Basilar artery flow characteristics and color Doppler sonography findings in healthy infants

Year 2022, Volume: 5 Issue: 1, 173 - 177, 17.01.2022

Hasibe Gökçe Çınar , Berna Ucan

https://doi.org/10.32322/jhsm.1008452

Abstract

Aim: Transcranial​ ​Doppler​ ​(TCD)​ is a widely used method for the evaluation of vertebrobasilar system. There is not neither a consensus nor significant number of publications about normal spectral Doppler waveform and resistance index (RI), peak systolic velocity (PSV), and end diastolic velocity (EDV) values of basilar artery (BA). We aim to define normal PSV, EDV, RI values of BA via TCD in healthy infants.
Material and Method: BA was evaluated from anterior fontanelle by creating sagittal and coronal images. Color doppler ultrasonography (CDUS) and spectral Doppler examinations were performed by placing the cursor in the middle portion of BA. PSV, EDV, and RI values were recorded. Patients were divided into 4 subgroups to analyze the change of normal values according to age groups: (1) 0-120 days, (2) 121-180 days, (3) 181-270 days, (4) >271 days.
Results: 115 healthy infants were included into the study. A weak positive correlation was found between PSV, EDV values and age; meanwhile a weak but significant negative correlation was present between age and RI values. We cannot find any correlation between sex and CDUS parameters.
Conclusion: BA PSV, EDV and RI values change by age. No correlation is present between CDUS characteristics and sex. BA pathologies are rare in pediatric population, nevertheless knowing normal CDUS characteristics can help radiologists for an appropriate assessment.

Keywords

Basilar artery, PSV, EDV, RI, Children

References

• Kirsch JD, Mathur M, Johnson MH, Gowthaman G, Scoutt LM. Advances in transcranial Doppler US: imaging ahead. Radiographics 2013; 33: 1-14.
• Verlhac S. Transcranial Doppler in children. Pediatr Radiol 2011; 41: 153–65.
• The American College of Radiology. ACR-AIUM practice guideline for the performance of transcranial Doppler ultrasound for adults and children. Available at: http: //www.acr.org/Secondary MainMenuCategories/quality_safety/guidelines/us/us_transcranial_ Doppler.aspx. (2007). Accessed 8 March 2011.
• Schatlo B, Pluta RM. Clinical applications of transcranial Doppler sonography. Rev Recent Clin Trials 2007; 2: 49–57
• Chavhan GB, Parra DA, Mann A, Navarro OM. Normal Doppler spectral waveforms of major pediatric vessels: specific patterns. Radiographics 2008; 28: 691-706.
• Couture AP. Normal neonatal brain: Color Doppler and pulsed Doppler. In: Couture A, Veyrac C, eds. Transfontanellar Doppler İmaging in Neonates. Heidelberg, Germany: Springer, 2001; 9-90.
• Carroll BA. The extracranial cerebral vessels. In: Rumack CM, Wilson SR, Charboneau JW, Johnson J, eds. Diagnostic ultrasound. 3rd ed. St. Louis, Mo: Elservier Mosby, 2005; 943-92.
• Lagman-Bartolome AM, Pontigon AM, Moharir M, et al. Basilar artery strokes in children: good outcomes with conservative medical treatment. Dev Med Child Neurol 2013; 55: 434-9.
• Lobbous M, Williams S, Rashid S. Child neurology: childhood basilar artery occlusion and stroke. Neurology 2017; 89: 68-70.
• Chikkannaiah M, Lo WD. Childhood basilar artery occlusion: a report of 5 cases and review of the literature. J Child Neurol 2014; 29: 633-45.
• Taylor KJ, Holland S. Doppler US. Part I. Basic principles, instrumentation, and pitfalls. Radiology 1990; 174: 297-307.
• Rubens DJ, Bhatt S, Nedelka S, Cullinan J. Doppler artifacts and pitfalls. Radiol Clin North Am 2006; 44: 805-35.
• Couture AP. Normal neonatal brain: colour Doppler and pulsed Doppler. In: Couture A, Veyrac C, eds. Transfontanellar Doppler imaging in neonates. Heidelberg, Germany: Springer, 2001; 9–90.
• Scheel P, Ruge C, Petruch UR, Scho¨ning M. Color duplex measurement of cerebral blood flow volume in healthy adults. Stroke 2000; 31: 147–50
• Binokay F, Balli T, Aikimbaev K, Seydaoğlu G, Çiçekçi S, Yalçın Ç. Normal transcranial Doppler flow parameters in children: implementation of Doppler imaging with angle correction. Neurosurgery Quarterly 2015; 25: 6-11.
• Kehrer M, Goelz R, Schoning M. The development of haemodynamics in the extracranial cerebral arteries of healthy preterm and term neonates. Ultrasound Med Biol 2004; 30: 283-7.
• Kehrer M, Schoning M. A Longitudinal study of cerebral blood flow over the first 30 months. Pediatr Res 2009; 66: 560-4.
• Yazici B, Erdogmus B, Tugay A. Cerebral blood flow measurements of the extracranial carotid and vertebral arteries with Doppler ultrasonography in healthy adults. Diagn Interv Radiol 2005; 11: 195-8.
• Scheel P, Ruge C, Schoning M. Flow velocity and flow volume measurements in the extracranial carotid and vertebral arteries in healthy adults: reference data and the effects of age. Ultrasound Med Biol 2000; 26: 1261-6.
• Yang J, Hua Y, Li X, et al. The assessment of diagnostic accuracy for basilar artery stenosis by transcranial color-coded sonography. Ultrasound Med Biol 2018; 44: 995-1002.
• Schöning M, Niemann G, Hartig B. Transcranial color duplex sonography of basal cerebral arteries: reference data of flow velocities from childhood to adulthood. Neuropediatrics 1996; 27: 249-55.
• Bode H ,Wais U. Age dependence of flow velocities in basal cerebral arteries. Arch Dis Child 1988; 63: 606-11.
• Perry BG, Cotter JD, Mejuto G, Mündel, T, Lucas SJE. Cerebral hemodynamics during graded Valsalva maneuvers. Front Physiol 2014; 5: 349.