CEREBELLAR AND SPINAL HEMANGIOBLASTOMAS - EVALUATION WITH INTRAOPERATIVE GRAY-SCALE AND COLOR DOPPLER FLOW ULTRASOUND

Intraoperative gray-scale and color Doppler flow ultrasound (US) studi es were performed in 12 patients with von Hippel-Lindau disease during surgical excision of hemangioblastomas. There were a total of 21 lesi ons: two were in the cerebellum and 19 were in the spinal cord. Twelve of the 19 spinal hemangioblastomas were hyperechoic to the spinal cor d and thus were easily detected with gray-scale US. Color Doppler flow images provided improved delineation of all lesions compared with the images produced with standard gray-scale US. Seven of the 19 spinal l esions were detected only with color Doppler flow imaging because they were isoechoic to the normal spinal cord at gray-scale US. Color Dopp ler flow imaging enabled differentiation of the cysts and syrinx cavit ies associated with hemangioblastomas from dilated intraspinal vascula r structures. In all cases, intraoperative color Doppler flow imaging facilitated the localization of hemangioblastomas during the neurosurg ical procedure.