title: Transcranial duplex imaging with a sulfurhexafluoride echocontrast agent: enhancement and diagnostic quality.
abstract: OBJECTIVE
  The authors investigate characteristics of ultrasound enhancement and diagnostic quality of a sulfurhexafluorides (SF6)-containing echocontrast agent (SonoVue) in cerebrovascular patients with insufficient temporal bone window by transcranial color-coded duplex (TCCD) sonography.
  
  
  METHODS
  Thirty patients (mean age = 62.2 +/- 11.1 years) were enrolled. SF6 was administered intravenously in 4 different doses (0.3, 0.6, 1.2, and 2.4 mL). By videotape analysis, time to contrast appearance, duration of contrast enhancement, and duration of clinically useful signal enhancement were measured. Overall quality of ultrasound investigation was also assessed.
  
  
  RESULTS
  Time to contrast appearance ranged from 11 to 74 seconds (mean = 26 seconds). For the 0.3, 0.6, 1.2, and 2.4 mL doses, average times to contrast appearance of 30 +/- 12 seconds, 28 +/- 10 seconds, 23 +/- 8 seconds, and 22 +/- 6 seconds were measured. Duration of TCCD signal enhancement was 438 +/- 169 seconds, 483 +/- 195 seconds, 713 +/- 299 seconds, and 788 +/- 344 seconds for the different doses. Clinically useful enhancement was 160 +/- 124 seconds, 200 +/- 157 seconds, 260 +/- 166 seconds, and 327 +/- 239 seconds.
  
  
  CONCLUSIONS
  Administration of SonoVue led to a quality improvement in 21 patients. In TCCD, it optimizes visualization of the cerebral arteries in patients with inadequate bone window. A dose of at least 1.2 mL provides the best enhanced images.
authors.affiliation: Department of Neurology, Neurosonology and Stroke Program Unit, University Hospital Basel, Basel, Switzerland.
authors.forename: K
authors.initials: K
authors.lastname: Schweikert
authors.forename: C
authors.initials: C
authors.lastname: Operschall
authors.forename: J B
authors.initials: JB
authors.lastname: Llull
authors.forename: P
authors.initials: P
authors.lastname: Lyrer
mesh_terms: D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging*; D003287:Contrast Media / Q000008:administration & dosage / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010743:Phospholipids / Q000008:administration & dosage / Q000493:pharmacokinetics; D018709:Statistics, Nonparametric; D013459:Sulfur Hexafluoride / Q000008:administration & dosage / Q000493:pharmacokinetics; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*; D014743:Videotape Recording
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride