Transfontanellar contrast enhanced ultrasound in infants: Initial experience

Kastler, Adrian; Manzoni, P.; Chapuy, Sandrine; Cattin, F.; Billon-Grand, C.; Aubry, S.; Biondi, Alessandra; Thiriez, Gérard; Kastler, B.

doi:10.1016/j.neurad.2013.11.001

Cited by 24 publications

(37 citation statements)

References 31 publications

(29 reference statements)

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“…Ten out of 12 neonates exhibited enhancement abnormalities on TCEUS. TCEUS successfully defined brain perfusion abnormalities (9/10 neonates) and several hypovascular (4/10 neonates) and avascular lesions (5/10 neonates) that were felt to represent ischemic pathology . In addition to areas of hypo/avascularity, TCEUS successfully defined arterially enhancing mass‐like lesions in one neonate that was concordant with MRI and consistent with cortical tubers of tuberous sclerosis …”

Section: Contrast‐enhanced Ultrasoundmentioning

confidence: 86%

“…When compared with MRI findings, TCEUS findings concerning for regional ischemia were accurate in the majority of cases, with either good or excellent correlation (10/12 neonates). In cases that were deemed to be discordant, TCEUS underestimated the extent of ischemic or hemorrhagic injury . Calculated sensitivity and specificity for detecting pathological brain lesions in neonates was 88.9% and 66.6%, respectively .…”

Section: Contrast‐enhanced Ultrasoundmentioning

confidence: 93%

“…In cases that were deemed to be discordant, TCEUS underestimated the extent of ischemic or hemorrhagic injury . Calculated sensitivity and specificity for detecting pathological brain lesions in neonates was 88.9% and 66.6%, respectively . For comparison, in larger samples of adults presenting after acute stroke, transcranial ultrasound has demonstrated a sensitivity and specificity for localizing areas of infarction ranging from 86–100% and 96–100%, respectively .…”

Section: Contrast‐enhanced Ultrasoundmentioning

confidence: 97%

“…Few off‐label studies have examined imaging findings in transfontanellar CEUS (TCEUS) . Kastler and colleagues performed one of the first studies of TCEUS in 2013 . Kastler examined several neonates with suspected neurological conditions using TCEUS.…”

Section: Contrast‐enhanced Ultrasoundmentioning

confidence: 99%

“…Specifically, the authors looked for abnormal parenchymal enhancement patterns on arterial, venous, and delayed phases to define regions of abnormal perfusion and masses/lesions. TCEUS findings were then correlated with brain MRI . Twelve neonates underwent TCEUS and MRI.…”

Section: Contrast‐enhanced Ultrasoundmentioning

confidence: 99%

See 4 more Smart Citations

Contrast‐Enhanced Ultrasound and Elastography Imaging of the Neonatal Brain: A Review

Bailey

Huisman

Jong

et al. 2017

Journal of Neuroimaging

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Neonates presenting with neurologic symptoms require rapid, noninvasive imaging with high spatial resolution and tissue contrast. Magnetic resonance imaging (MRI) is currently the most sensitive and specific imaging modality for evaluation of neurological pathology. This modality does come with several challenges in the neonatal population, namely, the need to transport a possibly critically sick neonate to the MRI suite and the necessity of the neonate to remain still for a significant length of time, occasionally requiring sedation. Cranial ultrasound has provided radiologists and clinicians with an invaluable imaging modality that allows of rapid, bedside point of care evaluation without ionizing radiation. The major drawback of cranial ultrasound is its lower sensitivity and specificity for subtle/early lesions. Contrast-enhanced ultrasound (CEUS) and elastography have the potential to improve sensitivity and specificity for a variety of neuropathology but also expand the indications for cranial ultrasound. Goal of this paper is to present and discuss CEUS and elastography for neonatal brain imaging.

