Carotid and transcranial color-coded duplex ultrasonography for the diagnosis of dural arteriovenous fistulas.
OBJECTIVE
Dural arteriovenous fistulas (DAVF) can affect a variety of cerebral venous structures and can present at various clinical stages. This study was designed to introduce the characteristic manifestation of DAVF detected with both carotid and transcranial color-coded duplex ultrasonography (CDUS) and to evaluate the diagnostic value of CDUS in DAVF.


METHODS
Nineteen patients with DAVF confirmed by cerebral angiography were studied with CDUS. The sonogram and spectrum of the affected area were observed. Hemodynamic parameters such as peak systolic velocity, end-diastolic velocity, mean velocity and resistance index (RI) were measured and recorded in the feeding artery, draining vein and extracranial artery. All results were compared with cerebral angiography. Fifty healthy volunteers were enrolled as a control group. Related hemodynamic changes were compared between the patients and normal controls.


RESULTS
The blood flow of fistulas presented as an irregular mosaic color bolus with a clear boundary detected with CDUS. Blood flow imaging of fistulas was abnormal in 12 cases and absent in 7 cases. The detection rate was 63% (12/19). Fifty-three main feeding arteries (73.6%) were detected by ultrasonography. All the venous drainages through the transverse sinus and superior ophthalmic vein were detected, while the ones through the superior sagittal sinus and cortical vein were not. There was a significant difference in average diameter, flow velocity and RI of the occipital artery and superficial temporal artery between the patients and normal controls (p < 0.05).


CONCLUSIONS
CDUS could indicate DAVF by analyzing both imaging results of the diseased region and hemodynamic changes of the relative vasculature. It is a promising technique for the diagnosis and follow-up study of DAVF.
Duan
Yun You
YY
Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China. Duanyy@fmmu.edu.cn
Zhou
Xiao Yan
XY
Liu
Xi
X
Gao
Guo Dong
GD
Zhao
Zhen Wei
ZW
Hou
Wei Hua
WH
Cao
Tie Sheng
TS
D000293:Adolescent; D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity / Q000502:physiology; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000503:physiopathology; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D002550:Cerebral Veins / Q000000981:diagnostic imaging / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods*; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*; D014655:Vascular Resistance / Q000502:physiology