Baumgartner R W
Department of Neurology, University Hospital, CH-8091 Zurich, Switzerland.
J Neurol. 1999 Aug;246(8):637-47. doi: 10.1007/s004150050424.
Transcranial color-coded duplex sonography (TCCS) enables the reliable assessment of intracranial stenoses, occlusions, and cross-flow through the circle of Willis without using potentially hazardous compression tests. Transpulmonary ultrasound contrast agents (UCAs) increase the number of conclusive TCCS investigations, which suggests that UCAs may provide the conclusive evaluation of intracranial arteries in most patients with ischemic cerebrovascular disease. Further, contrast-enhanced TCCS may become an important tool both for the management of acute ischemic stroke by assessing intracranial hemodynamics and the displacement and diameter changes in supratentorial ventricles. TCCS is useful for the detection and monitoring of intracranial vasospasm, may visualize larger supratentorial hematomas with subcortical location and hemorrhagic transformation of ischemic infarcts, and provides the incidental detection of cerebral aneurysms and arteriovenous malformations. Second-generation UCAs and new ultrasound machines are very likely to further increase the frequency of conclusive TCCS studies. Power-based three-dimensional, contrast-enhanced TCCS is an important further development, which would make the method much less operator dependent. Site-targeted UCAs appear to provide a new and exciting method for ultrasonic diagnosis and management of patients with ischemic cerebrovascular disease.
经颅彩色编码双功能超声检查（TCCS）能够可靠地评估颅内狭窄、闭塞以及通过 Willis 环的交叉血流，而无需进行可能有风险的压迫试验。经肺超声造影剂（UCA）增加了确定性 TCCS 检查的数量，这表明 UCA 可能为大多数缺血性脑血管疾病患者的颅内动脉提供确定性评估。此外，对比增强 TCCS 可能成为通过评估颅内血流动力学以及幕上脑室的移位和直径变化来管理急性缺血性卒中的重要工具。TCCS 对于检测和监测颅内血管痉挛很有用，可显示幕上较大的皮质下血肿以及缺血性梗死的出血性转化，并能偶然发现脑动脉瘤和动静脉畸形。第二代 UCA 和新型超声设备很可能会进一步增加确定性 TCCS 研究的频率。基于功率的三维对比增强 TCCS 是一项重要的进一步发展，这将使该方法对操作者的依赖性大大降低。靶向部位的 UCA 似乎为缺血性脑血管疾病患者的超声诊断和管理提供了一种新的、令人兴奋的方法。
