Abstract
Recently, noninvasive demonstration of major cerebral arteries has become possible by using transcranial color-coded duplex sonography. We carried out neurosurgical operations in 11 patients with brain tumor and in 1 patient with vascular malformation employing intraoperative Brightness mode (B-mode), color flow imaging and power Doppler imaging (CFI and PDI) to identify mass lesions and, the brain and vascular structure. Ultrasound imaging was performed with an Ultramark 9 HDI (Advanced Technology Laboratories, U.S.A.) using various kinds of scanning probe. Real-time monitoring of B-mode imaging aids in guidance when biopsy probes are applied for brain tumor biopsy as well as in the identification of the localization of tumor masses. CFI and PDI can also demonstrate major cerebral vessels and improve our understanding of the context of brain structure and pathological lesions. PDI was able to reveal slow flow at occult arteriovenous malformations, which failed to be depicted as flow vessels by angiography. In conclusion, intraoperative ultrasound imaging may be useful as a mean of real time monitoring and assists us in performing neurological operations safely.
