Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, 6 Tiantan Xili, Dongcheng District, 100050 Beijing China.
J Ultrasound Med. 2014 Feb;33(2):273-80. doi: 10.7863/ultra.33.2.273.
To compare the diagnostic value of transcranial color-coded real-time sonography and contrast-enhanced color-coded sonography in detection and characterization of intracranial arteriovenous malformations.
Thirty-one patients highly suspected to have an intracranial arteriovenous malformation were imaged with real-time and contrast-enhanced sonography. With digital subtraction angiography as the reference standard, the ability to detect the malformations and accurately determine their size and location was compared between the two imaging techniques.
One cavernous hemangioma and 30 intracranial arteriovenous malformations were imaged with real-time and contrast-enhanced sonography, which were confirmed by angiography. The detectability of contrast-enhanced sonography, especially for optimizing visualization of malformations located in the frontal, parietal, and occipital lobes, was higher than that of real-time sonography, although the overall number of malformations was too small to demonstrate significance. The sizes of the malformations (6 in the frontal lobe, 1 in the parietal lobe, and 1 in the occipital lobe) were underestimated by real-time sonography compared to angiography, whereas there was agreement in the sizes between contrast-enhanced sonography and angiography. The detection rates for the 30 arteriovenous malformations on contrast-enhanced and real-time sonography were 96.7% (29 of 30) and 70.0% (21 of 30), respectively (P = .008). Moreover, contrast-enhanced sonography was significantly superior to real-time sonography for detection of feeding arteries (59.5% [22 of 37] versus 83.7% [31 of 37]; P = .004). Although the feeding arteries showed increased peak systolic and end-diastolic velocities after contrast agent injection, there were no statistically significant differences in the velocities before and after injection.
Transcranial contrast-enhanced color-coded sonography is superior to color-coded real-time sonography for detection of intracranial arteriovenous malformations, particularly for lesions located in the frontal, parietal, and occipital lobes of the brain.
比较经颅彩色实时超声与对比增强彩色超声在颅内动静脉畸形检测和特征描述中的诊断价值。
对 31 例高度疑似颅内动静脉畸形的患者进行实时超声和对比增强超声检查。以数字减影血管造影为参考标准，比较两种成像技术检测畸形的能力，并准确判断其大小和位置。
实时超声和对比增强超声共成像 1 例海绵状血管瘤和 30 例颅内动静脉畸形，均经血管造影证实。对比增强超声，特别是对优化显示额叶、顶叶和枕叶的畸形，具有更高的检测能力，尽管畸形总数太少，无法显示其显著性。与血管造影相比，实时超声对畸形的大小（额叶 6 个，顶叶 1 个，枕叶 1 个）的估计值较低，而对比增强超声与血管造影的大小一致。对比增强和实时超声对 30 个动静脉畸形的检出率分别为 96.7%（29/30）和 70.0%（21/30）（P=0.008）。此外，对比增强超声在检测供血动脉方面明显优于实时超声（59.5%[22/37]与 83.7%[31/37]；P=0.004）。尽管在注射造影剂后，供血动脉的收缩期和舒张末期峰值速度增加，但注射前后的速度没有统计学上的显著差异。
经颅对比增强彩色编码超声在颅内动静脉畸形的检测中优于彩色实时超声，特别是在额叶、顶叶和枕叶的病变。
