TRANSCRANIAL COLOR DOPPLER IMAGING OF BRAIN ARTERIOVENOUS-MALFORMATIONS IN ADULTS

This study was performed to investigate the utility of transcranial co lor Doppler sonography in evaluating adult cerebral arteriovenous malf ormations. Twelve patients with such malformations underwent sonograph y. Spectral Doppler sonographic assessment included peak systolic velo city, end diastolic velocity, and resistive index within the intracran ial and extracranial vessels. Color Doppler sonography was used to vis ualize the site of shunting. Paired and unpaired Student's t-tests wer e used to determine significance of spectral findings. The nidus was s een in eight of 10 pial malformations. The nidi in two patients were l ocated in the parietal region and not visualized. When compared with t he corresponding contralateral artery, feeding arteries (identified in all 10 of the pial lesions) demonstrated diminished resistive indices (P = 0.09). Similarly, the end diastolic velocity was increased in al l feeding arteries (P = 0.03). When compared with published normal val ues, the peak systolic and end diastolic velocities were significantly elevated and the resistive indices were low (P < 0.0003). Transcrania l color Doppler sonography depicted the nidi of pial arteriovenous mal formations in 80% of cases. Feeding arteries demonstrated abnormal pea k systolic velocity, end diastolic velocity, and resistive index in al l cases when compared with published values. Transcranial color Dopple r sonography is not a good screening tool due to limited acoustical wi ndow, but it may be useful for noninvasive study of the physiology of arteriovenous malformations as they are treated.