| Objective 1 The dural arteriovenous fistulas (DAVF) is a rare intracranial vascular malformation accounting for only 10%~15% of all intracranial vascular malformations. The gold standard for the detection and characterization of these diseases is cerebral angiography and external carotid artery angiography. To our knowledge, we have not found any descriptions about preliminary diagnosis of DAVF based on the CDFI findings alone in adults. The purpose of this work was to characterize the hemodynamic changes of arteriovenous fistulas, feeding arteries, draining veins and extracranial arteries in patients with DAVF and to evaluate the diagnostic value of CDFI in DAVF.2 Scalp arteriovenous malformation is a rare extracranial vascular malformation with abnormal arteriovenous communication lying within the subcutaneous of the scalp. The diagnosis of the lesion based on cerebral angiography. Review of the literature we have just found the ultrasonic descriptions about the lesions from the point of hemangioma. The systematical investigations of the lesions from the point of arteriovenous malformations have not been found. We analyzed the ultrasonicmanifestations and the hemodynamic changes systematically in patients with scalp arteriovenous malformations from the point of arteriovenous malformations by high frequency ultrasound and evaluated the diagnostic value of ultrasound in scalp arteriovenous malformations.3 The intracranial vascular diseases cause the hemodynamic changes of extracranial vessels. We analyzed and characterized the hemodynamic changes of extracranial vessels in patients with direct carotid-cavernous fistulae (type A), cerebral arteriovenous malformations (AVM) and cerebral aneurysm so as to provide gist of ultrasonic differentiation in cerebral vascular diseases.Methods Thirteen patients with DAVF, 11 cases with scalp arteriovenous malformation and 35 cases with other intracranial vascular diseases (10 cases of direct carotid-cavernous fistulae, 12 cases of cerebral aneurysm and 13 cases of cerebral AVM) were studied through CDFI. Cerebral AVM were divided into two groups based on the origination of feeding artery: I group composed of 7 cases, feeding arteries originated from vertebrobasilar artery, II group composed of 6 cases, feeding arteries originated from internal carotid artery. The normal contrast group was consisted of 60 healthy volunteers.Detecting technique:(1)Patients with DAVF were studied by CDFI through the temporal and occipital window. The arteriovenous fistulas and spectra in it were detected. Hemodynamic parameters were measured in the feeding arteries, draining veins and extracranial arteries. (2)The head soft tissue mass, bilateral superficial temporal artery and occipital artery in patients with scalp arteriovenous malformation were examined using high frequency ultrasound. (3) Hemodynamic parameters within extracranial vessels were measured in patients with different intracranial vascular diseases.We used Acuson Sequoia 512 computed sonographer. The diameter, Vmax, Vmin, Vmean and Rl of the abnormal vessels were recorded. The extracranial vasculars such as ICA, ECA, VA, OccA and STA were checked. All of the cases were confirmed by the cerebral angiography. The ultrasonic findings were compared and analyzed with those of the cerebral angiography and those by ultrasonography in 60 healthy volunteers.Results 1 The CDFI manifestations of DAVF: (1)The fistulas of DAVF presented heterogenous mosaic flashes. The spectral shape in it was of multiple directions, high velocity and low resistance with Vmax (105.6 + 32.9) cm/s, Vmin (72.0 + 22.9) cm/s, Vmean (87.0 + 26.0) cm/s, Rl (0.31 + 0.04) . The acoustic frequency signals were rough and alound. (2) Identification rate of the fistulas were 69% (9/13) in 13 cases with DAVF by CDFI. Identification rate were 71.4% (5/7) for the DAVF of transverse-sigmoid sinus and 100% (3/3) for the DAVF of cavernous sinus. (3)Feeding arteries detected by CDFI counted up to 42 (72.4%). The venous drainage through transverse sin...
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