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The application of ultrasound in the management of cerebral arteriovenous malformation

超声技术在脑动静脉畸形中的应用

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Abstract

Ultrasound is used in the diagnosis, treatment and follow-up of cerebral arteriovenous malformation (AVM). Several parameters including flow velocity, flow volume, resistance index, pulsatility index, vasomotor reactivity and their influencing factors are reviewed. The applications of ultrasound in the preoperative evaluation, intraoperative monitor and postoperative follow-up of AVM, are summarized. Although some limits exist, ultrasound can provide more reliable information about AVM, if lesions are classified according to their characteristics, compared in different conditions between preoperation and postoperation, feeding and non-feeding side, patients and healthy adults, and if ultrasound method is combined with other examinations and different developed ultrasound techniques. With the appearance and development of new ultrasound technique, its application will be wider in management of AVM.

摘要

超声技术常应用于脑动静脉畸形诊断、 治疗以及随访。 本文回顾了用超声技术测量脑血맜血流速度、 流量、 脉搏指数、 阻力指数、 血맜反应性等指标以及其相关影响因素, 总结了超声技术在脑动静脉畸形的术前评估、 术中监测以及术后随访中的应用。 尽맜超声技术目前不能作为脑动静脉畸形的筛选手段, 但是, 如果根据脑动静脉畸形病变特性分组选择检查方法, 对比患者在手术前、 后, 供血侧与非供血侧以及患者与健康人群之间的检查结果, 配合其它检查手段以及不同的超声成像技术, 超声技术则能提供更为可靠的诊断信息。 随着新的超声技术的出现和发展, 超声在动静脉畸形方面的应用会更加广泛。

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References

  1. Grolimund P, Seiler RW, Aaslid R, Huber P, Zurbruegg H. Evaluation of cerebrovascular disease by combined extracranial and transcranial Doppler sonography: experience in 1,039 patients. Stroke 1987, 18: 1018–1024.

    PubMed  CAS  Google Scholar 

  2. Reutern GM, Büdingen HJ. Ultrasound diagnosis of cerebrovascular disease: Doppler sonography of the extra-and intracranial arteries duplex scanning. New York: Thieme Medical Publishers, 1993, 137–172.

    Google Scholar 

  3. Mast H, Mohr JP, Thompson JL, Osipov A, Trocio SH, Mayer S. et al. Transcranial Doppler ultrasonography in cerebral arteriovenous malformations. Diagnostic sensitivity and association of flow velocity with spontaneous hemorrhage and focal neurological deficit. Stroke 1995, 26: 1024–1027.

    PubMed  CAS  Google Scholar 

  4. Nagasawa S, Kawanishi M, Tada Y, Kawabata S, Ohta T. Intraoperative measurement of cortical arterial flow volumes in posterior circulation using Doppler sonography. Neurol Res 2000, 22: 194–196.

    PubMed  CAS  Google Scholar 

  5. Schöning M, Walter J. Evaluation of the vertebrobasilar-posterior system by transcranial color duplex sonography in adults. Stroke 1992, 23: 1280–1286.

    PubMed  Google Scholar 

  6. Tsuchiya T, Yasaka M, Yamaguchi T, Kimura K, Omae T. Imaging of the basal cerebral arteries and measurement of blood velocity in adults by using transcranial real-time color flow Doppler sonography. Am J Neuroradiol 1991, 12: 497–502.

    PubMed  CAS  Google Scholar 

  7. Schmidt EA, Piechnik SK, Smielewski P, Raabe A, Matta BF, Czosnyka M. Symmetry of cerebral hemodynamic indices derived from bilateral transcranial Doppler. J Neuroimaging 2003, 13: 248–254.

    Article  PubMed  Google Scholar 

  8. Zheng MZ, Chen XC, Wang Yi, Shi YM. Ultrasound study of ICA BFV in cerebral aneurysm and AVM. Chin Comput Med Imag 2007, 13: 5–10. (Chinese, English abstract)

    Google Scholar 

  9. Manchola IF, De Salles AA, Foo TK, Ackerman RH, Candia GT, Kjellberg RN. Arteriovenous malformation hemodynamics: a transcranial Doppler study. Neurosurgery 1993, 33: 556–562.

