Department of Neurosurgery, Huashan Hospital, Fudan University; Shanghai Neurosurgical Center, Shanghai 200040, China.
Chin Med J (Engl). 2010 Oct;123(20):2812-5.
Intraoperative Doppler sonography has been used in the neurosurgical operating room for the localization and description of cerebral arteriovenous malformations (AVMs). This study aimed to investigate the clinical value of contrast-enhanced intraoperative Doppler sonography, including its ability to assess the location and identify of feeding arteries in patients with AVMs and to compare this method with angiography.
Twenty-three patients with cerebral AVMs who were diagnosed using angiography, were examined with contrast-enhanced intraoperative Doppler sonography. As an echo-enhancing agent, Sulphur Hexafluoride Microbubbles for Injection ("SonoVue") was administered intravenously in all patients. Sonogram results were reviewed and correlated with angiographic findings. For statistical analysis, the Wilcoxon signed-rank test was applied.
Angiography identified 20 AVM lesions in the anterior or middle fossa and 3 in the posterior fossa. Contrast-enhanced intraoperative Doppler was somewhat less sensitive for only detecting 21/23 (91.3%) of the AVM lesions. Additionally, contrast-enhanced intraoperative Doppler slightly underestimated AVM size compared with angiographic findings but showed feeding arteries with sufficient acoustic properties. In 15 patients, angiography revealed a coincidental blood supply from another intracranial vessel, which was missed by contrast-enhanced intraoperative Doppler sonography.
In a limited group of patients with AVMs, contrast-enhanced intraoperative Doppler sonography was a less sensitive but useful and simple method for the detection of AVMs in contrast to angiography. No specific untoward effects were attributed to the use of "SonoVue" as a contrast-enhancing substance.
术中多普勒超声已在神经外科手术室中用于定位和描述脑动静脉畸形（AVM）。本研究旨在探讨对比增强术中多普勒超声的临床价值，包括评估 AVM 患者供血动脉的位置和识别能力，并将其与血管造影进行比较。
对 23 例经血管造影诊断为脑 AVM 的患者进行对比增强术中多普勒超声检查。所有患者均静脉注射六氟化硫微泡（“声诺维”）作为超声增强剂。回顾超声检查结果并与血管造影结果进行比较。统计分析采用 Wilcoxon 符号秩检验。
血管造影在前或中颅窝识别出 20 个 AVM 病变，在后颅窝识别出 3 个。对比增强术中多普勒超声的敏感性略低，仅检测到 21/23（91.3%）的 AVM 病变。此外，与血管造影结果相比，对比增强术中多普勒超声略低估了 AVM 的大小，但显示了具有足够声学特性的供血动脉。在 15 例患者中，血管造影显示了来自另一个颅内血管的偶然供血，而对比增强术中多普勒超声未能检测到这一供血。
在有限的 AVM 患者群体中，与血管造影相比，对比增强术中多普勒超声是一种敏感性较低但有用且简单的检测 AVM 的方法。使用“声诺维”作为超声增强剂没有引起任何特定的不良反应。
