Biomedical papers, 2015 (vol. 159), issue 4

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):595-600 | 10.5507/bp.2014.064

Comparison of brain vessel imaging from transtemporal and transcondylar approaches using contrast-enhanced transcranial color-coded duplex sonography and Virtual Navigator

David Skoloudika,b,c, Martin Kulihaa, Martin Roubeca, Jaroslav Havelkad, Katerina Langovae, Roman Herzigc
a Department of Neurology, University Hospital, Ostrava, Czech Republic
b Department of Nursing, Faculty of Health Science, Palacky University Olomouc and University Hospital Olomouc
c Department of Neurology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc
d Department of Radiology, University Hospital, Ostrava
e Department of Biophysics, Faculty of Medicine and Dentistry and Institute of Molecular and Translational Medicine, Palacky University Olomouc

Aims: The transcondylar approach is a new and used for detection of chronic cerebro-spinal venous insufficiency (CCSVI) and intracranial venous reflux in patients with multiple sclerosis. The aim of this study was to assess the ability of native and contrast enhanced (CE-) transcranial color-coded duplex sonography (TCCS) to detect flow and reflux in deep cerebral veins and intracranial venous sinuses from transcondylar and transtemporal approaches.

Methods: Brain magnetic resonance imaging and TCCS from transtemporal and transcondylar approaches using the new technology - Fusion Imaging - in 8 volunteers and 5 patients with multiple sclerosis.

Results: Using TCCS and CE-TCCS, the arteries of the circle of Willis could be detected from the transtemporal approach in 13/13 subjects in both examinations, while detection of the venous system was possible in 7/13 and 9/13 subjects, respectively. However, the arteries of the circle of Willis and venous system were detected through the transcondylar approach in only 5/13 (P=0.041) and 1/13 (P=0.031) subjects using TCCS, and in 12/13 (P=0.921) and 7/13 (P=0.687) subjects using CE-TCCS, respectively.

Conclusions: The results reveal that the TCCS transcondylar approach has serious limitations for the standard detection of intracranial venous reflux.

Keywords: ultrasound, magnetic resonance imaging, reflux, venous system, fusion imaging, Virtual Navigator

Received: January 4, 2014; Accepted: November 18, 2014; Prepublished online: December 5, 2014; Published: December 3, 2015


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