Kollár József, Schulte-Altedorneburg Gernot, Sikula Judit, Fülesdi Béla, Ringelstein E Bernd, Mehta Vineet, Csiba László, Droste Dirk W
Department of Radiology, Medical and Health Science Centre, Faculty of Medicine, University of Debrecen, Hungary.
Cerebrovasc Dis. 2004;17(1):61-5. doi: 10.1159/000073899. Epub 2003 Oct 3.
The major limitation of native transcranial colour-coded duplex sonography (TCCS) in older stroke patients is the relatively frequent occurrence of an insufficient temporal window. Our goal was to investigate the relationship between the in vivo Doppler ultrasound image quality of the temporal bone, and computed tomography (CT)-determined thickness, density, and homogeneity of cadaver temporal bone.
Thirty-three moribund neurological patients who eventually died were examined by TCCS using the transtemporal approach. The sonographer categorized the quality of the TCCS image (excellent, intermediate, and poor). During autopsy, a rectangular sample of the temporal squama was removed, which corresponded to the area of the in vivo acoustic window. The thickness of the whole temporal bone, cortical, and cancellous (= diploe) bone as well as the density and homogeneity were determined by high-resolution CT.
Thirty-seven temporal bones were obtained. The quality of the acoustic window was classified as excellent in 13, intermediate in 6 and poor in 18 cases. A significant correlation between the complete bone thickness, as well as between the absolute thickness of the diploe and the quality of the acoustic window was found: the thinner the bone/diploe, the better the colour Doppler signal. The thickness of the cortical plates and the homogeneity of the bones were identical in the three image quality categories.
The transtemporal TCCS image quality depends mainly on the thickness of the cancellous component of the temporal bone.
老年卒中患者经颅彩色编码双功超声检查（TCCS）的主要局限性在于颞窗显示不佳的情况相对频繁。我们的目标是研究颞骨的活体多普勒超声图像质量与计算机断层扫描（CT）测定的尸体颞骨厚度、密度及均匀性之间的关系。
对33例最终死亡的濒死神经系统患者采用经颞部途径进行TCCS检查。超声检查人员对TCCS图像质量进行分类（优、中、差）。尸检时，取对应活体声窗区域的颞鳞矩形样本。通过高分辨率CT测定整个颞骨、皮质骨和松质骨（=板障）的厚度以及密度和均匀性。
共获得37块颞骨。声窗质量分类为优的有13例，中6例，差18例。发现完整骨厚度以及板障绝对厚度与声窗质量之间存在显著相关性：骨/板障越薄，彩色多普勒信号越好。三个图像质量类别中皮质板厚度和骨的均匀性相同。
经颞部TCCS图像质量主要取决于颞骨松质成分的厚度。
