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Diagnostic ultrasound ( PDFDrive )

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1586 PART V Pediatric Sonography

A

B

C

D

E

F

G

FIG. 46.15 Vein of Galen Aneurysmal Malformation. (A) Sagittal gray-scale and (B) color Doppler images show a vascular mass due to

aneurysmal enlargement of the vein of Galen with prominent turbulent low. The tectal plate is compressed downward and the supratentorial

ventricles are dilated because of aqueductal obstruction and venous hypertension. (C)-(E) Color Doppler sonography with spectral analysis of the

malformation allows study of the hemodynamic angioarchitecture of the malformation. Normal low is noted within the pericallosal artery (C),

whereas a high low is noted within the feeding posterior choroidal artery (D) with matching low resistive index (RI) value (RI = 0.29) as a result

of the arteriovenous shunting. Within the dilated vein of Galen (E), extensive referred cardiac pulsations are noted. (F) Contrast-enhanced magnetic

resonance venography conirms the malformation. (G) Digital subtraction angiography shows that the vein of Galen aneurysmal malformation is

supplied by dilated bilateral posterior choroidal arteries.

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