title: Diagnostic transcranial ultrasound perfusion-imaging at 2.5 MHz does not affect the blood-brain barrier.
abstract: The purpose was to assess whether standard ultrasound (US) perfusion-imaging by means of contrast-enhanced transcranial color-coded sonography (TCCS) affects the blood-brain barrier (BBB) in patients with small-vessel disease (SVD). One week after a screening MRI to exclude a preexisting BBB disruption, unilateral TCCS phase inversion harmonic imaging (PIHI) was performed in an axial diencephalic plane after intravenous bolus application of 2.5 mL SonoVue (IGEA, Bracco, Italy). Magnetic resonance imaging (MRI) was performed immediately after US. In five patients, PIHI was performed applying a mean mechanical index (MI) of 0.7 +/- 0.1 for a time period of 2.5 min. MRI was started 12 +/- 2 min after US contrast injection. Comparisons of initial and post-US MRI by four blinded readers did not show any signs of BBB disruption. It is concluded that standard contrast-enhanced US perfusion imaging in patients with SVD did not lead to MRI-detectable BBB changes. This gives further evidence for safety of diagnostic US. Future investigations with larger sample sizes and higher-field MRI might give further insights into potential bioeffects of diagnostic, as well as therapeutic, contrast-enhanced transcranial US.
authors.affiliation: Department of Neurology and Berlin Neuroimaging Center Berlin, Charité, Germany. jan.jungehuelsing@charite.de
authors.forename: Gerhard J
authors.initials: GJ
authors.lastname: Jungehulsing
authors.forename: Peter
authors.initials: P
authors.lastname: Brunecker
authors.forename: Christian H
authors.initials: CH
authors.lastname: Nolte
authors.forename: Jochen B
authors.initials: JB
authors.lastname: Fiebach
authors.forename: Claudia
authors.initials: C
authors.lastname: Kunze
authors.forename: Florian
authors.initials: F
authors.lastname: Doepp
authors.forename: Arno
authors.initials: A
authors.lastname: Villringer
authors.forename: Stephan J
authors.initials: SJ
authors.lastname: Schreiber
mesh_terms: D000328:Adult; D000368:Aged; D001812:Blood-Brain Barrier; D002544:Cerebral Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003287:Contrast Media; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010743:Phospholipids; D013459:Sulfur Hexafluoride; D013788:Thalamus / Q000098:blood supply; D013997:Time Factors; D018615:Ultrasonography, Doppler, Color / Q000009:adverse effects / Q000379:methods; D017585:Ultrasonography, Doppler, Transcranial / Q000009:adverse effects* / Q000379:methods
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride