[Evaluation of steal phenomena by measuring the steal index using transcranial Doppler ultrasound in intracranial arteriovenous malformation].
OBJECTIVE
The authors previously deduced a formula for calculating the steal index (SI) for evaluation of the steal phenomena during the development of the collateral circulation resulting from unilateral carotid artery occlusion or stenosis. In this study the authors examine the application of SI in evaluating the steal phenomena of cerebral blood flow in cases of intracranial arteriovenous malformation (AVM).


METHODS
The clinical data of 16 cases of AVM confirmed by both digital subtraction angiography (DSA) and transcranial Doppler (TCD) ultrasound were analyzed retrospectively. The ratio of the mean blood velocity in the direct or indirect feeding artery (Vmfv) for the area containing AVM to the mean blood velocity in the neighboring feeding artery (Vmna), Vmfv/Vmna, was compared with SI of the corresponding arteries (SI=1-PI(1)/PI(2), where PI(1) is the pulsatility index of the feeding artery and PI the pulsatility index of the neighboring feeding artery), and the correlation between SI and the size of AVM was analyzed statistically.


RESULTS
The Vmfv/Vmna of (2)direct and indirect feeding arteries for AVM both exhibited positive correlation with SI (r=0.62, P<0.05, n=16; r=0.53, P<0.01, n=27), and SI appeared to be in positive correlation with the size of AVM, but which failed to be supported by statistical analysis (r=0.48, P>0.05, n=12).


CONCLUSIONS
The sizes, types and development of the vascular bed of AVM can be evaluatea by analysis of SI derived from TCD in combination with DSA.
Wu
Gang
G
Department of Neurology, Nanfang Hospital, First Military Medical University, Guangzhou 510515, China.
Zhang
Xiao-zheng
XZ
Lu
Bing-xun
BX
Xu
Guo-ying
GY
Zheng
Yi-yong
YY
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017585:Ultrasonography, Doppler, Transcranial