Use of intravenous contrast material in transcranial sonography

The appearance of the intracranial vasculature was compared on power and color Doppler ultrasound (US) scans obtained with and without a microbubble contrast agent. Nine patients (three men, six women) aged 42–70 years (mean age, 53 years) participated in the study. Seven patients underwent both color Doppler US and power Doppler US before and after intravenous administration of contrast agent, and two underwent only color Doppler US. All patients had previously undergone cerebral angiography. Before contrast material was administered, power Doppler US was more sensitive than color Doppler US in the detection of intracranial vessels ( P < .05); neither technique depicted the entire circle of Willis in eight of nine patients. Postcontrast power Doppler US depicted more vascular segments than postcontrast color Doppler US ( P < .01) or precontrast power Doppler US ( P < .01). Use of intravenous contrast material enabled the entire circle of Willis to be evaluated from a single temporal bone acoustic window with both power Doppler US and color Doppler US in all patients. Contrast-enhanced power Doppler US depicted vessels not shown by enhanced color Doppler US. Contrast-enhanced power Doppler US depicted more vessels, better demonstrated specific vascular segments, and provided better vascular definition of the intracranial vasculature than contrast-enhanced color Doppler US or unenhanced power Doppler US.