Real-Time and Spatial Quantification Using Contrast-Enhanced Ultrasonography of Spinal Cord Perfusion During Experimental Spinal Cord Injury

Soubeyrand, Marc; Laemmel, Elisabeth; Dubory, Arnaud; Vicaut, Éric; Court, Charles; Duranteau, Jacques

doi:10.1097/brs.0b013e318269790f

Cited by 24 publications

(27 citation statements)

References 21 publications

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“…Throughout the experiment, the ultrasound machine was alternatively set on ''harmonic'' mode or on ''B'' mode. The ''harmonic'' mode allows to measure SCBF, thanks to the CEU technique described below while the ''B'' mode (i.e., ''Brightness mode'') provides morphological grayscale slices and allows to visualize the parenchymal hemorrhage [17]. The ultrasound slice remained constant throughout the experiment, as the spine and ultrasound probe were locked into the stereotaxic frame.…”

Section: Surgical Preparation and Experimental Protocolmentioning

confidence: 99%

“…The CEU technique relies on injection of a contrast agent composed of microbubbles filled with sulfur hexafluoride and ranging in size from 1 to 10 lm [17]. The microbubbles reflect the ultrasound waves emitted by the probe, thereby increasing tissue echogenicity.…”

Section: Contrast-enhanced Ultrasonography (Ceu)mentioning

confidence: 99%

“…2). Indeed, we have previously shown that both these regions correspond to the penumbra zone where SCBF is decreased [17]. The ROIs were positioned identically for each acquisition.…”

Section: Contrast-enhanced Ultrasonography (Ceu)mentioning

confidence: 99%

“…A few experimental studies evaluated epinephrine, another catecholamine, and found no improvement in posttraumatic SCBF, as well as a trend toward larger parenchymal hemorrhage size [13][14][15][16]. Recently, our team has shown that contrast-enhanced ultrasonography (CEU) is a valuable tool to assess realtime and in vivo both the spinal cord ischemia and the parenchymal hemorrhage in the settings of experimental spinal cord injuries [17].…”

Section: Introductionmentioning

confidence: 99%

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Effect of norepinephrine on spinal cord blood flow and parenchymal hemorrhage size in acute-phase experimental spinal cord injury

Soubeyrand

Dubory

Laemmel³

et al. 2013

Eur Spine J

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Purpose In the acute phase of spinal cord injury (SCI), ischemia and parenchymal hemorrhage are believed to worsen the primary lesions induced by mechanical trauma. To minimize ischemia, keeping the mean arterial blood pressure above 85 mmHg for at least 1 week is recommended, and norepinephrine is frequently administered to achieve this goal. However, no experimental study has assessed the effect of norepinephrine on spinal cord blood flow (SCBF) and parenchymal hemorrhage size. We have assessed the effect of norepinephrine on SCBF and parenchymal hemorrhage size within the first hour after experimental SCI. Methods A total of 38 animals were included in four groups according to whether SCI was induced and norepinephrine injected. SCI was induced at level Th10 by dropping a 10-g weight from a height of 10 cm. Each experiment lasted 60 min. Norepinephrine was started 15 min after the trauma. SCBF was measured in the ischemic penumbra zone surrounding the trauma epicenter using contrast-enhanced ultrasonography. Hemorrhage size was measured repeatedly on parasagittal B-mode ultrasonography slices.Results SCI was associated with significant decreases in SCBF (P = 0.0002). Norepinephrine infusion did not significantly modify SCBF. Parenchymal hemorrhage size was significantly greater in the animals given norepinephrine (P = 0.0002). Conclusion In the rat, after a severe SCI at the Th10 level, injection of norepinephrine 15 min after SCI does not modify SCBF and increases the size of the parenchymal hemorrhage.Keywords Spinal cord injury Á Spinal cord blood flow Á Norepinephrine Á Contrast-enhanced ultrasonography A. Dubory and E. Laemmel have equally contributed to this work. E. Vicaut and J. Duranteau have equally contributed to this work.