    Article  PubMed  CAS  Google Scholar 

  10. Schöning M, Walter J, Scheel P. Estimation of cerebral blood flow through color duplex sonography of the carotid and vertebral arteries in healthy adults. Stroke 1994, 25:17–22.

    PubMed  Google Scholar 

  11. Wang Y, Wang YD, Wang Yi, Qin QM. Value of intraoperative ultrasound assisted in intracranial arteriovenous malformation surgical treatment. Chin Comput Med Imag 2006, 12: 231–235. (Chinese, English abstract)

    Google Scholar 

  12. Schreiber SJ, Franke U, Doepp F, Staccioli E, Uludag K, Valdueza JM. Dopplersonographic measurement of global cerebral circulation time using echo contrast-enhanced ultrasound in normal individuals and patients with arteriovenous malformations. Ultrasound Med Biol 2002, 28: 453–458.

    Article  PubMed  Google Scholar 

  13. Martin PJ, Evans DH, Naylor AR. Measurement of blood flow velocity in the basal cerebral circulation: advantages of transcranial color-coded sonography over conventional transcranial Doppler. J Clin Ultrasound 1995, 23: 21–26.

    Article  PubMed  CAS  Google Scholar 

  14. Schebesch KM, Simka S, Woertgen C, Brawanski A, Rothoerl RD. Normal values of volume flow in the internal carotid artery measured by a new angle-independent Doppler technique for evaluating cerebral perfusion. Acta Neurochir (Wien) 2004, 146: 983–987.

    Article  Google Scholar 

  15. Torbey MT, Hauser TK, Bhardwaj A, Williams MA, Ulatowski JA, Mirski MA, et al. Effect of age on cerebral blood flow velocity and incidence of vasospasm after aneurysmal subarachnoid hemorrhage. Stroke 2001, 32: 2005–2011.

    Article  PubMed  CAS  Google Scholar 

  16. Scheel P, Ruge C, Schöning M. Flow velocity and flow volume measurements in the extracranial carotid and vertebral arterires in healthy adults: reference data and the effects of age. Ultrasound Med Biol 2000, 26: 1261–1266.

    Article  PubMed  CAS  Google Scholar 

  17. Krejza J, Mariak Z, Walecki J, Szydlik P, Lewko J, Ustymowicz A. Transcranial color Doppler sonography of basal cerebral arteries in 182 healthy subjects: age and sex variability and normal reference values for blood flow parameters. Am J Roentgenol 1999, 172: 213–218.

    CAS  Google Scholar 

  18. Sorteberg W, Langmoen IA, Lindegaard KF, Nornes H. Side-to-side differences and day-to-day variations of transcranial Doppler parameters in normal subjects. J Ultrasound Med 1990, 9: 403–409.

    PubMed  CAS  Google Scholar 

  19. Martin PJ, Evans DH, Naylor AR. Transcranial color-coded sonography of the basal cerebral circulation. Reference data from 115 volunteers. Stroke 1994, 25: 390–396.

    PubMed  CAS  Google Scholar 

  20. Lindegaard KF, Grolimund P, Aaslid R, Nornes H. Evaluation of cerebral AVM’s using transcranial Doppler ultrasound. J Neurosurg 1986, 65: 335–344.

    Article  PubMed  CAS  Google Scholar 

  21. Uggowitzer MM, Kugler C, Riccabona M, Klein GE, Leber K, Simbrunner J, et al. Cerebral arteriovenous malformations: diagnostic value of echo-enhanced transcranial Doppler sonography compared with angiography. Am J Neuroradiol 1999, 20: 101–106.

