engleski

Impact of vertebrobasilar junction geometry on hemodynamics in basilar artery 3D ultrasound study

Introduction: In our previous studies we showed that three-dimensional ultrasound (3D US) reconstuction of images from Transcranial color-coded sonography (TCCS) and power Doppler imaging is very usefull in 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. In such cases 3D US enables mathematically reconstruction of the VB junction. The aim of this study was to calculate the angle of VB junction by means of 3D US and applie it into the vector analisys of the VB junction hemodinamics. Patients and 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 Power Doppler (PD) sonography. The images were postprocessed (TomTec imaging system). The technique was applied in 25 patients 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. Hemodynamic parameters such as mean blood velocity(MBFV), pulsatility index(PI) and resistance index(RI) were measured in all three vessels. Vector analysis was applied for each hemodynamic parameter. We took real time measured MBFV, PI and RI values for VA and the angle value between VA and BA. We tried to find correlation between real time measured MBFV, PI and RI in BA and mathematically calculated values for BA. Results: In TCCS the angle between VA could be obtained in 19/25 patients. In 6 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. Conclusion: 3D US enabled calculation of the angle between VA and BA.

vertebrobasilar; 3D ultrasound; geometry

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