Ultrasound perfusion imaging in acute middle cerebral artery infarction predicts outcome.
OBJECTIVE
Initial reports indicate that transcranial harmonic imaging after ultrasound contrast agent bolus injection (BHI) can detect cerebral perfusion deficits in acute ischemic stroke. We evaluated parametric images of the bolus washout kinetics.


METHODS
Twenty-three patients with acute internal carotid artery infarction were investigated with perfusion harmonic imaging after SonoVue bolus injection < or =40 hour after the onset of symptoms. The findings were compared with those of cranial computed tomography (CCT) and clinical course 4 months after stroke.


RESULTS
Images of pixel-wise peak intensity (PPI) and time to peak intensity could be calculated for all patients. Spearman rank correlations of r=0.772 (P<0.001) and r=0.572 (P=0.008) between area of PPI signal decrease and area of infarction in the follow-up CCT as well as outcome after 4 months were obtained, respectively.


CONCLUSIONS
In the early phase of acute ischemic stroke, BHI after SonoVue bolus injection is a useful ultrasound tool for analyzing cerebral perfusion deficits at the patient's bedside. BHI data correlate with the definite area of infarction and outcome after 4 months.
Seidel
Günter
G
Department of Neurology, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160 D-23538 Lübeck, Germany. seidel_g@neuro.mu-luebeck.de
Meyer-Wiethe
Karsten
K
Berdien
Grit
G
Hollstein
Dirk
D
Toth
Daniel
D
Aach
Til
T
D000208:Acute Disease; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D020244:Infarction, Middle Cerebral Artery / Q000175:diagnosis / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging*; D017063:Outcome Assessment, Health Care; D010743:Phospholipids; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D013459:Sulfur Hexafluoride; D018617:Ultrasonography, Doppler, Pulsed / Q000379:methods / Q000706:statistics & numerical data; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods / Q000706:statistics & numerical data
D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride