title: Transcranial color Doppler imaging of brain arteriovenous malformations in adults.
abstract: This study was performed to investigate the utility of transcranial color Doppler sonography in evaluating adult cerebral arteriovenous malformations. Twelve patients with such malformations underwent sonography. Spectral Doppler sonographic assessment included peak systolic velocity, end diastolic velocity, and resistive index within the intracranial and extracranial vessels. Color Doppler sonography was used to visualize the site of shunting. Paired and unpaired Student's t-tests were used to determine significance of spectral findings. The nidus was seen in eight of 10 pial malformations. The nidi in two patients were located in the parietal region and not visualized. When compared with the corresponding contralateral artery, feeding arteries (identified in all 10 of the pial lesions) demonstrated diminished resistive indices (P = 0.09). Similarly, the end diastolic velocity was increased in all feeding arteries (P = 0.03). When compared with published normal values, the peak systolic and end diastolic velocities were significantly elevated and the resistive indices were low (P < 0.0003). Transcranial color Doppler sonography depicted the nidi of pial arteriovenous malformations in 80% of cases. Feeding arteries demonstrated abnormal peak systolic velocity, end diastolic velocity, and resistive index in all cases when compared with published values. Transcranial color Doppler sonography is not a good screening tool due to limited acoustical window, but it may be useful for noninvasive study of the physiology of arteriovenous malformations as they are treated.
authors.affiliation: Department of Radiology, Veterans Affairs Medical Center, West Los Angeles, CA 90073, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: el-Saden
authors.forename: E G
authors.initials: EG
authors.lastname: Grant
authors.forename: J
authors.initials: J
authors.lastname: Sayre
authors.forename: F
authors.initials: F
authors.lastname: Vinuela
authors.forename: G
authors.initials: G
authors.lastname: Duckwiler
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D002533:Cerebral Angiography; D016001:Confidence Intervals; D003971:Diastole / Q000502:physiology; D005260:Female; D005625:Frontal Lobe / Q000098:blood supply / Q000000981:diagnostic imaging; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010296:Parietal Lobe / Q000098:blood supply / Q000000981:diagnostic imaging; D013599:Systole / Q000502:physiology; D013702:Temporal Lobe / Q000098:blood supply / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color; D014655:Vascular Resistance