Echography in brain imaging in intensive care unit: State of the art

Abstract

Transcranial sonography (TCS) is an ultrasound-based imaging technique, which allows the identification of several structures within the brain parenchyma. In the past it has been applied for bedside assessment of different intracranial pathologies in children. Presently, TCS is also used on adult patients to diagnose intracranial space occupying lesions of various origins, intracranial hemorrhage, hydrocephalus, midline shift and neurodegenerative movement disorders, in both acute and chronic clinical settings. In comparison with conventional neuroimaging methods (such as computed tomography or magnetic resonance), TCS has the advantages of low costs, short investigation times, repeatability, and bedside availability. These noninvasive characteristics, together with the possibility of offering a continuous patient neuro-monitoring system, determine its applicability in the monitoring of multiple emergency and non-emergency settings. Currently, TCS is a still underestimated imaging modality that requires a wider diffusion and a qualified training process. In this review we focused on the main indications of TCS for the assessment of acute neurologic disorders in intensive care unit.

Bedside Sonographic Duplex Technique as a Monitoring Tool in Patients after Decompressive Craniectomy: A Single Centre Experience

“…A bedside monitoring method for follow-up during further neurocritical care after DC on the ICU is thus desirable. As shown recently, bedside SDT may have the potential to serve as an adjunct to CCT in the assessment of ventricular dimensions with a high correlation to the "gold standard" [10][11][12]19]. In the present study, serial quantitative measurements of all four ventricle dimensions in identical patients after DC via SDT were compared to CCT with intraclass correlation coefficients ranging between 0.977 and 0.997 for all three measurements over time.…”

“…Recently, the sonographic duplex technique (SDT) has been suggested as an adjunct to CCT to diagnose and monitor TBI patients after DC [10][11][12]. The sonographic duplex technique has been introduced as a reliable bedside tool that is available in almost every ICU and is already being used by a number of centers to monitor DC patients.…”

Comparison between ultrasonography and computed tomography images for planning and neuronavigation in brain surgeries in dogs as an animal model

“…The value obtained with US is quite similar to that referred to in Schröder et al [36] which found that the left LVV in 67% of all cases was wider than the right LVV. The differences between LVV measurements obtained using US and CT could be because a craniectomy was performed to access the brain when acquiring US images, thus inducing changes in the intracranial anatomy and, therefore, bias in the measurements [14,15]. In addition, the LVV measurements obtained using US could change depending on the angle of the probe over the brain surface, thus allowing image collection but not corrections, as is possible with the CT technique [50].…”

“…Unlike US, access to CT and magnetic resonance (MR) techniques in veterinary medicine is limited to point centres. Compared with conventional neuroimaging methods, such as CT and MR, US is operator-dependent and have the advantages of low costs, short investigation times and repeatability; in addition, it does not have any harmful biological effects [14][15][16][17]. It is particularly suitable for imaging soft tissue and blood vessels.…”

Advances in Cerebral Monitoring for the Patient with Traumatic Brain Injury

“…17 Direct visualization of the brain using ultrasound can be done as well to monitor for midline shift, hydrocephalus, and hemorrhage. 18 Measurement from flow velocity tracings and calculated values (eg, Lindegaard ratio) are useful to evaluate for cerebral artery vasospasm. 17,19 The TCD Pulsatility Index may provide a noninvasive estimation of ICP by acting as a measure of increased resistance in distal arterioles.…”