![]() ![]() In adults, the four most frequently used acoustic windows are temporal, suboccipital, orbital, and submandibular. It is only feasible to insonate the cerebral arteries via the acoustic window while using a low-frequency probe ( Basri et al., 2021). TCD’s ease of use as a diagnostic approach could lead to an increase in its utility in clinical and research settings for a variety of cerebrovascular conditions ( Bhogal, 2021). When dealing with cerebrovascular complications, TCD is considered to be the most practical technique to keep track of vascular alterations in response to treatment. Such parameters provide physiologic information that can be used in combination with structural information taken from a variety of existing imaging techniques ( Purkayastha and Sorond, 2012). In the basal cerebral arteries, the TCD imaging tool uses low-frequency ultrasonic waves (i.e., ≤2 MHz) to evaluate blood flow parameters and cerebrovascular hemodynamics in real-time. Introduction Transcranial Doppler Ultrasonography This review summarizes the basic principles underlying the TCD imaging technique and its utility as a diagnostic tool for cerebrovascular disease. Timely diagnosis and treatment can restore the brain-impaired functions, resulting in a much-improved prognosis for the patients. The brain’s functions can be temporarily or permanently impaired as a result of this change in blood flow. Cerebrovascular disease indicates a group of disorders that alter the flow of blood in the brain. However, owing to its large operator dependency, it has a narrow application area. ![]() TCD is a commonly available and inexpensive diagnostic tool. TCD is a less expensive, non-invasive, and practically simpler approach to diagnosing cerebrovascular disorders than the others. Imaging techniques including transcranial Doppler (TCD), magnetic resonance imaging (MRI), computed tomography (CT), and cerebral angiography are available for cerebrovascular disease diagnosis. Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. ![]() All rights reserved.Yuanmei Pan, Wenbin Wan, Minjie Xiang and Yangtai Guan * Carotid duplex testing can be used for atherosclerotic disease screening, surveillance for disease progression or restenosis after intervention, and diagnosis of occlusive and nonatherosclerotic conditions involving the aortic arch branches, carotid, vertebral, or subclavian arteries.Ĭopyright © 2013 Elsevier Inc. Appropriate test interpretation allows an initial clinical decision regarding medical treatment, intervention, or the need for additional cerebrovascular imaging. Carotid duplex ultrasound is the recommended diagnostic test for symptomatic and asymptomatic patients with known or suspected extracranial carotid artery occlusive disease. The interpretation criteria are based on carotid artery bifurcation imaging and pulsed Doppler velocity spectra analysis with measurements of peak systolic and end-diastolic velocity from the diseased ICA and peak systolic velocity ratio calculated from the nondiseased common carotid artery and the site of maximum ICA stenosis. In an effort to bring standardization to carotid duplex testing, the Intersocietal Accreditation Commission of vascular laboratories has recommended use of the Society of Radiologists in Ultrasound Consensus Conference criteria for ICA stenosis severity. The interpretation of carotid duplex testing is not standardized most vascular laboratories use either referenced or internally validated criteria for stenosis classification. When compared with angiography, the sensitivity and specificity of predicting internal carotid artery (ICA) stenosis are both high (>90%), but vary with disease prevalence, stenosis severity categories, and the velocity spectra criteria used. Carotid duplex ultrasound is an accurate noninvasive technique to estimate the risk of atheroembolic stroke using extracranial carotid artery bifurcation-based imaging and velocimetry criteria. ![]()
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