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Image-guided Transcranial Doppler Sonography for Monitoring of Defined Segments of Intracranial Arteries.
MedLine Citation:
PMID:  23027224     Owner:  NLM     Status:  Publisher    
BACKGROUND:: Transcranial Doppler sonography (TCD) is widely used in neurointensive care. Image guidance (IG) could simplify secure vessel identification and reduce interinvestigator and intrainvestigator variability. The present study was purposed to investigate the precision and reproducibility of image-guided TCD. METHODS:: The Kolibri IG system (Brainlab AG, Feldkirchen, Germany) was used to track a hand-held Doppler probe of a DWL Multi-Dop T digital device (Compumedics Germany GmbH, Singen, Germany). The patient's head was registered noninvasively to the IG system. Distance between predefined vascular target and optimal Doppler signal was evaluated to assess spatial accuracy of image-guided TCD. To investigate reproducibility, spatial accuracy of trajectories acquired during an initial examination using the IG system was analyzed in serial examinations. Furthermore, stability of noninvasive registration of the patient's head to the IG system was analyzed. Data are presented as mean±SD for descriptive statistics. Twelve patients were included. RESULTS:: Using IG, a Doppler signal was recorded immediately in all cases for middle cerebral artery (MCA) (29 examinations), in 81% for carotid-T (27 examinations), and in 90% for basilar tip (29 examinations). The optimal Doppler signal was found within 2.64±1.15 mm (94 preplanned targets). At serial examinations, a spatial deviation of 2.75±1.20 mm was found (56 trajectories acquired in 19 serial examinations). Examination time did not influence accuracy of noninvasive patient registration. CONCLUSIONS:: Data suggest that image-guided TCD allows for accurate examinations with high intraprocedural and high interprocedural reproducibility. It facilitates identification of specific vessel segments and generation of standardized examination protocols for serial examinations.
Christian Greke; Axel Neulen; Sven R Kantelhardt; Achim Birkenmayer; Fritz C Vollmer; Ingmar Thiemann; Alf Giese
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-28
Journal Detail:
Title:  Journal of neurosurgical anesthesiology     Volume:  -     ISSN:  1537-1921     ISO Abbreviation:  J Neurosurg Anesthesiol     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-10-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8910749     Medline TA:  J Neurosurg Anesthesiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
*Department of Neurosurgery, Georg-August-University of Goettingen, Goettingen †Department of Neurosurgery, Johannes-Gutenberg-University of Mainz, Mainz ‡Compumedics Germany GmbH, Singen §Brainlab AG, Feldkirchen, Germany.
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