Parameters of cerebral perfusion in phase-inversion harmonic imaging (PIHI) ultrasound examinations.
The aim was to evaluate phase-inversion harmonic imaging (PIHI) with respect to brain perfusion imaging using a novel "bilateral approach" (depth of examination: 150 mm) and established unilateral approach (100 mm). After bolus injection of two contrast agents (CA, Optison and SonoVue), perfusion-related parameters (time-to-peak intensity, Itpk, peak intensity, Ipk, and peak width, Wpk) were extracted by fitting a model function to time-intensity curves for different regions-of-interest (ROI) in 14 volunteers. In 207 (92%) of 224 ipsilateral ROIs and in 165 (98%) of 168 contralateral ROIs (372 or 95% of 392 altogether), parameters could be derived. Itpk and Wpk of gray matter ROIs did not vary in or between both CA groups (18.1-21.9 s and 7.9-14.2 s). ROIs within arteries showed significantly shorter Itpk (16.1-16.7 s) and longer Wpk (12.8-28.3 s). Level of significance was 0.05 (two-sided). Newer CAs are usable for nonlinear imaging over a wider range of acoustic intensities, so that sensitivity of PIHI is sufficient to image the brain bilaterally. This approach proves to be reliable in patients with adequate bone windows. For acute stroke patients, this implies that both hemispheres can be compared in one instead of two examinations, reducing time of examination by 50%. Furthermore, evaluation of regions close to the probe becomes possible. Thus, the "bilateral approach" should be considered as a new standard approach of acute ultrasonic perfusion imaging.
Department of Neurology, St. Josef Hospital, Ruhr-University Bochum, Ruhr Center of Competence for Medical Engineering, Bochum, Germany. jeyding@web.de
Jens
J
Eyding
Christos
C
Krogias
Wilko
W
Wilkening
Saskia
S
Meves
Helmut
H
Ermert
Thomas
T
Postert
D000328:Adult; D000418:Albumins; D002560:Cerebrovascular Circulation; D003287:Contrast Media; D004453:Echoencephalography / Q000379:methods*; D005260:Female; D005466:Fluorocarbons; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D010743:Phospholipids; D013459:Sulfur Hexafluoride; D017585:Ultrasonography, Doppler, Transcranial
D000418:Albumins; D003287:Contrast Media; C099458:FS 069; D005466:Fluorocarbons; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride