title: Clinical utility of echocontrast agents in neurosonology.
abstract: BACKGROUND
  Neurosonological investigations of the extracranial and intracranial brain supplying arteries are helpful in the assessment of stroke and stroke-prone patients.
  
  
  METHODS
  In this paper we review the indications, application and advantages of second-generation (gas-filled) microbubble contrast agents such as SonoVue.
  
  
  RESULTS
  Gas-filled microbubbles have a strong echo enhancing effect and produce enhancement for several minutes, enabling the sonographer to perform the investigation with a single injection or two or three repeated injections without the need for continuous administration. Echocontrast agents provide better delineation of normal blood flow, occlusions, pseudo-occlusions, stenoses, and collaterals in the extracranial and intracranial vascular beds. They are of particular value during transcranial color-coded transcranial duplex investigations via the temporal and occipital window.
  
  
  CONCLUSIONS
  Echocontrast agents give additional information on the patient's vascular situation that is often crucial to planning further diagnostic and therapeutic steps. The use of second-generation gas-filled microbubbles, such as SonoVue in transcranial neurosonology, may help to avoid unnecessary, expensive and potentially harmful additional investigations such as intra-arterial DSA. Future applications include the visualization of brain tissue perfusion.
authors.affiliation: Service de Neurologie, Centre Hospitalier de Luxembourg, 4, rue Barblé, L-1210, Luxembourg. droste.dirk@chl.lu
authors.forename: Dirk W
authors.initials: DW
authors.lastname: Droste
authors.forename: René J
authors.initials: RJ
authors.lastname: Metz
mesh_terms: D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging*; D006801:Humans; D010743:Phospholipids; D013459:Sulfur Hexafluoride; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*
chemical_list: D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride