Transcranial Doppler Ultrasound, a Review for the Pediatric Intensivist

Lovett, Marlina; O’Brien, Nicole

doi:10.3390/children9050727

Cited by 8 publications

(3 citation statements)

References 50 publications

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“…During the TCD examination, the subjects were insonated via the same TTW location used in the TCCD examination using a 1.6 MHz hand-held probe. The uni-channel mode on the Delica EMS-9PB TCD machine was used, with the following typical parameters (probe frequency = 1.6 MHz, power output = 23.3, and gain- (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)). The sample volume depths were set at the two ROIs similar to those interrogated at TCCD, whereas a sample volume gate of 4 mm was similarly maintained across the techniques.…”

Section: Data Collection Methods and Equipmentmentioning

confidence: 99%

“…Despite the inherent technical urge of TCCD over TCD, its application in ICA assessment has been limited, mainly due to its unavailability. Recent evidence points towards a surge in the acquisition and adoption of TCCD into clinical practice [14]. The study centre to which the non-imaging TCD system has been the sole TCD equipment available has also not been spared in this acquisition trend.…”

Section: Introductionmentioning

confidence: 99%

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A Comparative Study of Transcranial Color-Coded Doppler (TCCD) and Transcranial Doppler (TCD) Ultrasonography Techniques in Assessing the Intracranial Cerebral Arteries Haemodynamics

Gunda,

Ng,

Liu

et al. 2024

Diagnostics

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Cerebrovascular disease (CVD) poses a major public health and socio-economic burden worldwide due to its high morbidity and mortality rates. Accurate assessment of cerebral arteries’ haemodynamic plays a crucial role in the diagnosis and treatment management of CVD. The study compared a non-imaging transcranial Doppler ultrasound (TCD) and transcranial color-coded Doppler ultrasound (with (cTCCD) and without (ncTCCD)) angle correction in quantifying middle cerebral arteries (MCAs) haemodynamic parameters. A cross-sectional study involving 50 healthy adults aged ≥ 18 years was conducted. The bilateral MCAs were insonated via three trans-temporal windows (TTWs—anterior, middle, and posterior) using TCD, cTCCD, and ncTCCD techniques. The MCA peak systolic velocity (PSV) and mean flow velocity (MFV) were recorded at proximal and distal imaging depths that could be visualised on TCCD with a detectable spectral waveform. A total of 152 measurements were recorded in 41 (82%) subjects with at least one-sided open TTW across the three techniques. The mean PSVs measured using TCD, ncTCCD, and cTCCD were 83 ± 18 cm/s, 81 ± 19 cm/s, and 93 ± 21 cm/s, respectively. There was no significant difference in PSV between TCD and ncTCCD (bias = 2 cm/s, p = 1.000), whereas cTCCD yielded a significantly higher PSV than TCD and ncTCCD (bias = −10 cm/s, p < 0.001; bias = −12 cm/s, p ≤ 0.001, respectively). The bias in MFV between TCD and ncTCCD techniques was (bias = −0.5 cm/s; p = 1.000), whereas cTCCD demonstrated a higher MFV compared to TCD and ncTCCD (bias = −8 cm/s, p < 0.001; bias = −8 cm/s, p ≤ 0.001, respectively). TCCD is a practically applicable imaging technique in assessing MCA blood flow velocities. cTCCD is more accurate and tends to give higher MCA blood flow velocities than non-imaging TCD and ncTCCD techniques. ncTCCD is comparable to non-imaging TCD and should be considered in clinical cases where using both TCD and TCCD measurements is needed.

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Section: Data Collection Methods and Equipmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Comparative Study of Transcranial Color-Coded Doppler (TCCD) and Transcranial Doppler (TCD) Ultrasonography Techniques in Assessing the Intracranial Cerebral Arteries Haemodynamics

Gunda,

Ng,

Liu

et al. 2024

Diagnostics

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“…Additionally, at a technical level, Doppler angle correction that helps improve the measurement accuracy of blood flow velocities is not possible with TCD. Over recent years, transcranial color-coded Doppler (TCCD) has emerged, and is increasingly becoming available on ultrasound systems and adopted into clinical practice [ 15 ]. Contrary to non-imaging TCD, TCCD enables direct visualization of intracranial cerebral arteries through the intact skull by color-coding blood flow velocities [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

The Diagnostic Accuracy of Transcranial Color-Coded Doppler Ultrasound Technique in Stratifying Intracranial Cerebral Artery Stenoses in Cerebrovascular Disease Patients: A Systematic Review and Meta-Analysis

Gunda,

Yip,

et al. 2024

JCM

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The early and accurate stratification of intracranial cerebral artery stenosis (ICAS) is critical to inform treatment management and enhance the prognostic outcomes in patients with cerebrovascular disease (CVD). Digital subtraction angiography (DSA) is an invasive and expensive procedure but is the gold standard for the diagnosis of ICAS. Over recent years, transcranial color-coded Doppler ultrasound (TCCD) has been suggested to be a useful imaging method for accurately diagnosing ICAS. However, the diagnostic accuracy of TCCD in stratifying ICASs among patients with CVD remains unclear. Therefore, this systematic review and meta-analysis aimed at evaluating the diagnostic accuracy of TCCD in the stratification of intracranial steno-occlusions among CVD patients. A total of six databases—Embase, CINAHL, Medline, PubMed, Google Scholar, and Web of Science (core collection)—were searched for studies that assessed the diagnostic accuracy of TCCD in stratifying ICASs. The meta-analysis was performed using Meta-DiSc 1.4. The Quality Assessment of Diagnostic Accuracy Studies tool version 2 (QUADAS-2) assessed the risk of bias. Eighteen studies met all of the eligibility criteria. TCCD exhibited a high pooled diagnostic accuracy in stratifying intracranial steno-occlusions in patients presenting with CVD when compared to DSA as a reference standard (sensitivity = 90%; specificity = 87%; AUC = 97%). Additionally, the ultrasound parameters peak systolic velocity (PSV) and mean flow velocity (MFV) yielded a comparable diagnostic accuracy of “AUC = 0.96”. In conclusion, TCCD could be a noble, safe, and accurate alternative imaging technique to DSA that can provide useful diagnostic information in stratifying intracranial steno-occlusions in patients presenting with CVD. TCCD should be considered in clinical cases where access to DSA is limited.

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