Changes of Contrast-Specific Ultrasonic Cerebral Perfusion Patterns in the Course of Stroke; Reliability of Region-Wise and Parametric Imaging Analysis

Eyding, Jens; Nolte-Martin, Anke; Krogias, Christos; Postert, Thomas

doi:10.1016/j.ultrasmedbio.2006.08.013

Cited by 18 publications

(24 citation statements)

References 8 publications

(26 reference statements)

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“…Several studies have shown that such parameters may be suitable for assessment of the perfusion state, particularly the analysis of local time-intensity curves in prespecified ROI [37] or the visual interpretation of parametric images [52,53,54,55,56]. MRI and PET studies in acute stroke patients have demonstrated the diagnostic value of TPIs maps for differentiation between unaffected parenchyma, penumbra, and ischemic core area [57].…”

Section: Examination Of the Microcirculation – Brain Perfusion Imagingmentioning

confidence: 99%

“…Different nonlinear imaging modalities (harmonic imaging, power modulation, and pulse inversion imaging) with high MI triggering and different contrast agents (Levovist, Optison, and SonoVue) were used [36, 37, 53, 55, 58,69,70,71,72,73,74,75,76,77]. With new, more sensitive multipulse ultrasound technologies, it is possible to analyze brain perfusion not only in the ipsilateral but also in the contralateral hemisphere within one investigation, improving the geometry of the insonation plane and overcoming near-field artifacts [55, 75]. When using this approach, additional artifacts (calcification of the pineal gland and choroid plexus of lateral ventricles causing shadowing artifacts) have to be considered.…”

Section: Examination Of the Microcirculation – Brain Perfusion Imagingmentioning

confidence: 99%

“…8). These images provide information on the time intensity data of all pixels under evaluation, thus facilitating the visualization and documentation of the perfusion state [55, 64]. Although the supplying artery was found patent by color-coded duplex, in 13–14% of acute ischemic stroke patients a perfusion deficit in the MCA territory could be identified with parametric perfusion imaging [37, 64].…”

Section: Examination Of the Microcirculation – Brain Perfusion Imagingmentioning

confidence: 99%

“…Another critical point in detection of perfusion deficits in acute ischemic stroke is the time window for detection. A study on ischemic stroke patients in the acute (<12 h) and the subacute (>28 h) phase showed that the detection rate of lesions decreases with time [55]. Reperfusion phenomena may impair the diagnostic impact in later examination.…”

Section: Examination Of the Microcirculation – Brain Perfusion Imagingmentioning

confidence: 99%

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Ultrasound Contrast Agents in Ischemic Stroke

Seidel

Meairs²

2009

Cerebrovasc Dis

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The general indication for the use of ultrasound contrast agents in neurosonologic applications is an insufficient signal-to-noise ratio when investigating the cerebral macro- and microcirculation. Clinical problems that are often encountered in native sonography are ‘no flow, slow flow and low flow’ phenomena. In these cases, ultrasound contrast agents are used to differentiate between vessel occlusion and insufficient insonation conditions, as well as for the detection of very slow blood flow velocities and low flow volumes. Echo-contrast agents significantly increase the success rate of transcranial color duplex examinations of patients with acute cerebrovascular disease. Ultrasound contrast imaging also allows assessment of the cerebral microcirculation. There are a number of techniques available for performing perfusion studies. These generally utilize high mechanical index imaging, since until recently lower acoustic outputs were unable to detect microbubbles in the brain. New-generation microbubbles in combination with very sensitive contrast-specific ultrasound techniques now enable real-time visualization of stroke. Moreover, destruction sequences with assessment of microbubble replenishment using real-time, low mechanical index imaging are now available. This article reviews of state-of-the-art contrast-specific imaging techniques for ultrasound evaluation of acute stroke patients.

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Section: Examination Of the Microcirculation – Brain Perfusion Imagingmentioning

confidence: 99%

Section: Examination Of the Microcirculation – Brain Perfusion Imagingmentioning

confidence: 99%

Section: Examination Of the Microcirculation – Brain Perfusion Imagingmentioning

confidence: 99%

Section: Examination Of the Microcirculation – Brain Perfusion Imagingmentioning

confidence: 99%

See 2 more Smart Citations

Ultrasound Contrast Agents in Ischemic Stroke

Seidel

Meairs²

2009

Cerebrovasc Dis

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“…Several studies have shown that such parameters may be suitable for assessment of the perfusion state, particularly the analysis of local time-intensity curves in prespecified regions of interest [5] or the visual interpretation of parametric images [15,16,17,18,19]. MRI and PET studies in acute stroke patients have demonstrated the diagnostic value of TPI maps for differentiation between unaffected parenchyma, penumbra, and ischemic core area [20].…”

Section: Bolus Kineticsmentioning

confidence: 99%

Contrast-Enhanced Ultrasound Perfusion Imaging in Acute Stroke Patients

Meairs

2008

Eur Neurol

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The field of neurovascular ultrasound is expanding rapidly with exciting new applications. While ultrasound contrast agents were initially used to overcome insufficient transcranial bone windows for identification of the basal cerebral arteries, new-generation microbubbles in combination with very sensitive contrast-specific ultrasound techniques now enable real-time visualization of stroke. This article will provide a review of recent and emerging developments in ultrasound technology and contrast-specific imaging techniques for evaluation of acute stroke patients.

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