title: Ultrasound perfusion imaging in acute middle cerebral artery infarction predicts outcome.
abstract: 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.
authors.affiliation: Department of Neurology, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160 D-23538 Lübeck, Germany. seidel_g@neuro.mu-luebeck.de
authors.forename: Günter
authors.initials: G
authors.lastname: Seidel
authors.forename: Karsten
authors.initials: K
authors.lastname: Meyer-Wiethe
authors.forename: Grit
authors.initials: G
authors.lastname: Berdien
authors.forename: Dirk
authors.initials: D
authors.lastname: Hollstein
authors.forename: Daniel
authors.initials: D
authors.lastname: Toth
authors.forename: Til
authors.initials: T
authors.lastname: Aach
mesh_terms: 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
chemical_list: D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride