Cerebral Arteriovenous Malformations: Diagnostic Value of Echo-Enhanced Transcranial Doppler Sonography Compared with Angiography
Martin M. Uggowitzer
,a,
Christian Kuglera,
Michael Riccabonaa,
Günther E. Kleina,
Klaus Lebera,
Josef Simbrunnera and
Franz Quehenbergera
a From the Departments of Radiology (M.M.U., C.K., M.R., G.E.K., J.S.), Neurosurgery (K.L.), University Hospital Graz; and the Institute of Medical Statistics and Documentation, Graz (F.Q.).
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FIG 1. A, EE-TCD shows an AVM with a diameter of 2.7 cm. The lesion is fed by the right PCA (arrow).
B, In the duplex mode, a high PSV (129.4 cm/s) and a low RI (35%) can be detected, indicating low vascular resistance.
C, Angiogram after catheterization of the left vertebral artery confirms the sonographic diagnosis.
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FIG 2. A, Medium-sized AVM involving the left cerebellar hemisphere. The lesion gets its arterial supply via the left posterior inferior cerebellar artery (PICA). Large draining veins are exhibited in the early angiographic phase (arrows).
B, Three-dimensional image of the lesion depicts the malformation filled with color signals (curved arrow). A tortuous and hypertrophic feeder (straight arrow), representing the enlarged PICA, emerges from the basilar artery (open arrow).
C, Spectral Doppler samples reveal venous flow within a draining vessel adjacent to the PICA (arrow).
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