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Journal of Neurosonology 2016; 8 ( 1) : 1-13

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경두개도플러초음파 표준검사지침 1부. 검사의 시행과 해석
  • 이종윤*,※ 유성욱†,※ 이성익‡ 정근화§ 서우근† 박종무∥ 권순억¶ 이경열** 남효석** 홍지만†† 송희정‡‡ 이태규§§ 한시령∥∥ 김상범¶¶ 황양하*** 김응규††† 한상원††† 권형민‡‡‡ 석승한‡ 이준홍§§§ 정슬기∥∥∥ 김용재¶¶¶ 이용석§
  • 국립중앙의료원 신경과*, 고려대학교 의과대학 신경과학교실†, 원광대학교 의과대학 산본병원 신경과, 인암뇌신경연구센터‡, 서울대학교 의과대학신경과학교실§, 을지대학교 의과대학 신경과학교실∥, 울산대학교 의과대학 신경과학교실¶, 연세대학교 의과대학 신경과학교실**, 아주대학교 의과대학 신경과학교실††, 충남대학교 의과대학 신경과학교실‡‡, 이태규신경과§§, 가톨릭대학교 의과대학 신경과학교실∥∥, 경희대학교 의과대학 신경과학교실¶¶, 경북대학교 의과대학 신경과학교실***, 인제대학교 의과대학 신경과학교실†††, 국민건강보험 일산병원 신경과§§§, 전북대학교 의과대학 신경과학교실∥∥∥, 이화여자대학교 의과대학 신경과학교실¶¶¶

Transcranial Doppler Ultrasound: Practice Standards Part I. Test Performance and Interpretation
  • Jong Yun Lee, MD, PhD*,※, Sungwook Yu, MD, PhD†,※, Sung Ik Lee, MD‡, Keun Hwa Jung, MD, PhD§, Woo-Keun Seo, MD, PhD†, Jong-Moo Park, MD, PhD∥, Sun U. Kwon, MD, PhD¶, Kyung-Yul Lee, MD, PhD**, Hyo Suk Nam, MD, PhD**, Ji Man Hong, MD, PhD††, Hee-Jung Song, MD PhD‡‡, Te Gyu Lee, MD, PhD§§, Si-Ryung Han, MD, PhD∥∥, Sang-Beom Kim, MD, PhD¶¶, Yang-Ha Hwang, MD, PhD***, Eung-Gyu Kim, MD, PhD†††, Sang Won Han, MD†††, Hyung-Min Kwon, MD, PhD‡‡‡, Seung-Han Suk, MD, PhD‡, Jun Hong Lee, MD, PhD§§§, Seul-Ki Jeong, MD, PhD∥∥∥, Yong-Jae Kim, MD, PhD¶¶¶, Yong-Seok Lee, MD, PhD§
  • Departments of Neurology, National Medical Center*, Korea University College of Medicine†, InAm Neuroscience Center, Sanbon Medical Center, Wonkwang University School of Medicine‡, Seoul National University College of Medicine§, Eulji University College of Medicine∥, Ulsan University College of Medicine¶, Yonsei University College of Medicine**, Ajou University College of Medicine††, Chungnam National University College of Medicine‡‡, LTG Neuromedical center§§, Catholic University College of Medicine∥∥, Kyung Hee University College of Medicine¶¶, Kyungpook National University College of Medicine***, Inje University College of Medicine†††, National Health Insurance Service Ilsan Hospital§§§, Chonbuk National University College of Medicine∥∥∥, Ewha Womans University School of Medicine¶¶¶
Transcranial Doppler ultrasound (TCD) has been widely used to assess and monitor cerebrovascular hemodynamics. TCD has strong advantages of easy accessibility in time and space, and non-invasiveness over other imaging techniques. However, in addition to the dependency of examiner’s skills and experience, lack of the standardized scanning protocols is one of obstacles to overcome. Based on the present reports and expert’s consensuses, a routine TCD evaluation should include velocity measurement and waveform recording of the major intracranial vessels of circle of Willis and the extracranial carotid arteries via three transcranial and one submandibular insonation. TCD examination should contain 1) the transtemporal approach for the middle cerebral, anterior cerebral and posterior cerebral arteries, 2) the transorbital approach for the ophthalmic artery and internal carotid artery siphon 3) the transforaminal approach for both vertebral and basilar arteries. A routine TCD technique in combination with headframe with dual probe fixation devices provide real-time flow monitoring. Therefore, TCD monitoring could be used for hemodynamic change in various clinical situations. Real-time flow monitoring using TCD gives hemodynamic information to clinicians regarding to successful recanalization in in the occluded vessel of acute ischemia, plaque stability by detecting microemboli and collateral reservoir by vasomotor reactivity test. Beyond cerebrovascular disease, hemodynamic information is useful in assessing brain death, subclavian steal, syncope, rotational vertebral artery syndrome and perioperative monitoring. As TCD has expanded clinical utilities from cerebrovascular disease to other neurological diseases for the last thirty years, standardization of TCD protocol is essential for clinical practice as well as the future clinical studies. The authors reviewed the present literatures and expert\\\'s consensuses, and made the current scientific statements of TCD for proper application and interpretation.
Journal of Neurosonology 8(1):1-13, 2016
Key Words: Transcranial Doppler, Practice standards, Clinical indication, Interpretation