Ultrasonic evaluation with second harmonic imaging and SonoVue in the assessment of cerebral perfusion in diabetic patients: a case-control study

Abstract

The purpose was to compare human brain tissue perfusion in diabetic patients and healthy subjects with second harmonic imaging ultrasound and SonoVue to test the hypothesis that brain tissue perfusion differences are present in these two groups of patients. In a prospective case-control study, second harmonic examinations performed in 20 patients with type II diabetes mellitus and in 20 matched control patients were compared. After administration of 2.5 ml of SonoVue, 60 time-triggered images were recorded. Time-intensity curves, including peak intensity and positive gradient normalized to the middle cerebral artery, were calculated to quantify ultrasound intensity in a region of interest. The Mann-Whitney U-test was used to reveal any differences between healthy and diabetic subjects. Mean peak intensity was 0.64+/-0.1 Au in healthy subjects and 0.53+/-0.09 Au in diabetic patients. Mean positive gradient was 0.04+/-0.007 Au/s in healthy subjects and 0.04+/-0.008 Au/s in diabetic patients. Peak intensity and positive gradient were significantly lower in diabetic patients than in healthy subjects (P<0.05). Ultrasound examination with second harmonic imaging and SonoVue administration is able to detect clinically silent, reduced cerebral perfusion in type II diabetic patients. Diabetic patients have reduced cerebral perfusion in comparison to healthy subjects.

Ultrasound contrast agents as markers of vascularity and microcirculation

“…Sharply delineated contrast defects can indicate traumatic lacerations [16,17], filled by thrombosed blood (no microbubble entry) or with still active bleeding (microbubbles leave the vascular bed into the defect). Reduced peak enhancement compared to normal tissue indicates hypoemia [18], delayed contrast inflow may indicate a stenosis in a supplying artery [19]. Increased peak enhancement may be due to neoangiogenesis (resulting from regenerative or neoplastic processes) [20,21] or vasodilatation (e.g.…”