Article Figures & Data
Figures
- FIG 1.
Doppler imaging protocol of the SSS and cortical veins in a median sagittal section. A, SSS in median sagittal section in color-coded Doppler US with tilted Doppler beam (dotted line) and corresponding angular correction (white line). B, Cortical arteries and veins in sagittal section in color-coded Doppler US show possible measurement points (white lines).
- FIG 2.
Classification of Doppler FPs of the SSS in neonates with vein of Galen malformation. A, FP1: Doppler FP with low fluctuation, minimum velocity, never less than half of the maximum velocity. B, FP2: Increased fluctuations of the flow velocities with minimum velocity less than half of the maximum velocity. C, FP3: Doppler FP with intermittent retrograde flow. D, FP4: Doppler FP with pulsatile retrograde flow. E, FP5: Doppler FP with a high retrograde flow (equal or more than one-third retrograde flow of the total Doppler flow). F, FP6: Doppler FP with complete retrograde flow.
- FIG 3.
Scheme and MR imaging of a VGAM. A, Simplified scheme of VGAM. B, Sagittal T2-weighted MR image. C, Arterial TOF-MRA. D, Venous TOF-MRA. 1) internal carotid artery; 2) basilar artery; 3) anterior cerebral artery; 4) pericallosal artery; 5) posterior cerebral artery; 6) dilated MPV; 7) falcine sinus; 8) straight sinus; 9) accessory confluence; 10) SSS; 11) transverse sinus; 12) internal jugular vein.
- FIG 4.
A, Individual course of the FPs in the SSS across time per patient. T1 = US Doppler measurement before embolization/first cMRI; T2 = US Doppler measurement 1 day after embolization/first cMRI; T3 = US Doppler measurement 5–7 days after embolization; T4 = US Doppler measurement before discharge. B, Association between Doppler FPs and BNES before therapy. Spearman rank correlation coefficient ρ = −0.97 (95% CI, −0.995 to −0.787; P < . 0001). Pat. indicates patient.
- FIG 5.
Relationship between the FP in the SSS at T1 and T4 and the damage due to venous congestion detectable in the first and second cMRI.
- FIG 6.
A, Timeline of the FPs in the SSS during 9 life months in patient 5. B, Course of Doppler FPs in the SSS under endovascular interventional therapy of stenosis of the jugular bulb in patient 5 (in the angiography room at the age of 16 weeks). A (upper left), An US Doppler FP in the SSS directly before balloon dilation on the left showing an arterialized retrograde flow. B (upper right), After balloon dilation and stent implantation on the left side decrease in flow velocities with reduced retrograde flow. C (bottom left), After additional balloon dilation on the right side, further reduction of the retrograde flow component and normalization of the flow direction. D (bottom right), At 24 hours after the procedure, further normalization of the US Doppler FP and increased undulation with minor retrograde components. Vmax indicates maximum velocity; Vmin, minimum velocity.
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