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Section: Surgical Preparation and Experimental Protocolmentioning

confidence: 99%

Section: Contrast-enhanced Ultrasonography (Ceu)mentioning

confidence: 99%

“…2). Indeed, we have previously shown that both these regions correspond to the penumbra zone where SCBF is decreased [17]. The ROIs were positioned identically for each acquisition.…”

Section: Contrast-enhanced Ultrasonography (Ceu)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of norepinephrine on spinal cord blood flow and parenchymal hemorrhage size in acute-phase experimental spinal cord injury

Soubeyrand

Dubory

Laemmel³

et al. 2013

Eur Spine J

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“…In recent years, some studies that used ultrasound contrast agents described changes in blood flow perfusion of the spinal cord after acute spinal cord injury in animal models. 5 However, no literature report exists on the evaluation of spinal cord blood flow (SCBF) perfusion using ultrasound contrast agents. Therefore, the current study used real-time gray-scale CEUS to evaluate SCBF perfusion during an operation.…”

Section: Introductionmentioning

confidence: 99%

Evaluating perfusion of thoracic spinal cord blood using CEUS during thoracic spinal stenosis decompression surgery

et al. 2015

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Study design: A clinical study in human spinal cord. Objectives: To evaluate changes in spinal cord blood perfusion in patients with thoracic spinal stenosis using contrast-enhanced ultrasonography and to semiquantitatively analyze blood perfusion changes in compressed spinal cord before and after ventral decompression. Setting: Ultrasound department of a university hospital. Methods: Twelve patients with confirmed thoracic spinal stenosis who needed decompression surgery participated. They underwent an intravenous injection of a contrast agent before and after ventral decompression. Quantitative analysis software (Philips Healthcare, Bothell, WA, USA) was used to perform time-intensity curve (TIC) analysis. The enhanced intensity (ΔI), rise time (ΔT) and slope of the TIC (β) were separately calculated; t-tests of the independent samples were performed on the indicators. Results: The TICs showed no significant differences between compressed spinal cord and normal spinal cord in ΔT, enhanced ΔI and β (P = 0.46, P = 0.23 and P = 0.16, respectively). After ventral decompression, ΔI of the originally compressed spinal cord increased substantially (P = 0.04) compared with ΔI of the normal spinal cord; however, the ΔT and β showed no significant differences (P = 0.18 and P = 0.09, respectively). Comparison of the blood perfusion parameters (that is, ΔT and ΔI) of the compressed spinal cords before and after ventral decompression showed no significant differences (P = 0.14 and P = 0.12, respectively), but β showed significant difference (P = 0.02). Conclusion: Contrast-enhanced ultrasonography can dynamically display spinal cord blood perfusion. The characteristics of blood perfusion can be semiquantitatively analyzed using a software technique.

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Rat model of spinal cord injury preserving dura mater integrity and allowing measurements of cerebrospinal fluid pressure and spinal cord blood flow

et al. 2013

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Purposes Cerebrospinal fluid (CSF) pressure elevation may worsen spinal cord ischaemia after spinal cord injury (SCI). We developed a rat model to investigate relationships between CSF pressure and spinal cord blood flow (SCBF). Methods Male Wistar rats had SCI induced at Th10 (n = 7) or a sham operation (n = 10). SCBF was measured using laser-Doppler and CSF pressure via a sacral catheter. Dural integrity was assessed using subdural methyleneblue injection (n = 5) and myelography (n = 5). Results The SCI group had significantly lower SCBF (p \ 0.0001) and higher CSF pressure (p \ 0.0001) values compared to the sham-operated group. Sixty minutes after SCI or sham operation, CSF pressure was 8.6 ± 0.4 mmHg in the SCI group versus 5.5 ± 0.5 mmHg in the shamoperated group. No dural tears were found after SCI. Conclusion Our rat model allows SCBF and CSF pressure measurements after induced SCI. After SCI, CSF pressure significantly increases.

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Real-Time and Spatial Quantification Using Contrast-Enhanced Ultrasonography of Spinal Cord Perfusion During Experimental Spinal Cord Injury

Cited by 24 publications

References 21 publications

Effect of norepinephrine on spinal cord blood flow and parenchymal hemorrhage size in acute-phase experimental spinal cord injury

Effect of norepinephrine on spinal cord blood flow and parenchymal hemorrhage size in acute-phase experimental spinal cord injury

Evaluating perfusion of thoracic spinal cord blood using CEUS during thoracic spinal stenosis decompression surgery

Rat model of spinal cord injury preserving dura mater integrity and allowing measurements of cerebrospinal fluid pressure and spinal cord blood flow

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