Transcranial contrast-enhanced ultrasonography with Sonazoid in semiquantitative evaluation of brain perfusion
- PDF / 362,012 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 75 Downloads / 158 Views
ORIGINAL ARTICLE
Transcranial contrast-enhanced ultrasonography with Sonazoid in semiquantitative evaluation of brain perfusion Kozue Saito • Toshiko Hirai • Satoshi Ueno
Received: 15 June 2012 / Accepted: 1 October 2012 / Published online: 28 February 2013 Ó The Japan Society of Ultrasonics in Medicine 2013
Abstract Purpose To semiquantitatively evaluate brain perfusion by transcranial contrast-enhanced ultrasonography (TCEUS) using Sonazoid. Methods We performed TCEUS in 11 healthy volunteers and seven patients with occlusive cerebrovascular disease involving the anterior circulation. After recording first-pass perfusion images on one side of the head and flushreplenishment (FR) images on both sides, we measured the time from arrival to peak (TAP) and peak intensity (PI) at first pass. Using the FR method, plateau value (A) and rise rate (b) of intensity (I) were obtained from the curve I(t) = A(1 - e-b*t). Results In the patients, TAP was longer and PI was smaller in middle cerebral artery (MCA) areas than in posterior cerebral artery (PCA) areas on the ipsilesional side of the head (p \ 0.05). A and b were smaller in MCA areas than in PCA areas on the ipsilesional side of the head (p \ 0.05), while these parameters showed no apparent differences between MCA and PCA areas in the volunteers. Conclusion TCEUS with Sonazoid allows effective semiquantitative evaluation of brain perfusion. Keywords Transcranial ultrasound perfusion imaging Ultrasound contrast agent Brain ischemia
K. Saito (&) S. Ueno Department of Neurology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan e-mail: [email protected] T. Hirai Department of Endoscopy and Ultrasound, Nara Medical University, Kashihara, Japan
Introduction Transcranial ultrasound brain perfusion assessments have advanced with the development of contrast agents. While new contrast agents that are stable in vivo have recently been developed overseas, Levovist is the only contrast agent currently approved for brain perfusion studies in Japan. Shiogai et al. showed that perfusion imaging using transcranial contrast-enhanced ultrasonography (TCEUS) with Levovist allowed repeatable non-invasive bedside evaluation of brain perfusion, including cerebrovascular reserve capacity [1, 2]. Because TCEUS with Levovist is based on the destruction of microbubbles by high mechanical index (MI) pulses, this method mainly shows the vascular structure of the major cerebral arteries in real time. To visualize perfusion images of brain parenchyma, we have to wait for microbubbles to refill in the scanning plane before the next scan can be performed. However, second-generation contrast agents such as Optison (Nycomed-Amersham, Oslo, Norway) and SonoVue (Bracco, Milan, Italy) containing less-soluble gases for microbubbles are being developed to allow resonance without destruction of microbubbles, and are available in a limited number of Western countries. TCEUS using these second-generation contrast agents allows visualization of brain perfusion images in real
Data Loading...
