Abstract
Background
Transcranial Doppler (TCD) is reliable and reproducible for the diagnosis of right-to-left
cardiac shunts (RLS).
Methods
Various factors limiting the performance and diagnostic methods of RLS by TCD are
discussed.
Results
In patients with insufficient temporal acoustic windows, TCD may still be reliably
used to monitor the microembolic signals at various alternative sites. Diagnostic
yield of TCD may be further improved and better quantitative assessment of the ‘functional
potential’ of the RLS by optimizing the preparation of the ‘air–saline–blood’ contrast-mixture,
injecting the mixture in controlled body positions and using power M-mode TCD.
Conclusions
TCD may be used reliably for the detection as well as the quantification of RLS even
in patients with insufficient temporal acoustic windows.
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Article info
Publication history
Published online: January 27, 2009
Accepted:
January 6,
2009
Received in revised form:
September 4,
2008
Received:
August 30,
2008
Identification
Copyright
© 2009 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
