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Published online before print October 24, 2002, 10.1148/radiol.2253011572
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Transcranial Duplex Sonography in the Detection of Patent Foramen Ovale1

Wendelin K. Blersch, MD, Bogdan M. Draganski, MD, Stefan R. Holmer, MD, Horst J. Koch, MD, Felix Schlachetzki, MD, Ullrich Bogdahn, MD and Thilo Hölscher, MD

1 From the Departments of Neurology (W.K.B., B.M.D., F.S., T.H., U.B.), Cardiology (S.R.H.), and Psychiatry (H.J.K.), University of Regensburg, Universitätsstrasse 84, 93053 Regensburg, Germany. Received September 24, 2001; revision requested November 21; final revision received May 7, 2002; accepted May 16. Address correspondence to W.K.B. (e-mail: wendelin.blersch@klinik.uni-regensburg.de).



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  		Figure 1a. Patient 36. Transverse c-mode duplex c-TCCS scans show the circle of Willis and vessel segments. The Doppler spectra below show no HITS. No PFO is depicted. ACA = anterior cerebral artery, CMCA = contralateral middle cerebral artery, MCA = middle cerebral artery, PCA = posterior cerebral artery. (a) Scan obtained at the first test with contrast agent administered 5 seconds after the Valsalva maneuver. (b) Scan obtained at the second test with contrast agent administered immediately after the Valsalva maneuver.

 


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  		Figure 1b. Patient 36. Transverse c-mode duplex c-TCCS scans show the circle of Willis and vessel segments. The Doppler spectra below show no HITS. No PFO is depicted. ACA = anterior cerebral artery, CMCA = contralateral middle cerebral artery, MCA = middle cerebral artery, PCA = posterior cerebral artery. (a) Scan obtained at the first test with contrast agent administered 5 seconds after the Valsalva maneuver. (b) Scan obtained at the second test with contrast agent administered immediately after the Valsalva maneuver.

 


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  		Figure 2a. Patient 28. Transverse c-mode duplex c-TCCS scans show the circle of Willis and vessel segments. Category 1 PFO is depicted. Number of HITS (arrows) is indicated. ACA = anterior cerebral artery, CMCA = contralateral middle cerebral artery, MCA = middle cerebral artery, PCA = posterior cerebral artery. (a) Scan obtained at the first test shows one HITS and (b) that obtained at the second test reveals four HITS.

 


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  		Figure 2b. Patient 28. Transverse c-mode duplex c-TCCS scans show the circle of Willis and vessel segments. Category 1 PFO is depicted. Number of HITS (arrows) is indicated. ACA = anterior cerebral artery, CMCA = contralateral middle cerebral artery, MCA = middle cerebral artery, PCA = posterior cerebral artery. (a) Scan obtained at the first test shows one HITS and (b) that obtained at the second test reveals four HITS.

 


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  		Figure 3a. Patient 22. Transverse c-mode duplex c-TCCS scans show intracranial vessel segments. Category 2 PFO is depicted. Number of HITS (arrows) is indicated. ACA = anterior cerebral artery, CMCA = contralateral middle cerebral artery, MCA = middle cerebral artery, PCA = posterior cerebral artery. (a) Scan obtained at the first test shows 22 HITS and (b) that obtained at the second test shows 21 HITS.

 


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  		Figure 3b. Patient 22. Transverse c-mode duplex c-TCCS scans show intracranial vessel segments. Category 2 PFO is depicted. Number of HITS (arrows) is indicated. ACA = anterior cerebral artery, CMCA = contralateral middle cerebral artery, MCA = middle cerebral artery, PCA = posterior cerebral artery. (a) Scan obtained at the first test shows 22 HITS and (b) that obtained at the second test shows 21 HITS.

 


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  		Figure 4a. Patient 17. Transverse c-mode duplex c-TCCS scans show intracranial vessel segments. ACA = anterior cerebral artery, MCA = middle cerebral artery. Category 3 PFO is depicted. (a, b) Scans show that single HITS (arrows), consequently, could not be discriminated with both tests.

 


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  		Figure 4b. Patient 17. Transverse c-mode duplex c-TCCS scans show intracranial vessel segments. ACA = anterior cerebral artery, MCA = middle cerebral artery. Category 3 PFO is depicted. (a, b) Scans show that single HITS (arrows), consequently, could not be discriminated with both tests.

 




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