Transcranial color-coded Doppler (TCCD) is an ultrasonographic technique used to obtain and evaluate images of the cerebral parenchyma and to assess blood flow velocities of the intracranial vessels. One of the major limitations of TCCD is the failure to insonate through the transtemporal window, which occurs in about 5%–44% of patients. Temporal bone thickness has been strongly associated with transtemporal window failure (TWF). The aims of the study were to evaluate the association between TWF on TCCD and radiologic findings on computed tomography of the skull along with the demographic characteristics of patients with acute stroke or transient ischemic attack (TIA), and to propose a classification for transcranial window quality (TWQ) on B-mode scan of TCCD. A total of 187 consecutive patients with acute stroke or TIA were included. Among them, 21.9% had TWF and 34.8% had TWQ categorized as insufficient on B-mode scan of TCCD. On logistic regression, age (odds ratio [OR] = 1.07, 95% confidence interval [CI]: 1.03–1.12, p < 0.001), female sex (OR = 5.99, 95% CI: 2.09–17.16, p = 0.001), pneumatized temporal bone (OR = 7.90, 95% CI: 1.95–32.03, p = 0.004) and temporal bone thickness (OR = 3.04, 95% CI: 1.73–5.35, p < 0.001) were independent predictors of TWF, even after adjusting for confounders. These findings may help to select patients in whom echogenic contrast or even other imaging methods could be used to assess intracranial vessels.

经颅彩色编码多普勒 (TCCD) 是一种超声技术，用于获取和评估脑实质的图像以及评估颅内血管的血流速度。TCCD 的主要限制之一是无法通过跨颞窗进行声波检测，这种情况发生在大约 5%–44% 的患者中。颞骨厚度与跨颞窗失效 (TWF) 密切相关。该研究的目的是评估 TCCD 上的 TWF 与颅骨计算机断层扫描的放射学结果以及急性中风或短暂性脑缺血发作 (TIA) 患者的人口统计学特征之间的关联，并提出经颅窗质量的分类(TWQ) 在 TCCD 的 B 模式扫描上。总共包括 187 名连续的急性卒中或 TIA 患者。其中，21.9% 的 TWF 和 34.8% 的 TWQ 归类为 TCCD 的 B 模式扫描不足。在逻辑回归中，年龄（优势比 [OR] = 1.07，95% 置信区间 [CI]：1.03–1.12，p < 0.001），女性（OR = 5.99，95% CI：2.09–17.16，p  = 0.001），充气颞骨（OR = 7.90，95% CI：1.95–32.03，p  = 0.004）和颞骨厚度（ OR = 3.04, 95% CI: 1.73–5.35, p < 0.001) 是 TWF 的独立预测因子，即使在调整混杂因素后也是如此。这些发现可能有助于选择回声对比或什至其他成像方法可用于评估颅内血管的患者。