[Intraoperative Doppler ultrasonography and ultrasound angiography in operation for brain arteriovenous malformations].
OBJECTIVE
To investigate the reliability and clinical value of intraoperative Doppler ultrasonography and ultrasound angiography in treatment of brain arteriovenous malformations (AVMs). We demonstrate the correlation between the change of resistive index (RI) of feeding artery and the completeness of resection of brain AVMs.


METHODS
Intraoperative Doppler ultrasonography was applied in 82 patients with intracranial brain AVMs undergoing resection, and ultrasound angiography was used in 15 of the 82 patients in addition. The resistive index (RI) of the feeding artery was recorded so as to identify the residual AVMs. Intraoperative angiography or postoperative angiography was performed in all patients.


RESULTS
Intraoperative color Doppler ultrasonography clearly identified the position, size, and flow characteristics of AVMs by showing double colors and directions of flow pattern, the feeding arteries, and draining veins. The mean pre-resection RI of the feeding artery was (0.37 +/- 0.08), and the post-resection RI was (0.63 +/- 0.09) (P < 0.05). In 8 cases the AVMs were translocated the translocation so they needed localized and delineated again. In 7 cases residual AVMs were suspected intraoperatively by ultrasonography and were confirmed by re-exploration and resected totally.


CONCLUSIONS
Intraoperative Doppler ultrasonography is a reliable tool for intraoperative localization and complete resection of AVMs. Providing real-time flow pattern of AVMs, intraoperative ultrasound angiography combined with RI effectively indicates the completeness of resection of AVMs.
Zhang
Yan
Y
Department of Neurosurgery, Department of Ultrasonography, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China.
Wang
Shuo
S
He
Wen
W
D000293:Adolescent; D000328:Adult; D002533:Cerebral Angiography; D002648:Child; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D019635:Neurosurgical Procedures; D017585:Ultrasonography, Doppler, Transcranial