Colour-coded Doppler sonographic study of the haemodynamics in the parent artery of intracranial aneurysms.
We investigated the haemodynamics in the parent artery of 17 small (< 9 mm) and 17 large (L 9.5 mm) saccular aneurysms by transcranial colour-coded Doppler sonography (TCCD) and related the findings to digital subtraction angiography (DSA). We measured flow velocity within the parent artery and, by positioning the Doppler gate within the colour flow image close to the ostium of the aneurysm, obtained a superselective Doppler spectral waveform. The parameters measured included the time-averaged maximal velocity (TAMX), peak systolic, and end-diastolic velocity and pulsatility index (PI). The values were compared to the contralateral side and between small and large aneurysms. DSA was analysed for parent artery stenosis. Mean systolic velocities in the parent arteries of large aneurysms were significantly higher than in the contralateral normal artery (1.08 +/- 0.23 vs 0.80 +/- 0.23 m/s; P = 0.0003) and higher than in the parent artery of small aneurysms (0.89 +/- 0.18 m/s; P = 0.01). Increased systolic velocity accounted for a higher PI in the parent artery of large aneurysms (mean 1.48 +/- 0.42) than on the other side (0.87 +/- 0.12; P = 0.0001) and in the parent artery of small aneurysms (0.85 +/- 0.14; P = 0.0001). PI proximal to seven thrombosed large aneurysms was higher (mean 1.85 +/- 0.38) than close to unthrombosed large aneurysms (1.23 +/- 0.22; P = 0.0005). Increased PI and systolic velocities could not be shown within branches of 5 large aneurysms and were reversible in the parent artery of four patients examined again after occlusion of the aneurysm. Systolic velocities and PI did not differ significantly (P = 0.41 and P = 0.25, respectively) in ruptured and unruptured aneurysms. Stenosis of the parent artery was not shown by DSA in any case.
Schuknecht
B
B
Institute of Neuroradiology, University Hospital of Zurich, CH-8091 Zurich, Switzerland,
Khan
N
N
Yonekawa
Y
Y
Valavanis
A
A
D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D001783:Blood Flow Velocity; D002533:Cerebral Angiography; D005260:Female; D006439:Hemodynamics; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011673:Pulsatile Flow; D018615:Ultrasonography, Doppler, Color; D017585:Ultrasonography, Doppler, Transcranial