Ultrasonic quantification of cerebral perfusion in acute anterior circulation occlusive stroke-A comparative challenge of the refill- and the bolus-kinetics approach.

Eyding, Jens; Reitmeir, Raluca; Oertel, Markus Florian; Fischer, Urs; Wiest, Roland; Gralla, Jan; Raabe, Andreas; Zubak, Irena; Z'Graggen, Werner Josef; Beck, Jürgen (2019). Ultrasonic quantification of cerebral perfusion in acute anterior circulation occlusive stroke-A comparative challenge of the refill- and the bolus-kinetics approach. PLoS ONE, 14(8), e0220171. Public Library of Science 10.1371/journal.pone.0220171

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PURPOSE To prospectively evaluate the potential of semi-quantitative evaluation of cerebral perfusion in acute ischemic stroke by comparing two established ultrasound approaches. MATERIALS AND METHODS Consecutive inclusion of patients with acute occlusion of middle cerebral artery (MCA) confirmed by either magnetic resonance imaging (MRI) or computed tomography (CT) perfusion imaging qualifying for interventional therapy. Comparison of bilateral high mechanical index (MI) bolus-kinetics (HighMiB) and unilateral low MI refill-kinetics (LowMiR) performed before specific treatment. RESULTS In 16/31 patients HighMiB was eligible, in 8/31 patients LowMiR was eligible. In six out of these eight patients both HighMiB and LowMiR were eligible for direct comparison. In MR/CT perfusion imaging of the 16 patients eligible for HighMiB, 29/48 cortical regions of interest (ROIs) (60%) displayed hypoperfusion or ischemia, areas inadequately accessible by LowMiR. These ROIs made up 49% of the 59 ROIs displaying hypoperfusion or ischemia, altogether. Matching of parameters in normal and impaired ROIs between LowMiR and MRI/CT perfusion imaging was significantly poorer than in HighMiB. CONCLUSION LowMiR using refill-kinetics potentially has the advantage of real time imaging and better resolution. The diagnostic impact, however, proves inferior to HighMiB both with respect to imaging quality and semi-quantitative evaluation.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Reitmeir, Raluca; Oertel, Markus Florian; Fischer, Urs; Wiest, Roland; Gralla, Jan; Raabe, Andreas; Zubak, Irena; Z'Graggen, Werner Josef and Beck, Jürgen

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1932-6203

Publisher:

Public Library of Science

Language:

English

Submitter:

Martin Zbinden

Date Deposited:

20 Aug 2019 16:32

Last Modified:

25 Aug 2019 02:38

Publisher DOI:

10.1371/journal.pone.0220171

PubMed ID:

31415579

BORIS DOI:

10.7892/boris.132671

URI:

https://boris.unibe.ch/id/eprint/132671

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