title: [Application of intraoperative real-time ultrasound in the surgical treatment of cerebral arteriovenous malformation].
abstract: OBJECTIVE
  To investigate the value of intraoperative real-time ultrasound during surgery of cerebral arteriovenous malformations (AVMs).
  
  
  METHODS
  Thirteen patients with cerebral AVMs, 12 supratentorial and 1 infratentorial, underwent microsurgical treatment. Intraoperative ultrasound (IOUS) with multimodality was performed before the starting of resection in order to: (1) localize and delineate the AVM, (2) differentiate the embolized and perfused parts of AVM, and (3) identify the feeding arteries and draining veins. After removal of the lesion, sonographic examination was repeated to detect the residual AVM tissue and the findings were compared with the intra- and/or post-operative angiographic finding.
  
  
  RESULTS
  Total resection was achieved in all 13 patients with AVM under real-time ultrasonographic navigation. The niduses of AVM were localized and defined precisely by IOUS due to their dichromatic flow pattern. The embolized parts of AVM exhibited hyperechogenicity without blood signals. The feeding and draining vessels were distinguished from normal ones morphologically and hemodynamically. Complete removal of the AVM determined sonographically was then confirmed by angiography.
  
  
  CONCLUSIONS
  Intraoperative real-time ultrasound allows accurate localization and navigation of the cerebral AVMs, provides valuable information during surgery, and helps determine the degree of removal of the cerebral AVM.
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital University of Medical Sciences, Beijing 100050, China.
authors.forename: Da-biao
authors.initials: DB
authors.lastname: Zhou
authors.forename: Ji-zong
authors.initials: JZ
authors.lastname: Zhao
authors.forename: Shuo
authors.initials: S
authors.lastname: Wang
authors.forename: Ming
authors.initials: M
authors.lastname: Ni
authors.forename: Rong
authors.initials: R
authors.lastname: Wang
authors.forename: Dong
authors.initials: D
authors.lastname: Zhang
authors.forename: Yuan-li
authors.initials: YL
authors.lastname: Zhao
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging* / Q000601:surgery*; D007432:Intraoperative Period; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D038361:Neuronavigation; D017585:Ultrasonography, Doppler, Transcranial