Feasibility and validation of spinal cord vasculature imaging using high resolution ultrasound Foad Abd Allah, MD, Shahram Majidi, MD, Masaki Watanabe,

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Feasibility and validation of spinal cord vasculature imaging using high resolution ultrasound Foad Abd Allah, MD, Shahram Majidi, MD, Masaki Watanabe, MD, PhD, Saqib A. Chaudhry, MD, Adnan I. Qureshi, MD Journal of Vascular Surgery Volume 56, Issue 3, Pages 637-643 (September 2012) DOI: 10.1016/j.jvs.2012.02.037 Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 1 Patient placed in the sitting position with slight bending of thoracolumbar spine. The field of insonation is marked between T8 and T12 by identification of thoracic levels using high frequency 3 to 9 MHz linear array transducer. Journal of Vascular Surgery 2012 56, 637-643DOI: (10.1016/j.jvs.2012.02.037) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 2 Interspinous space between T9 and T10 visualized at depth range from 3 cm to 4.5 cm by high resolution B-mode. Journal of Vascular Surgery 2012 56, 637-643DOI: (10.1016/j.jvs.2012.02.037) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 3 One of the segmental arteries is identified in the interspinous spaces at the same depth range with characteristic Doppler waveform of high resistance flow. Journal of Vascular Surgery 2012 56, 637-643DOI: (10.1016/j.jvs.2012.02.037) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 4 Imaging of anterior spinal artery by high resolution ultrasound. A, B-mode image showed the anterior spinal artery as a tiny structure with a diameter of 1.42 mm at the anterior portion of dural sac. B, Color-coded image showed the anterior spinal artery among venous network. C, Doppler analysis of anterior spinal artery flow with characteristic low resistance flow. *As we have used the focus option and captured the image at the specific depth of interest, start point of scale which was 0 is not visualized in this image. Journal of Vascular Surgery 2012 56, 637-643DOI: (10.1016/j.jvs.2012.02.037) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 5 A, Digital subtraction angiographic image of T9 segmental artery (arrows) in the cadaveric model acquired by selective catheterization and injection. B, Doppler flow signal in the cadaveric model after injection of artificial blood recorded at depth of 6 cm. Journal of Vascular Surgery 2012 56, 637-643DOI: (10.1016/j.jvs.2012.02.037) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 6 Color-coded ultrasonography showed flow pattern of artificial blood through the 4F catheter in the cadaveric model simulating anterior spinal artery flow at depth of 6.2 cm. Journal of Vascular Surgery 2012 56, 637-643DOI: (10.1016/j.jvs.2012.02.037) Copyright © 2012 Society for Vascular Surgery Terms and Conditions