경두개도플러초음파 표준검사지침 2부. 임상적용 및 유용성

초록

Transcranial Doppler (TCD) sonography is a safe and efficacious ultrasound test for various cerebrovascular diseases. We suggest the clinical indications and utility of TCD with the established evidences. We reviewed the published literature on TCD from 1982 through December 2015 in their respective fields, including previous updates and considered reported clinical indications as established if TCD performance has been tested in terms of applicability, yield, accuracy, and prognosis including outcomes. Clinical indications considered by the expert panels as established are: sickle cell disease, cerebral ischemia, detection of right-to-left shunts, subarachnoid hemorrhage, brain death, and periprocedural or surgical monitoring. In clinical practices, the following TCD-procedures could be considered in routine: TCD-examination to detect stenosed or occluded intracranial vessels, collateral flow status and refine carotid-duplex or angiographic findings; vasomotor reactivity test to identify high-risk patients for stroke; micro-emboli detection; right-to-left shunt detection in patients with suspected paradoxical embolism; monitoring and facilitating thrombolysis; monitoring of endovascular stenting, carotid endarterectomy, and cardiac surgery to detect perioperative embolism, thrombosis, hypo- and hyperperfusion. These clinical indications and utility of TCD will assist the physicians who care the patients with various cerebrovascular diseases.