    PubMed  CAS  Google Scholar 

  22. Rothoerl RD, Schebesch KM, Woertgen C, Brawanski A. Ultrasonic blood flow volume assessment in the extracranial internal carotid artery in arteriovenous malformations. Neurol Res 2005, 27: 209–211.

    Article  PubMed  CAS  Google Scholar 

  23. Murayama Y, Usami S, Hata Y, Ganaha F, Hasegawa Y, Terao T, et al. Transvenous hemodynamic assessment of arteriovenous malformations and fistulas. Preliminary clinical experience in Doppler guidewire monitoring of embolotherapy. Stroke 1996, 27: 1358–1364.

    PubMed  CAS  Google Scholar 

  24. Diehl RR, Henkes H, Nahser HC, Kühne D, Berlit P. Blood flow velocity and vasomotor reactivity in patients with arteriovenous malformations: a transcranial Doppler study. Stroke 1994, 25: 1574–1580.

    PubMed  CAS  Google Scholar 

  25. Massaro AR, Young WL, Kader A, Ostapkovich N, Tatemichi TK, Stein BM, et al. Characterization of arteriovenous malformation feeding vessels by carbon dioxide reactivity. Am J Neuroradiol 1994, 15: 55–61.

    PubMed  CAS  Google Scholar 

  26. De Salles AA, Manchola I. CO2 reactivity in arteriovenous malformations of the brain: a transcranial Doppler ultrasound study. J Neurosurg 1994, 80: 624–630.

    PubMed  Google Scholar 

  27. Jindal A, Mahapatra AK. Correlation of ventricular size and transcranial Doppler findings before and after ventricular peritoneal shunt in patients with hydrocephalus: prospective study of 35 patients. J Neurol Neurosurg Psychiatry 1998, 65: 269–271.

    Article  PubMed  CAS  Google Scholar 

  28. Bellner J, Romner B, Reinstrup P, Kristiansson KA, Ryding E, Brandt L. Transcranial Doppler sonography pulsatility index (PI) reflects intracranial pressure (ICP). Surg Neurol 2004, 62: 45–51.

    Article  PubMed  Google Scholar 

  29. Zhuang L, Duan YY, Cao TS, Ruan LT. Potential of transcranial power Doppler imaging in the diagnosis of cerebral arteriovenous malformation. Chin J Ultrasonogr 2000, 9: 300–302. (Chinese, English abstract)

    Google Scholar 

  30. Yu LB, Wang S, He W, Jiang XQ, Zhao YL, Zhao JZ. Intraoperative measurement of RI by colored Doppler for brain AVM surgery. Beijing Yi Xue 2007, 29: 7–9. (Chinese, English abstract)

    Google Scholar 

  31. Rubin JM, Hatfield MK, Chandler WF, Black KL, DiPietro MA. Intracerebral arteriovenous malformations: intraoperative color Doppler flow imaging. Radiology 1989, 170: 219–222.

    PubMed  CAS  Google Scholar 

  32. Woydt M, Perez J, Meixensberger J, Krone A, Soerensen N, Roosen K. Intra-operative colour-duplex-sonography in the surgical management of cerebral AV-malformations. Acta Neurochir (Wien) 1998, 140: 689–698.

    Article  CAS  Google Scholar 

  33. Zhou DB, Zhao JZ, Wang S, Ni M, Wang R, Zhang D, et al. Application of intraoperative real-time ultrasound in the surgical treatment of cerebral arteriovenous malformation. Natl Med J China 2005, 85: 1688–1691. (Chinese, English abstract)

    Google Scholar 

  34. Thien C, Rosenfeld JV, Phelan E. Colour Doppler imaging as an aid to excision of an arteriovenous malformation. J Clin Neurosci 1996, 3: 358–362.

    Article  PubMed  CAS  Google Scholar 

  35. Cokluk C, Iyigün O, Senel A, Celik F, Rakunt C. The guidance of intraoperative ultrasonography in the surgical treatment of arteriovenous malformation. Minim Invasive Neurosurg, 2003, 46: 169–172.

