The Guidance of Intraoperative Ultrasonography in the Surgical Treatment of Arteriovenous Malformation

Abstract

In this operative case-based report, we have investigated the ability and benefits of intraoperative grey-scale sonographic examination in the localising of arteriovenous malformations in the brain, the identification of feeding artery or arteries, the description of perilesional changes, and the detection of accompanying hematomas. The surrounding edematous brain tissue was observed as hyperechioc areas. The arteriovenous malformation appeared in two echogenic parts, a hyperechioc thrombotic part and a hypoechoic perfused part. We were able to identify the feeding artery. The sonographic characteristics of this artery are thick vascular wall, the presence of arterial systolic pulsation and a close relation with the nidus. We conclude that intraoperative ultrasonographic examination during the surgical treatment of arteriovenous malformation is a non-invasive, useful, and simple diagnostic tool in the detection of the components and accompanying parts of the lesion.