Technological progression has led to the development of increasingly smaller ultrasonography systems. Here we describe the usefulness of VSCAN, a newly-developed pocket-sized portable ultrasound, for neurosonology. The VSCAN measures 135 × 73 mm and weighs 390 g. Its excellent portability allows physicians to perform ultrasonography anywhere in the hospital, and its usefulness has been reported in cases from cardiology, gynecology, and emergency medicine. We preliminarily employed VSCAN for 25 neurosurgical treatments and evaluated carotid arteries, femoral arteries, and inferior vena cavas, among others. The handling of the VSCAN was quite simple, and color flow images were able to be obtained; however, the resolution of the images was not sufficient to evaluate the arterial walls of either the carotid or femoral artery. The probe was fixed; therefore, only one type was available for deep-seated regions such as the thoracic or abdominal organs. Our experience suggests that this version of the VSCAN pocket-sized portable ultrasound is not useful for neurosonology, and development of a linear probe is required.
Purpose: The aim of this study was to evaluate the usefulness of intraoperative ultrasonography in combination with a navigation system. Methods: Between June 2012 and December 2012, 16 patients with intra-axial brain tumors underwent surgery using SonoSite ultrasonography, a StealthStation navigation system, and a SonoNav system. The ultrasonographic image was directly integrated into the navigation system, and the findings were compared with the preoperative images. Results: Intraoperative ultrasonography-linked navigation provided information about brain shift and the extent of resection during surgery. Using this type of assistance, total resection was achieved in 10 of 16 cases, and subtotal resection was achieved in 6. No operative complications were observed. Conclusions: Intraoperative ultrasonography supported by a navigation system improves the quality assurance of image-guided neurosurgery.
Purpose: Vertebral artery dissection is an established cause of ischemic stroke in the vertebrobasilar circulation territory in young adults with no risk factors for atherosclerotic arterial disease. This study examined characteristic findings of extracranial vertebral artery dissection using ultrasonography. Subjects: Abnormalities in 6 vertebral arteries of 5 patients (3 women, 2 men; mean age, 43.8 ± 22.1 years) were followed using ultrasonography at 1, 2, 3, 6 and 12 months. Results: Typical ultrasonographic findings comprised localized dilation, intramural hematoma, spiral flow, double lumen and false lumen flow. At follow-up, we identified reduced diameter, improved hematoma, and lumen dilation, as well as altered echogenicity. Abnormal findings in four young patients improved around 2 months later and normalized around 6 months later. However, findings did not change in one older patient. Conclusions: Ultrasonography helped to diagnose extracranial vertebral artery dissection and was thus useful as a follow-up methodology.