BACKGROUND AND PURPOSE: Gradation of high-grade intracranial internal carotid artery
(ICA) stenosis poses a challenge to noninvasive neurovascular imaging, which seems
critical for angioplasty in the ICA segments C1 and C5. We investigated cutoff values of
intracranial ICA stenosis for transcranial color-coded sonography (TCCS) and compared this
method with the “gold standard,” digital subtraction angiography (DSA). Materials and
METHODS: Forty patients (mean age, 58.9±13.8 years) with intracranial ICA lesions were …

Transcranial color-coded duplex sonography (TCCS) enables the reliable assessment of
intracranial stenoses, occlusions, and cross-flow through the circle of Willis without using
potentially hazardous compression tests. Transpulmonary ultrasound contrast agents
(UCAs) increase the number of conclusive TCCS investigations, which suggests that UCAs
may provide the conclusive evaluation of intracranial arteries in most patients with ischemic
cerebrovascular disease. Further, contrast-enhanced TCCS may become an important tool …