Transcranial color duplex sonography in childhood and adolescence. Age dependence of flow velocities and waveform parameters.

Abstract

Transcranial color duplex sonographic examinations in children and adolescents without cerebrovascular disease were evaluated retrospectively. Flow velocities and waveform parameters were determined and their side-to-side differences and age dependence analyzed and, finally, compared with analogous data of a previously described group of healthy adults. With a 2.0-MHz sector transducer of a computed sonographic system, the anterior, middle, and posterior cerebral arteries were examined in 64 children and adolescents between 1.5 and 17.5 years of age. Angle-corrected systolic peak, end-diastolic maximum, time-averaged, and time-averaged maximum velocities, and the resistance, pulsatility, and spectral broadening indexes were determined in all vessels. Mean +/- SD values for time-averaged maximum velocity (and time-averaged velocity) were 92.2 +/- 13.0, 79.9 +/- 17.7, and 63.9 +/- 13.6 (55.3 +/- 11.7, 40.4 +/- 10.4, and 34.2 +/- 9.2) cm/s, respectively, in the middle, anterior, and posterior cerebral arteries in children under 10 years of age; values were 83.2 +/- 11.9, 69.4 +/- 13.8, and 55.6 +/- 10.1 (50.8 +/- 9.0, 39.9 +/- 10.5, and 33.1 +/- 6.3) cm/s, respectively, in children 10 years of age and older. Time-averaged maximum velocity decreased significantly with age in all vessels (P < .001). Although time-averaged velocity did not change significantly during childhood and adolescence, a clear decline occurred from adolescence to adulthood (P < .0001 in the middle and posterior cerebral arteries; P < .01 in the anterior cerebral artery). The spectral broadening index decreased significantly from childhood to adolescence in the anterior and posterior cerebral arteries (P < .0001). The resistance and pulsatility indexes remained stable throughout childhood. Transcranial color duplex sonography allows angle-corrected measurements of "true" flow velocities in basal cerebral arteries. Additional determination of time-averaged velocity permits more detailed evaluation of flow characteristics for all age groups. The transcranial color duplex technique may provide deeper insights on normal cerebral perfusion and its disorders.