Assessment of dural arteriovenous fistulae by transcranial color-coded duplex sonography

To study hemodynamic changes and to determine the value of contrast-enhanced transcranial color-coded sonography (TCCS) for the evaluation of dural arteriovenous fistulae (DAVF) before and after transcatheter embolization. Twenty-four patients (mean age 61+/-11 years) with occipitally located DAVF w...

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Bibliographic Details
Published in:Stroke (1970) 2005-05, Vol.36 (5), p.976-979
Main Authors: HARRER, Judith U, POPESCU, Octavian, HENKES, Hans H, KLOTZSCH, Christof
Format: Article
Language:English
Subjects:
Adult
Aged
Angiography, Digital Subtraction
Biological and medical sciences
Central Nervous System Vascular Malformations - diagnostic imaging
Central Nervous System Vascular Malformations - therapy
Embolization, Therapeutic
Female
Humans
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Middle Aged
Nervous system
Neurology
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Ultrasonic investigative techniques
Ultrasonography, Doppler, Color
Ultrasonography, Doppler, Transcranial
Vascular diseases and vascular malformations of the nervous system
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Summary:To study hemodynamic changes and to determine the value of contrast-enhanced transcranial color-coded sonography (TCCS) for the evaluation of dural arteriovenous fistulae (DAVF) before and after transcatheter embolization. Twenty-four patients (mean age 61+/-11 years) with occipitally located DAVF were studied with contrast-enhanced TCCS using the transtemporal bone window in transverse-axial and coronal insonation planes. Blood flow velocity measurements of all depictable basal cerebral veins and sinuses were obtained before and after transcatheter embolization. Pretreatment and post-treatment flow velocity values were compared. Four of the 24 patients (17%) could not be studied because of an insufficient temporal bone window. In all remaining patients (n=20), draining veins/sinuses could be identified because of pathologically increased blood flow velocities with peak systolic flow velocities of >50 cm/s. Of the 27 draining vessels depicted by DSA, TCCS correctly identified 25 (93%): the basal vein (3 of 3), the straight sinus (3 of 3), the superior sagittal sinus (1 of 3), the transverse sinus (9), the sigmoid sinus (4), and the superior petrosal sinus (5/5). However, TCCS failed to depict supplementary drainage via cortical veins. After transcatheter embolization, mean reduction of blood flow velocity was 44+/-18% (P
ISSN:0039-2499
1524-4628
DOI:10.1161/01.str.0000162586.55769.fb