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The use of 3D ultrasound in spinal vascular surgeries.
Angiography remains the gold standard to assess vascular malformations. This invasive technique is not without risk. Three-dimensional ultrasound (3DUS) has been introduced to overcome some of the disadvantages of angiography. To assess the potential of 3DUS in the assessment of spinal vascular malformations, we investigated its use in eight patients, including two with Klippel-Trénaunay syndrome. In this prospective observational study, the first patient was examined under general anaesthesia to allow for accurate assessment of the entire aorta. The remaining seven patients were examined under conscious sedation. Axial, sagittal and coronal images were acquired with a General Electric Voluson E8 system (GE Healthcare, Milwaukee, WI, USA). The images were stored and retrieved via the Virtual Place application (GE Healthcare, Milwaukee, WI, USA). After the whole process, including injection of the contrast agent, the patients were asked to evaluate the effectiveness of the examination and the ease of the technique. Two anesthesiologists and two vascular surgeons assessed all images with the accuracy of the virtual examination compared to the surgical findings. Six out of the eight patients were diagnosed with arteriovenous malformations, two had a spinal dural arteriovenous fistula and one had a spinal arteriovenous fistula. The accuracy of diagnosis was 90.9% (seven out of eight patients). The success rate was 83.3% (six out of eight patients). No intra-operative complications were observed. The procedure was well tolerated. 3DUS is safe and effective in patients with spinal vascular malformations. (on 5 July 2016). Once again, it is a big change from last year (6%) and only slightly better than last month (4%). See the table for a full breakdown. The drop in labor share is basically attributable to a drop in the number of full-time workers. It is also interesting to note that in most cases, the decline in the labor share is exactly equal to the decline in total employment. But in one case, the decline in labor share was less than total employment, meaning that employment growth be359ba680
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