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Section: Contrast‐enhanced Ultrasoundmentioning

confidence: 86%

Section: Contrast‐enhanced Ultrasoundmentioning

confidence: 93%

Section: Contrast‐enhanced Ultrasoundmentioning

confidence: 97%

Section: Contrast‐enhanced Ultrasoundmentioning

confidence: 99%

Section: Contrast‐enhanced Ultrasoundmentioning

confidence: 99%

See 3 more Smart Citations

Contrast‐Enhanced Ultrasound and Elastography Imaging of the Neonatal Brain: A Review

Bailey

Huisman

Jong

et al. 2017

Journal of Neuroimaging

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Novel Contrast‐Enhanced Ultrasound Evaluation in Neonatal Hypoxic Ischemic Injury: Clinical Application and Future Directions

Hwang

Jong

Herman

et al. 2017

J of Ultrasound Medicine

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Sensitive, specific, and safe bedside evaluation of brain perfusion is key to the early diagnosis, treatment, and improved survival of neonates with hypoxic ischemic injury. Contrast-enhanced ultrasound (US) imaging is a novel imaging technique in which intravenously injected gas-filled microbubbles generate enhanced US echoes from an acoustic impedance mismatch. This article describes contrast-enhanced US imaging in 2 neonates with hypoxic ischemic injury and future directions on developing quantitative contrast-enhanced US techniques for improved characterization of perfusion abnormalities. The importance of studying the temporal evolution of brain perfusion in neonatal hypoxic ischemic injury is also highlighted.

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Contrast‐Enhanced Brain Ultrasound Perfusion Metrics in the EXTra‐Uterine Environment for Neonatal Development (EXTEND): Correlation With Hemodynamic Parameters

Lawrence

Coons

Sridharan

et al. 2021

J of Ultrasound Medicine

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Objectives-Contrast-enhanced ultrasound (CEUS) can provide quantitative perfusion metrics and may be useful to detect cerebral pathology in neonates and premature infants, particularly in extrauterine environments. The effect of hemodynamics on cerebral perfusion metrics is unknown, which limits the clinical application of this technology. We aimed to determine associations between systemic hemodynamics and concurrently measured brain perfusion parameters in an animal model of extrauterine support.Methods-Nine fetal lambs were transferred to an extrauterine support device. Lumason® ultrasound contrast (0.1-0.3 ml) was administered via the umbilical vein and 90-second cine clips were obtained. Time-intensity-curves (TICs) were generated and time-dependent and area-undercurve (AUC) parameters were derived. Associations between brain perfusion metrics and hemodynamics including heart rate (HR) and mean arterial pressure (MAP) were evaluated by multilevel linear mixed-effects models.Results-Eighty-six ultrasound examinations were performed and 72 examinations were quantifiable. Time-dependent measurements were independent of all hemodynamic parameters (all p ≥.05). Oxygen delivery and mean blood flow were correlated with AUC measurements (all p ≤.01). Physiologic HR and MAP were not correlated with any measurements (all p ≥.05).Conclusion-Detected aberrations in time-dependent CEUS measurements are not correlated with hemodynamic parameters and are thought to reflect the changes in cerebral blood flow, thus providing a promising tool for evaluation of brain perfusion. CEUS brain perfusion parameters are not correlated with physiologic HR and MAP, but AUC-dependent measurements are correlated with oxygen delivery and blood flow, suggesting that CEUS offers additional value over standard monitoring. Overall, these findings enhance the applicability of this technology.

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Transfontanellar contrast enhanced ultrasound in infants: Initial experience

Cited by 24 publications

References 31 publications

Contrast‐Enhanced Ultrasound and Elastography Imaging of the Neonatal Brain: A Review

Contrast‐Enhanced Ultrasound and Elastography Imaging of the Neonatal Brain: A Review

Novel Contrast‐Enhanced Ultrasound Evaluation in Neonatal Hypoxic Ischemic Injury: Clinical Application and Future Directions

Contrast‐Enhanced Brain Ultrasound Perfusion Metrics in the EXTra‐Uterine Environment for Neonatal Development (EXTEND): Correlation With Hemodynamic Parameters

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