    Article  PubMed  CAS  Google Scholar 

  36. Griffith S, Pozniak MA, Mitchell CC, Ledwidge ME, Dempsey R, Peters A, et al. Intraoperative sonography of intracranial arteriovenous malformations: how we do it. J Ultrasound Med 2004, 23: 1065–1072.

    PubMed  Google Scholar 

  37. Dempsey RJ, Moftakhar R, Pozniak M. Intraoperative Doppler to measure cerebrovascular resistance as a guide to complete resection of arteriovenous malformations. Neurosurgery 2004, 55: 155–161.

    Article  PubMed  Google Scholar 

  38. Wang YD, Wang Y, Qin QM, Wang Y, Chen XC. Intraoperative real-time contrast-enhanced ultrasound angiography applied in the surgical treatment of arteriovenous malformations. Shanghai Medical Imaging, 2008, 17: 1–4. (Chinese, English abstract)

    Google Scholar 

  39. Mathiesen T, Peredo I, Edner G, Kihlström L, Svensson M, Ulfarsson E, et al. Neuronavigation for arteriovenous malformation surgery by intraoperative three-dimensional ultrasound angiography. Neurosurgery 2007, 60: 345–351.

    PubMed  Google Scholar 

  40. Akdemir H, Oktem S, Menkü A, Tucer B, Tuğcu B, Günaldi O. Image-guided microneurosurgical management of small arteriovenous malformation: role of neuronavigation and intraoperative Doppler sonography. Minim Invasive Neurosurg 2007, 50: 163–169.

    Article  PubMed  CAS  Google Scholar 

  41. Tyagi SK, Mahapatra AK, Mishra NK. Transcranial Doppler evaluation of blood flow velocity changes in basal cerebral arteries in cerebral AVMs following embolisation and surgery. Neurol India 2000, 48: 112–115.

    PubMed  CAS  Google Scholar 

  42. Klötzch C, Henkes H, Nahser HC, Kühne D, Berlit P. Transcranial color-coded duplex sonography in cerebral arteriovenous malformations. Stroke 1995, 26: 2298–2301.

    PubMed  Google Scholar 

  43. Harders A, Bien S, Eggert HR, Laborde G, Merland JJ, Rufenacht D. Haemodynamic changes in arteriovenous malformations induced by superselective embolization: transcranial Doppler evaluation. Neurol Res 1988, 10: 239–245.

    PubMed  CAS  Google Scholar 

  44. Hölscher T, Ozgur B, Singel S, Wilkening WG, Mattrey RF, Sang H. Intraoperative ultrasound using phase inversion harmonic imaging: first experiences. Neurosurgery 2007, 60: 382–387.

    PubMed  Google Scholar 

  45. Bartels E. Evaluation of arteriovenous malformations (AVMs) with transcranial color-coded duplex sonography: does the location of an AVM influence its sonographic detection? J Ultrasound Med 2005, 24: 1511–1517.

    PubMed  Google Scholar 

  46. Baumgartner RW, Mattle HP, Schroth G. Transcranial colour-coded duplex sonography of cerebral arteriovenous malformations. Neuroradiology 1996, 38: 734–737.

    Article  PubMed  CAS  Google Scholar 

  47. Baumgartner RW, Mattle HP, Aaslid R. Transcranial color-coded duplex sonography, magnetic resonance angiography, and computed tomography angiography: methods, applications, advantages, and limitations. J Clin Ultrasound 1995, 23: 89–111.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China

    Bing Fu  (傅兵), Ji-Zong Zhao  (赵继宗) & Lan-Bing Yu  (于兰冰)

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  1. Bing Fu  (傅兵)
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  2. Ji-Zong Zhao  (赵继宗)
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Correspondence to Ji-Zong Zhao  (赵继宗).

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Fu, B., Zhao, JZ. & Yu, LB. The application of ultrasound in the management of cerebral arteriovenous malformation. Neurosci. Bull. 24, 387–394 (2008). https://doi.org/10.1007/s12264-008-1013-6

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