Ultrafast Doppler Vascular Imaging for Intraoperative Physiological Monitoring of Human Spinal Cord

Monitoring physiological parameters is essential for assessing the patient's condition during intraoperative scenarios. Hemodynamic information, such as blood pressure and heart rate, can be derived from ultrasound Doppler signals, reflecting vascular function and indicating pathological risks in real-time. Compared to oscillometry, magnetic resonance imaging (MRI), conventional Doppler, and piezoelectric methods, ultrafast Doppler provides superior temporal resolution and high sensitivity for small vessels. In this study, an intraoperative application of ultrafast Doppler imaging in the spinal cord of a patient with Chiari malformation is described. Post-processing of the data generated power Doppler images of the spinal cord vasculature and physiological parameters, including detailed mapping of the resistivity index (RI) and pulsatility index (PI). Both RI and PI showed significant reductions after surgical intervention (RI mean: 0.47 → 0.32; PI mean: 0.63 → 0.39; p < 0.001), with consistent trends observed in the medians, indicating improved spinal cord hemodynamics. Evaluation of changes in PI/RI parameters using this method may offer a broader understanding of disease progression and treatment efficacy, potentially guiding surgical strategies and therapeutic approaches.