Comparison of transcranial color Doppler sonography without and with contrast enhancement for detection and characterization of intracranial aneurysms.

OBJECTIVE

To compare the diagnostic value of transcranial color Doppler sonography (TCCS) with contrast-enhanced transcranial color Doppler sonography (CE-TCCS) for the detection and characterization of intracranial aneurysms.

METHODS

Thirty patients highly suspected of having an intracranial aneurysm were imaged using TCCS and CE-TCCS. The ability to detect the aneurysms and determine their size and location accurately was compared with findings from digital subtraction angiography.

RESULTS

The overall sensitivity of CE-TCCS was greater than that of TCCS (24/30 versus 20/30, respectively) (p = 0.125), but the difference was not significant. Neither TCCS nor CE-TCCS could detect the three small (≤5 mm diameter) aneurysms. The detection rate for larger aneurysms (5-15 mm diameter, n = 17) was nonsignificantly greater with CE-TCCS (14/17) than with TCCS (11/17) (p = 0.438). Similarly, CE-TCCS detected more large or giant aneurysms (>16 mm diameter) than TCCS (10/10 versus 9/10, respectively) but the difference was not significant (p = 1.000). The benefit of contrast enhancement was identical for aneurysms ≥10 mm or <10 mm in diameter. All (7/7) middle cerebral artery aneurysms were detected by both TCCS and CE-TCCS. CE-TCCS yielded similar or slightly better results than TCCS for all other aneurysm locations.

CONCLUSION

CE-TCCS can improve the sensitivity and detection rate of intracranial aneurysms ≥5 mm in size.