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DOI: 10.1055/s-0031-1299054
Complete Basilar Artery Assessment by Transcranial Color-Coded Duplex Sonography Using the Combined Transforaminal and Transtemporal Approach
Die vollständige Untersuchung der A. basilaris in der farbkodierten transkraniellen Duplex-Sonografie (TCCD) unter Kombination des transforaminalen und transtemporalen ZugangswegsPublication History
30 May 2011
05 December 2011
Publication Date:
19 December 2011 (online)
![](https://www.thieme-connect.de/media/ultraschall/2011S02/lookinside/thumbnails/10.1055-s-0031-1299054-1.jpg)
Abstract
Purpose: Visualization of the basilar artery (BA) by transcranial color-coded duplex sonography (TCCD) can be challenging. The detection of stenosis or occlusion of the BA often has to rely on indirect signs like a highly pulsatile flow in the vertebral arteries. In case of a distal BA occlusion, however, the flow of the VAs can even be normal. The aim of our TCCD study was to visualize a maximum length of the BA combining the customarily used transforaminal appraoch for the proximal part and the less well known transtemporal coronal approach for the distal BA segment.
Materials and Methods: TCCD was performed in 60 subjects with a good temporal bone window. Detectable extracranial or intracranial pathology was previously excluded. The BA was insonated using the transforaminal and transtemporal insonation plane and the visible length was measured. In one subject MRA was performed to substantiate our findings.
Results: The BA was visualized in all subjects via both approaches. The maximal detectable BA length via the transforaminal and transtemporal approach was 26 ± 8 mm and 18 ± 5 mm, respectively. Assuming a previously reported average anatomical total BA length of 33 ± 6 mm, we supposed complete vessel visualization in 44 subjects (73 %).
Conclusion: The combined transforaminal and transtemporal insonation approach may permit total BA insonation, thus facilitating the evaluation of BA pathology.
Zusammenfassung
Ziel: Die Darstellung der BA in der TCCD stellt eine besondere Herausforderung dar. Häufig gelingt es nur über indirekte Zeichen, wie erhöhte Pulsatilität in der A. vertebralis (VA), Hinweise für eine Basilaristhrombose zu finden. Bei einer distalen Okklusion der BA kann jedoch der Fluss in der VA normal sein. Ziel unserer Arbeit war die Darstellung einer möglichst großen Länge der BA unter Kombination der transforaminalen Beschallung für die proximale und der transtemporalen koronaren Insonation für die distale BA.
Material und Methoden: Wir untersuchten 60 Probanden in der TCCD mit einem guten temporalen Knochenfenster. Detektierbare extra- und intrakranielle Gefäßpathologien wurden zuvor ausgeschlossen. Die BA wurde transforaminal und transtemporal dargestellt und die sichtbare Länge bestimmt. In einem Fall wurde eine MRA zum unterstützenden Vergleich hinzugezogen.
Ergebnisse: Die BA konnte in allen 60 Fällen über beide Untersuchungsebenen dargestellt werden. Die maximale im Farbbild darstellbare Länge betrug transforaminal 26 ± 8 mm und transtemporal 18 ± 5 mm. Unter Annahme einer mittleren anatomischen Länge der BA von 33 ± 6 mm konnte die BA bei 44 Probanden komplett dargestellt werden (73 %).
Schlussfolgerung: Die Kombination aus transforaminaler und transtemporaler TCCD-Untersuchung ermöglicht die komplette BA-Insonation, wodurch eine BA-Pathologie besser beurteilt werden kann.
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