title: Semiquantitative human cerebral perfusion assessment with ultrasound in brain space-occupying lesions: preliminary data.
abstract: OBJECTIVE
  Transcranial Duplex ultrasound imaging with ultrasound contrast agents is an emerging technique for evaluating brain perfusion. The aim of this study was to evaluate cerebral perfusion with ultrasound in brain space-occupying lesions to identify different perfusion patterns.
  
  
  METHODS
  Twenty patients with brain space-occupying lesions underwent ultrasound assessment of brain perfusion with a contrast pulse sequencing nonharmonic ultrasound technique and an ultrasound contrast agent bolus. Data were analyzed with software for semiquantitative analysis.
  
  
  RESULTS
  Contrast pulse sequencing imaging with the semiquantitative analysis software allowed identification of qualitative and semiquantitative brain perfusion. Brain hemorrhages showed lower or absent perfusion compared with normal tissue. Meningiomas and glioblastomas without large necrotic areas showed higher perfusion compared with normal tissue. Glioblastomas with large necrotic areas showed overall reduced perfusion compared with normal tissue but higher than that of brain hemorrhages. In glioblastomas with large necrotic areas, it was possible to distinguish between solid and necrotic tissue.
  
  
  CONCLUSIONS
  This bedside ultrasound technique, if validated by larger-scale studies, may add helpful information in noninvasive staging of brain tumors. Further potential applications may be in follow-up imaging to evaluate postoperative tumor recurrence or the presence of radionecrosis.
authors.affiliation: Department of Neurological Sciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy. edoardo.vicenzini@uniroma1.it
authors.forename: Edoardo
authors.initials: E
authors.lastname: Vicenzini
authors.forename: Roberto
authors.initials: R
authors.lastname: Delfini
authors.forename: Francesca
authors.initials: F
authors.lastname: Magri
authors.forename: Francesco
authors.initials: F
authors.lastname: Puccinelli
authors.forename: Marta
authors.initials: M
authors.lastname: Altieri
authors.forename: Antonio
authors.initials: A
authors.lastname: Santoro
authors.forename: Maria Fabrizia
authors.initials: MF
authors.lastname: Giannoni
authors.forename: Luigi
authors.initials: L
authors.lastname: Bozzao
authors.forename: Vittorio
authors.initials: V
authors.lastname: Di Piero
authors.forename: Gian Luigi
authors.initials: GL
authors.lastname: Lenzi
mesh_terms: D001810:Blood Volume / Q000502:physiology; D001927:Brain Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003287:Contrast Media; D005909:Glioblastoma / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging; D008579:Meningioma / Q000000981:diagnostic imaging / Q000503:physiopathology; D045423:Microbubbles; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging; D009336:Necrosis; D012984:Software; D013997:Time Factors; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods
chemical_list: D003287:Contrast Media