[Application of intraoperative real-time ultrasound in the surgical treatment of cerebral arteriovenous malformation].
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.
Zhou
Da-biao
DB
Department of Neurosurgery, Beijing Tiantan Hospital, Capital University of Medical Sciences, Beijing 100050, China.
Zhao
Ji-zong
JZ
Wang
Shuo
S
Ni
Ming
M
Wang
Rong
R
Zhang
Dong
D
Zhao
Yuan-li
YL
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