title: Microvascular imaging in acute ischemic stroke.
abstract: BACKGROUND
  Microvascular imaging (MVI), a new ultrasound technology, is used to analyze brain perfusion at the patient's bedside. This study aims to evaluate the diagnostic and prognostic value of MVI in patients with acute ischemic stroke (AIS).
  
  
  METHODS
  Nineteen patients suffering from AIS (mean age, 70.9 ± 12.2 years; 47% female; mean NIHSS-score, 12 ± 8) were investigated within the first 12 hours after symptom onset. We used the iU22 (Philips) system (S5-1 probe; low-mechanical index; depth, 13 cm), and 2 bolus injections of an ultrasound contrast agent (2.4 mL SonoVue per injection). The area of maximal perfusion deficit (AMPD) was compared with infarction on follow-up cranial computed tomography (CT) and NIHSS score 24 hours after stroke onset.
  
  
  RESULTS
  Of 19 patients, 15 patients (79%) had sufficient insonation conditions. Of these patients, 12 had infarctions. The sensitivity and specificity of detecting infarctions with ultrasound perfusion imaging were 91% and 67%, respectively. A significant correlation existed between the AMPD and NIHSS score at 24 hours after symptom onset (P= .023), and with occlusion of the internal carotid artery (P= .005).
  
  
  CONCLUSIONS
  Performing bedside MVI in the early phase of AIS provides information on brain parenchyma perfusion and prognosis of AIS.
authors.affiliation: Department of Neurology, Asklepios Klinik Nord-Heidberg, Hamburg, Germany. g.seidel@asklepios.com
authors.forename: Günter
authors.initials: G
authors.lastname: Seidel
authors.forename: Florian
authors.initials: F
authors.lastname: Roessler
authors.forename: Mohamed
authors.initials: M
authors.lastname: Al-Khaled
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000150:complications / Q000000981:diagnostic imaging*; D003287:Contrast Media; D004453:Echoencephalography / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D055806:Microvessels / Q000000981:diagnostic imaging*; D055420:Perfusion Imaging / Q000379:methods*; D010743:Phospholipids; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D020521:Stroke / Q000000981:diagnostic imaging* / Q000209:etiology; D013459:Sulfur Hexafluoride
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride