Document Detail


Diagnostic benefit of echocontrast enhancement for the insufficient transtemporal bone window.
MedLine Citation:
PMID:  10208108     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Echocontrast agents (ECA) are known to improve transcranial color-coded duplex (TCCD) imaging, but its diagnostic benefit in the routine clinical setting has not clearly been defined. The authors investigated the diagnostic benefit of ECA application in 54 patients with insufficient transtemporal bone window, consecutively referred to their ultrasound laboratory. According to the precontrast imaging quality, patients were assigned to three categories: A, no intracranial structures or vessel segments visible on B-mode imaging and TCCD (n = 5); and intracranial structures visible on B-mode imaging and vessel segments less than 5 mm in length (B, n = 21), or larger than 5 mm in length (C, n = 28) visible on TCCD. The effect of the echocontrast enhancement was assessed with respect to signal enhancement, imaging quality, and diagnostic confidence. In 49 out of 54 patients (91%), a significant improvement of the imaging quality was noted, enabling 43 (80%) neurovascular diagnoses of sufficient diagnostic confidence. The diagnostic ECA effect was strongly dependent on the precontrast imaging quality: upon echoenhancement, a satisfactory image quality was obtained in none of the patients of category A, as opposed to 16 (76%) and 27 (96%) patients of categories B and C, respectively. In summary, in 80% of our consecutive patient series with insufficient transtemporal bone window, application of ECA allowed for a conclusive TCCD study. Properties of the transtemporal precontrast scans are strongly predictive of the diagnostic benefit and should be taken into the decisive consideration.
Authors:
D G Nabavi; D W Droste; G Schulte-Altedorneburg; V Kemény; M Panzica; S Weber; E B Ringelstein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neuroimaging : official journal of the American Society of Neuroimaging     Volume:  9     ISSN:  1051-2284     ISO Abbreviation:  J Neuroimaging     Publication Date:  1999 Apr 
Date Detail:
Created Date:  1999-05-03     Completed Date:  1999-05-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9102705     Medline TA:  J Neuroimaging     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  102-7     Citation Subset:  IM    
Affiliation:
Department of Neurology, University of Münster, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Brain / blood supply*
Brain Ischemia / ultrasonography
Carotid Stenosis / ultrasonography
Cerebrovascular Disorders / ultrasonography*
Cohort Studies
Contrast Media*
Female
Forecasting
Humans
Image Enhancement / methods*
Male
Middle Aged
Polysaccharides / diagnostic use
Prospective Studies
Temporal Bone
Ultrasonography, Doppler, Color / methods*
Ultrasonography, Doppler, Duplex / methods*
Ultrasonography, Doppler, Transcranial / methods*
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Polysaccharides; 127279-08-7/SHU 508

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