Transcranial contrast imaging of cerebral perfusion in patients with space-occupying intracranial lesions.
OBJECTIVE
The aim of this study was to evaluate a deficit in cerebral perfusion after administration of the contrast agent SonoVue (Bracco Altana Pharma, Konstanz, Germany) in patients with intracranial space-occupying lesions.


METHODS
We used transcranial duplex sonography to examine 10 healthy volunteers and 4 patients. Of the patients, one 55-year-old woman had an intracranial glioblastoma; one 54-year-old woman had an intracranial hemorrhage; and one 49-year-old woman and one 69-year-old man had a malignant middle cerebral artery infarction. A decompressive craniectomy was performed in the 2 patients with malignant middle cerebral artery infarction. Triggered images with pulsing intervals of 1000 milliseconds were used for the evaluation of time-intensity curves in several regions of interest. The mechanical index was set at 1.6; in patients with a craniectomy, the mechanical index was set at 1.1.


RESULTS
In all patients, the perfusion deficit could be recognized in the ipsilateral hemisphere. The superimposition of the sonographic images with those from computed tomography or magnetic resonance imaging showed a good correspondence in shape and size in patients with a craniectomy. In patients without a craniectomy, a rough correspondence with findings from magnetic resonance imaging or computed tomography could be recognized.


CONCLUSIONS
By using contrast-enhanced transcranial duplex sonography, it is possible to image the perfusion deficit in cerebral microcirculation in patients with intracranial space-occupying lesions. These results should be confirmed by more pathologic cases and correlated with magnetic resonance imaging and other neuroimaging techniques. Additionally, further technical development in sonographic systems is necessary to improve the diagnostics of cerebral perfusion deficit.
Bartels
Eva
E
Department of Clinical Neurophysiology, Georg-August-University Göttingen, Robert-Koch-Strasse 40, D-37075 Göttingen, Germany. bartels.eva@t-online.de
Bittermann
Hans-Joachim
HJ
D000328:Adult; D001921:Brain / Q000098:blood supply*; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging*; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D010743:Phospholipids; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*
D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride