Transcranial Doppler Ultrasound Imaging

Stephanie Wilson, BS, RDMS, RVT

*Coordinator, Vascular Sonography, South Hills School of Business and Technology, State College, Pennsylvania.

Address correspondence to: Stephanie Wilson, BS, RDMS, RVT, Coordinator, Vascular Sonography, South Hills School of Business and Technology, 480 Waupelani Drive, State College, PA, 16801. E-mail:

Disclosures: The author reports having no significant financial or advisory relationships with corporate organizations related to this activity.


The transcranial Doppler imaging examination is one of the least-used testing methods in ultrasound today and has yet to reach its full potential. This application of sonography is an accurate and efficient method to assist diagnosing patients with atherosclerotic disease as well as for monitoring patients for vasospasm after neurosurgery. As with learning any new technique, the first step is to begin to understand the transcranial vascular anatomy, normal physiology of intracranial blood flow, and how the body can provide numerous collateral pathways to recalculate blood where necessary. The circle of Willis is a naturally occurring collateral pathway and is the starting point in a transcranial Doppler imaging examination because the majority of the blood vessels examined are part of the circle of Willis. The circle of Willis also provides a pathway for the blood to move from the brain's posterior to anterior, or from the right to left hemispheres, if needed. This article will present the basic starting points to learn how to perform a transcranial Doppler imaging examination.

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