title: Contrast burst depletion imaging (CODIM): a new imaging procedure and analysis method for semiquantitative ultrasonic perfusion imaging.
abstract: OBJECTIVE
  Established methods of ultrasonic perfusion imaging using a bolus application of echo contrast agent provide only qualitative data because of various physical phenomena. This study was intended to investigate whether a new ultrasound perfusion imaging method termed contrast burst depletion imaging (CODIM) may provide semiquantitative measures of parenchymal perfusion independent of examination depth and acoustic energy distribution.
  
  
  METHODS
  In a system with a constant concentration of contrast agent, analyzing the decrease in image intensity that occurs with microbubble-destructive imaging modes yields parameters that are considered to correlate with tissue perfusion. This method was first evaluated with a perfusion model that showed that the main resulting parameter "perfusion coefficient" (PC) is a monotonic nonlinear function of flow velocity. Seventeen human volunteers were then scanned according to this method with the use of 2 different contrast agents. Results were correlated with those from perfusion-weighted MRI examinations.
  
  
  RESULTS
  The PC did not show significant differences in gray matter areas (ranging from 1.466x10(-2) x s(-1) to 1.641x10(-2) x s(-1)) of the brain despite different insonation depths (eg, ipsilateral and contralateral thalamus). In contrast, white matter exhibited significantly lower perfusion values in both imaging modes (PC: 0.604x10(-2) x s(-1) to 0.745x10(-2) x s(-1); P<0.05).
  
  
  CONCLUSIONS
  CODIM is a promising new tool of imaging parenchymal (brain) perfusion in healthy persons. The method provides semiquantitative and depth-independent perfusion parameters and in this way overcomes the limitations of the perfusion methods using a bolus kinetic. Further investigations must be done to evaluate the potential of the method in patients with perfusion deficits.
authors.affiliation: Department of Neurology, Ruhr University Bochum, Bochum, Germany. jeyding@web.de
authors.forename: Jens
authors.initials: J
authors.lastname: Eyding
authors.forename: Wilko
authors.initials: W
authors.lastname: Wilkening
authors.forename: Markus
authors.initials: M
authors.lastname: Reckhardt
authors.forename: Gebhard
authors.initials: G
authors.lastname: Schmid
authors.forename: Saskia
authors.initials: S
authors.lastname: Meves
authors.forename: Helmut
authors.initials: H
authors.lastname: Ermert
authors.forename: Horst
authors.initials: H
authors.lastname: Przuntek
authors.forename: Thomas
authors.initials: T
authors.lastname: Postert
mesh_terms: D000328:Adult; D002545:Brain Ischemia / Q000175:diagnosis; D002560:Cerebrovascular Circulation; D004453:Echoencephalography / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D019047:Phantoms, Imaging; D020521:Stroke / Q000175:diagnosis