Possibility and Limits of Transcranial Color Flow Imaging in Screening the Cerebral Aneurysms

概要

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It is generally believed that TCD is not helpful in detecting intracranial aneurysms smaller than 15mm in diameter, to despite great improvement in technology of transcranial Doppler (TCD) in transcranial Doppler angiography (TCDA), three dimentional transcranial Doppler (3D-TCD) and transcranial color flow image (TCFI) . So far there haven't been any reports to challenge this theory. In this study, we examined a 50-yearold female with diffuse subarachnoid hemorrhage. We were able to detect four aneurysms in this patient. The size of aneurysms ranged from 2mm to 9mm in diameter using TCFI under the following criteria before cerebral angiography. We conducted the experiment as follow: 1) Set up sample volume from 1.5 × 1.0mm to 3.0 × 1.0mm. 2) Carefully scanned the captured artery. 3) Detected an appendage structure with pathological blood flow near the normal cerebral artery using axial and coronal view in B-mode scan. 4) Detected a pathlogical color-flow image with Doppler sonogram, which indicates a turbulent flow. 5) Found normal flow pattern at the proximal and distal portions of the turbulent flow region. This is the first report showing the turbulent flow of small cerebral aneurysms using B-mode scan and Doppler son ogram. We believe that our report indicates the reliability of TCFI for screening unruptured cerebral aneurysms.