an unfavorable insonation angle, or low flow velocity or volume. In these cases, echocontrast could be helpful to increase the diagnostic confidence or to make the diagnosis at all. Methods —We investigated 50 temporal windows of 44 patients with ipsilateral high-grade (≥70%) ICA stenosis or occlusion and insufficient native transtemporal insonation conditions before and after the application of the echo enhancer Levovist with an infusion pump. Results —Compared with the precontrast scans, echocontrast allowed for more segments to be evaluated by pulsed Doppler sonography ( P P P P Conclusions —In patients with poor precontrast visualization of intracranial arteries, echocontrast-enhanced TCCD is very helpful in the assessment of intracranial collateral pathways recruited downstream to ICA stenoses and occlusions.