INTRACRANIAL ANEURYSMS AND ARTERIOVENOUS-MALFORMATIONS - TRANSCRANIALCOLOR-CODED SONOGRAPHY AS A DIAGNOSTIC-AID

Transcranial colour-coded sonography (TCCS) is a new development in no ninvasive cerebral vascular imaging. We studied 5 patients with known intracranial aneurysms and 12 patients with arteriovenous malformation s (AVM). We were unable to image any of the aneurysms (all 5 mm or les s in diameter) using colour flow ultrasound. Similarly, pulsed wave Do ppler interrogation failed to reveal any flow disturbances. Nine out o f 12 AVMs were successfully visualised as serpiginous structures and t he principal feeder vessels were identified in 11 cases, Blood how vel ocities in the feeder vessels were elevated compared with the same ves sel contalaterally (median [cm/s]; peak systolic 227 vs. 89, P = 0.001 ; mean 178 vs. 57, P = 0.001; end diastolic 138 vs. 37, P < 0.0005). P ulsatility indices (PI) and resistance indices (RI) in the feeder vess els were reduced relative to the same vessel contralaterally (median P I 0.46 vs. 0.94, P < 0.0005; median RI 0.37 vs. 0.59, P < 0.0005). At present, TCCS appears of little value in the diagnosis of intracranial aneurysms, but it shows promise for the imaging of AVMs and their hae modynamic study.