A new method for imaging intracranial cerebral arteries--3-dimensional transcranial duplex ultrasonography with image enhancement

Abstract

A new data acquisition system for transcranial 3 D-ultrasonography was used. The present study examines the evaluation of intracranial cerebral arteries by 3 D-ultrasound and echo contrast agents in comparison to cerebral angiography. Ten patients, who underwent diagnostic cerebral angiography, were examined without knowledge of the angiographic results. Data acquisition through the transtemporal acoustic bone window was performed with a magnetic sensor system to track the spatial orientation of the ultrasound probe while scanning the volume of interest. We used a transcranial duplex system with power mode and stored a 3 D-data set before injection of transpulmonary stable contrast medium and afterwards. Ipsilateral to the transducer anterior cerebral artery (ACA) in 90%, middle cerebral artery (MCA) in 90%, three or more branches of MCA in 60% and posterior cerebral artery (PCA) in 40% were analysed without injecting an echo contrast agent. After the contrast injection ACA, MCA, branches of MCA and PCA in 100% were visible. In 70% of cases the posterior and anterior communicating arteries were visualised only by means of a contrast agent. Application of a transpulmonary stable ultrasound contrast agent in combination with 3 D transcranial duplex ultrasonography significantly enhances the visualisation of intracranial arteries.