Practice Standards for Transcranial Doppler (TCD) Ultrasound. Part II. clinical indications and expected outcomes

Andrei V. Alexandrov, Michael A. Sloan, Charles H. Tegeler, David N. Newell, Alan Lumsden, Zsolt Garami, Christopher R. Levy, Lawrence K.S. Wong, Colleen Douville, Manfred Kaps, Georgios Tsivgoulis

Research output: Contribution to journalReview articlepeer-review

182 Scopus citations


Introduction: Transcranial Doppler (TCD) is a physiological ultrasound test with established safety and efficacy. Although imaging devices may be used to depict intracranial flow superimposed on structural visualization, the end-result provided by imaging duplex or nonimaging TCD is sampling physiological flow variables through the spectral waveform assessment. Summary of Results: Clinical indications considered by this multidisciplinary panel of experts as established are: sickle cell disease, cerebral ischemia, detection of right-to-left shunts (RLS), subarachnoid hemorrhage, brain death, and periprocedural or surgical monitoring. The following TCD-procedures are performed in routine in- and outpatient clinical practice: complete or partial TCD-examination to detect normal, stenosed, or occluded intracranial vessels, collaterals to locate an arterial obstruction and refine carotid-duplex or noninvasive angiographic findings; vasomotor reactivity testing to identify high-risk patients for first-ever or recurrent stroke; emboli detection to detect, localize, and quantify cerebral embolization in real time; RLS-detection in patients with suspected paradoxical embolism or those considered for shunt closure; monitoring of thrombolysis to facilitate recanalization and detect reocclusion; monitoring of endovascular stenting, carotid endarterectomy, and cardiac surgery to detect perioperative embolism, thrombosis, hypo- and hyperperfusion. Conclusion: By defining the scope of practice, these standards will assist referring and reporting physicians and third parties involved in the process of requesting, evaluating, and acting upon TCD results.

Original languageEnglish (US)
Pages (from-to)215-224
Number of pages10
JournalJournal of Neuroimaging
Issue number3
StatePublished - Jul 2012


  • Applications and outcomes
  • Indications
  • TCD

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology


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