[The hemodynamics of intracranial aneurysm by transcranial Doppler arteriography].
The use of an ultrasonic transcranial Doppler arteriography (TCDA) technique for noninvasive diagnosis of cerebral aneurysm is described. Twenty one patients with intracranial aneurysm previously diagnosed by conventional angiography were evaluated with Trans-Scan (EME). Mapping image was used as a guide to identify parent artery and aneurysm. In four patients, we could not record aneurysmal blood flow because of their poor or non existent acoustic window. Good images were recorded in 17 patients. The location of aneurysms were A-com (1 case), Distal ACA (2 cases), IC (7 cases), MCA (3 cases), Basilar (1 case) and IC fusiform (3 cases). Two types of Doppler spectra were obtained from the aneurysmal blood flow. One was characterized by a high density zone along the base line and the other was characterized by a homogeneous high density zone. In both types, Doppler sound was characterized by low frequency sound. The low frequency sound reflects the turbulent flow in the aneurysm. The pattern of Doppler spectra obtained from ordinary arteries was characterized by a high density zone along the descending limb of the envelope. Doppler sound is characterized by high frequency sound. A homogeneous spectral pattern was obtained in both aneurysms and ordinary arteries. But it was possible to differentiate them by Doppler sound. Consequently to be able to hear Doppler sound is very important. We were able to detect fourteen of seventeen aneurysms (A-com 1/1, Distal ACA 1/2, IC 7/7, MCA 2/3, Basilar 1/1, and IC fusiform 2/3). The rate of detection was 82 percent. Aneurysm size ranged from 5mm x 4mm to 16mm x 18mm.(ABSTRACT TRUNCATED AT 250 WORDS)
Tsujimoto
S
S
Department of Neurosurgery, Nara Medical University, Japan.
Takeshima
T
T
Sakai
T
T
Yokoyama
K
K
Okumura
Y
Y
Nagata
K
K
Sawai
F
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography; D002560:Cerebrovascular Circulation; D005260:Female; D006439:Hemodynamics; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D014463:Ultrasonography