Ultrasound perfusion imaging of small stroke involving the thalamus.
OBJECTIVE
Ultrasound (US) perfusion imaging of ischemic stroke has mainly been applied to large middle cerebral artery infarction. We investigated whether small stroke involving the thalamus can also be detected.


METHODS
Phase inversion harmonic imaging (PIHI) was applied to patients with small infarctions involving the thalamus (maximal longitudinal infarct diameter less than 3 cm). PIHI was performed from both the left and right side in axial diencephalic planes. Infarct size and location as well as perfusion properties (MTT maps) were known from MRI. US perfusion parameters were derived from the signal enhancement time course (bolus kinetics, SonoVue for peak-signal increase and time-to-peak.


RESULTS
Seventeen patients (52 +/- 11 years, 24% female) with 18 strokes (16 unilateral, 1 bilateral) were included. Six US examinations (18%) were inadequate for analysis due to an insufficient transtemporal bone window. US perfusion depicted 90 % of infarcts with a longitudinal diameter of more than 2 cm. Infarcts with a longitudinal diameter of less than 2 cm were hardly identified.


CONCLUSIONS
PIHI allows identification of a small infarction involving the thalamus subject to infarct size.
Neurology, Charite Campus Benjamin Franklin, Berlin. christian.nolte@charite.de
C H
CH
Nolte
J
J
Gruss
J
J
Steinbrink
G J
GJ
Jungehulsing
P
P
Brunecker
A M
AM
Hopt
S J
SJ
Schreiber
D000328:Adult; D000368:Aged; D002544:Cerebral Infarction / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000000981:diagnostic imaging* / Q000473:pathology; D013788:Thalamus / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography / Q000379:methods