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Real-time ultrasound perfusion imaging in acute stroke: assessment of cerebral perfusion deficits related to arterial recanalization.
- Source :
-
Ultrasound in medicine & biology [Ultrasound Med Biol] 2013 May; Vol. 39 (5), pp. 745-52. Date of Electronic Publication: 2013 Feb 27. - Publication Year :
- 2013
-
Abstract
- We investigated whether real-time ultrasound perfusion imaging (rt-UPI) is able to detect perfusion changes related to arterial recanalization in the acute phase of middle cerebral artery (MCA) stroke. Twenty-four patients with acute territorial MCA stroke were examined with rt-UPI and transcranial color-coded duplex ultrasound (TCCD). Ultrasound studies were consecutively performed within 24 h and 72-96 h after stroke onset. Real-time UPI parameters of bolus kinetics (time to peak, rt-TTP) and of refill kinetics (plateau A and slope β of the exponential replenishment curve) were calculated from regions of interest of ischemic versus normal brain tissue; these parameters were compared between early and follow-up examinations in patients who recanalized. At the early examination, there was a delay of rt-TTP in patients with MCA occlusion (rt-TTP [s]: 13.09 ± 3.21 vs. 10.16 ± 2.6; p = 0.01) and a lower value of the refill parameter β (β [1/s]: 0.62 ± 0.34 vs. 1.09 ± 0.58; p = 0.01) in ischemic compared with normal brain tissue, whereas there were no differences of the parameters A and Axβ. At follow-up, the delay of rt-TTP was reversible once recanalization of an underlying MCA obstruction was demonstrated: rt-TTP [s], 13.09 ± 3.21 at 24 h versus 10.95 ± 1.5 at 72-96 h (p = 0.03). Correspondingly, β showed a higher slope than at the first examination: β [1/s]: 0.55 ± 0.29 at 24 h versus 0.71 ± 0.27 at 72-96 h (p = 0.04). We conclude that real-time UPI can detect hemodynamic impairment in acute MCA occlusion and subsequent improvement following arterial recanalization. This offers the chance for bedside monitoring of the hemodynamic compromise (e.g. during therapeutic interventions such as systemic thrombolysis).<br /> (Copyright © 2013 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Aged, 80 and over
Computer Systems
Female
Fibrinolytic Agents administration & dosage
Humans
Image Enhancement methods
Injections, Intravenous
Male
Middle Aged
Reproducibility of Results
Sensitivity and Specificity
Treatment Outcome
Algorithms
Echoencephalography methods
Image Interpretation, Computer-Assisted methods
Infarction, Middle Cerebral Artery diagnostic imaging
Infarction, Middle Cerebral Artery drug therapy
Perfusion Imaging methods
Tissue Plasminogen Activator administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1879-291X
- Volume :
- 39
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Ultrasound in medicine & biology
- Publication Type :
- Academic Journal
- Accession number :
- 23453375
- Full Text :
- https://doi.org/10.1016/j.ultrasmedbio.2012.11.022