case_images: PMC4696245_01
case_images: Contrast enhanced scans (axial view in a, c, e and sagittal view in b, d, f) several months prior to treatment (a, b), directly after treatment showing a non-perfused volume (c, d), and at 3 months follow-up showing a reduction in size of the malformation (e, f)
case_images: 40349_2015_42_Fig1_HTML.jpg
case_images: PMC4696245_01_40349_2015_42_Fig1_HTML.jpg
case_images: Fig1
case_images: TSE spectral presaturation with inversion recovery (SPIR), Fig. 1a, b), and a digital subtraction angiogram (MRA) (Fig. 2). The lesion had a volume of 1.9 mL. When comparing the pre- and post-treatment contrast-enhanced scans, the targeted region within the vascular malformation showed no enhancement after treatment (Fig. 1c, d). At 3-month follow-up, a contrast-enhanced scan (T1 SPIR) was performed (Fig. 1e, f), which showed a decrease in volume of the lesion of >30 % (rest volume of 1.3 mL, software Osirix, Pixmeo, Switzerland). The part of the vascular malformation that was targeted with HIFU showed a large decrease in size, whilst the part adjacent to the nerves and main vessels, which was not targeted, was still intact (Fig. 1e, f).
case_images: Set-up of the HIFU including the device for active skin cooling, which is integrated in the MR scanner (a). Temperature measurement during HIFU treatment. b Coronal and (c) sagittal views
case_images: 40349_2015_42_Fig3_HTML.jpg
case_images: PMC4696245_01_40349_2015_42_Fig3_HTML.jpg
case_images: Fig3
case_images: An actively cooled water cushion provided skin cooling and enhanced acoustic coupling (Fig. 3a). This allowed the physician to observe the heating in and outside the target area (Fig. 3).