engleski

THREE DIMENSIONAL IlLTRASOUND OF THE VERTEBROBASILAR SYSTEM

Background: Transcranial color-coded sonography (TCCS) is used for evaluation of the vertebrobasilar (VB) system. In most indviduals the origin of the basilar artery (BA) can not be visualised due to unfavourable angle of the vertebral arteries (VA) junction or unfavourable angle of insonation. All three vessels can be rarely visualised at the same time. Three-dimensional ultrasound (3D US) enables reconstruction from transcranial power Doppler (PD) imaging of the VB system. Methods: We tried to display the 3D images of the intracranial parts of the VA and BA. Interactive 3D imaging software was integrated into an ultrasound platform (Aloka Prosound 5500). Data aquisition was performed using 2, 5 MHz sector transducer, freehanded in a fixed length of time (10 seconds), allowing PD sonography. The images were postprocessed (TomTec imaging system). 12 patients were investigated in order to visualise all three vessels at the time, and to calculate the angle between each pair of vessels, according to the direction of the blood vessels. Results: In TCCS was not possible to obtain all three vessels at the time in neither patient while in PD mode we were able to obtain all three vessels at the time in 2112 patients. 3D PD enabled visualization of all three vessels at the time in 9/12 patients (1 VA was occluded-diagnose was suspected by 3D PD and confirmed by angiography, in 2 cases suboptimal suboccipital window ). The angle between VA could be obtained in 9/12 patients. In 2 patients the angle between VA and BA origin couldn't be adequately visualised, but mathematical reconstruction according to the direction of the blood vessels was possible. Conclusions: 3D US enabled visualization of the VB junction, and in the cases of inadequate visualisation of the BA origin mathematically reconstruction was possible.

three dimensional ultrasound; vertebrobasilar system

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