Baumgartner R W, Baumgartner I B
Neurologische Klinik, Universität Bern, Inselspital, Schweiz.
Ultraschall Med. 1996 Apr;17(2):50-4. doi: 10.1055/s-2007-1003146.
Transcranial Doppler and color-coded duplex sonography provide reliable information on cross-flow through the circle of Willis, stenoses, occlusions and vasospasm of the major basal cerebral arteries. The CO2 and acetazolamide tests allow quantitative evaluation of the hemodynamic impact of obstructive cerebrovascular disease. Furthermore, transcranial Doppler sonography is used for detection of enhanced intracranial pressure, confirmation of brain death, detection of cerebral microemboli ("high intensity transient signals" = "HITS"), and patent foramen ovale. In the future, cerebral microemboli may become a marker for embolic activity of both occlusive carotid artery and cardiac disease. Transcranial color-coded duplex sonography identifies intracranial hemorrhage, cerebrovascular malformations, and hydrocephalus, but is inferior to neuroradiological techniques. Transpulmonary contrast agents make the examination of patients with inadequate insonation windows feasible, and increase diagnostic confidence in transcranial ultrasonography. Transcranial power-based color-coded duplex sonography ("power Doppler") may further improve transcranial ultrasonography, and visualize flow in smaller vessels.
经颅多普勒和彩色编码双功能超声检查可为 Willis 环的交叉血流、主要脑基底动脉的狭窄、闭塞和血管痉挛提供可靠信息。二氧化碳和乙酰唑胺试验可对阻塞性脑血管疾病的血流动力学影响进行定量评估。此外，经颅多普勒超声检查还用于检测颅内压升高、确认脑死亡、检测脑微栓子（“高强度瞬态信号”=“HITS”）以及卵圆孔未闭。未来，脑微栓子可能成为闭塞性颈动脉疾病和心脏病栓子活动的标志物。经颅彩色编码双功能超声检查可识别颅内出血、脑血管畸形和脑积水，但在这方面不如神经放射学技术。经肺造影剂使声窗不佳的患者的检查成为可能，并提高了经颅超声检查的诊断可信度。基于功率的经颅彩色编码双功能超声检查（“功率多普勒”）可能会进一步改善经颅超声检查，并使较小血管内的血流可视化。
