TCD/Circle of Willis

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UT 504C - Vascular Sonography 3

Last updated 5:35 AM on 3/8/26
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29 Terms

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<p>1</p>

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Middle cerebral artery (MCA)

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<p>2</p>

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Anterior communicating artery (ACoA)

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<p>3</p>

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Anterior cerebral artery (ACA)

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<p>4</p>

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Ophthalmic artery (OA)

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<p>5</p>

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Anterior choroidal artery

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<p>6</p>

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Posterior cerebral artery (PCA)

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<p>7</p>

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Superior cerebellar artery

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<p>8</p>

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Basilar artery

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<p>9</p>

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Anterior inferior cerebellar artery

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<p>10</p>

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Vertebral artery

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<p>11</p>

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Posterior inferior cerebellar artery

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<p>12</p>

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Anterior spinal artery

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<p>13</p>

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Pontine arteries

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<p>14</p>

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Posterior communicating arteries (PCoA)

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<p>15</p>

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ICA

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Vessel

Direction

Middle cerebral artery (MCA)

?

Toward the probe

<p><span style="background-color: transparent;"><span>Toward the probe</span></span></p>
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Vessel

Direction

Bifurcation level

?

Bidirectional

<p><span style="background-color: transparent;"><span>Bidirectional</span></span></p>
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Vessel

Direction

Anterior cerebral artery (ACA)

?

Away from the probe

<p><span style="background-color: transparent;"><span>Away from the probe</span></span></p>
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Vessel

Direction

Terminal ICA

?

Toward the probe

<p><span style="background-color: transparent;"><span>Toward the probe</span></span></p>
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Vessel

Direction

Posterior cerebral artery (PCA)

?

  • P1 segment toward the probe

  • P2 segment away from the probe

<ul><li><p><span style="background-color: transparent;"><span>P1 segment toward the probe</span></span></p></li><li><p><span style="background-color: transparent;"><span>P2 segment away from the probe</span></span></p></li></ul><p></p>
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Vessel

Direction

Ophthalmic artery 

?

Toward the probe

<p><span style="background-color: transparent;"><span>Toward the probe</span></span></p>
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Vessel

Direction

Carotid siphon

?

Away or toward the probe

<p><span style="background-color: transparent;"><span>Away or toward the probe</span></span></p>
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Vessel

Direction

Vertebral artery 

?

Away from the probe

<p><span style="background-color: transparent;"><span>Away from the probe</span></span></p>
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Vessel

Direction

Basilar artery

?

Away from the probe

<p><span style="background-color: transparent;"><span>Away from the probe</span></span></p>
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Anterior circulation

  • Cavernous ICA (AKA carotid siphon or cavernous siphon)

  • ICA branches

  • Ophthalmic artery (OA)

  • Anterior cerebral artery (ACA)

  • Anterior communicating artery (ACoA)

  • Middle cerebral artery (MCA)

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Posterior circulation

  • Posterior cerebral artery (PCA)

  • Posterior communicating artery (PCoA)

  • Rt and lt vertebral arteries

  • Posterior inferior cerebellar arteries

  • Basilar artery

  • Anterior inferior cerebellar arteries

  • Superior cerebellar arteries

  • Posterior cerebral arteries

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TCD spectral doppler characteristics

  • Large sample volume creates spectral broadening in all waveforms

  • All vessels have low resistance w/ relatively high diastolic flow

    • Except for OA - it has high resistance

<ul><li><p><span style="background-color: transparent;"><span>Large sample volume creates spectral broadening in all waveforms</span></span></p></li><li><p><span style="background-color: transparent;"><span>All vessels have low resistance w/ relatively high diastolic flow</span></span></p><ul><li><p><span style="background-color: transparent;"><span>Except for OA - it has high resistance</span></span></p></li></ul></li></ul><p></p>
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Approaches

  • Transtemporal (a) - MCA, ACA, TICA, PCA

    • Posterior

    • Middle

    • Anterior

    • Frontal

  • Transorbital (b) - OA and siphon

  • Transoccipital (c)

  • Submandibular (d) - distal extracranial ICA

  • Foramen magnum 

  • Atlas loop approach - extracranial vertebral artery

<ul><li><p><span style="background-color: transparent;"><span>Transtemporal (a) - MCA, ACA, TICA, PCA</span></span></p><ul><li><p><span style="background-color: transparent;"><span>Posterior</span></span></p></li><li><p><span style="background-color: transparent;"><span>Middle</span></span></p></li><li><p><span style="background-color: transparent;"><span>Anterior</span></span></p></li><li><p><span style="background-color: transparent;"><span>Frontal</span></span></p></li></ul></li><li><p><span style="background-color: transparent;"><span>Transorbital (b) - OA and siphon</span></span></p></li><li><p><span style="background-color: transparent;"><span>Transoccipital (c)</span></span></p></li><li><p><span style="background-color: transparent;"><span>Submandibular (d) - distal extracranial ICA</span></span></p></li><li><p><span style="background-color: transparent;"><span>Foramen magnum&nbsp;</span></span></p></li><li><p><span style="background-color: transparent;"><span>Atlas loop approach - extracranial vertebral artery</span></span></p></li></ul><p></p>
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Criteria for identifying vessels

  • Approach (cranial window)

  • Sample volume depth

  • Direction of flow relative to TDR

  • Spatial relationship between arteries

  • Flow velocities

    • MCA > ACA > PCA = BA = VA