Transcranial Doppler ultrasound for the assessment of intracranial arterial flow velocity--Part 1. Examination technique and normal values.

We present the examination technique and normal values of flow velocity from intracranial basal cerebral arteries for a recently developed pulsed Doppler system operating at 2 MHz emitting frequency. Peak systolic, peak diastolic, and mean flow velocity values are analyzed from fast-Fourier transformed (FFT) Doppler spectra at selected depths for 50 presumed normal subjects ranging in age from 22 to 79 years. Interindividual variation is high for peak flow but moderate for mean flow velocity values, which hence are more likely to discriminate normal from abnormal. Flow velocity values within the posterior cerebral artery (PCA) and the basilar artery (BA) are significantly lower than in the anterior cerebral artery (ACA) and the middle cerebral artery (MCA), which is also unique in showing significantly decreasing values with increasing age: calculated mean flow velocities are 47.3 +/- 13.6 and 45.3 +/- 13.5 cm/sec in the ACA, and 58.4 +/- 8.4 and 44.7 +/- 11.1 cm/sec in the MCA in patients less than 40 years and greater than 60 years, respectively, but 34.2 +/- 7.8 and 29.9 +/- 9.3 (PCA) (patients less than 40 years and patients greater than 60 years), and 34.9 +/- 7.8 and 30.5 +/- 12.4 (BA) (patients less than 40 years and patients greater than 60 years). A new scanning system is introduced, which we suggest will reduce interindividual variations and improve the accurate separation of nearby vessels, which are major causes for the comparatively large standard deviations at present.