Is ultrasound perfusion imaging capable of detecting mismatch? A proof-of-concept study in acute stroke patients.

Reitmeir, Raluca; Eyding, Jens; Oertel, Markus Florian; Wiest, Roland; Gralla, Jan; Fischer, Urs; Giquel, Pierre-Yves; Weber, Stefan; Raabe, Andreas; Mattle, Heinrich; Z'Graggen, Werner Josef; Beck, Jürgen (2017). Is ultrasound perfusion imaging capable of detecting mismatch? A proof-of-concept study in acute stroke patients. Journal of cerebral blood flow and metabolism, 37(4), pp. 1517-1526. Sage 10.1177/0271678X16657574

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In this study, we compared contrast-enhanced ultrasound perfusion imaging with magnetic resonance perfusion-weighted imaging or perfusion computed tomography for detecting normo-, hypo-, and nonperfused brain areas in acute middle cerebral artery stroke. We performed high mechanical index contrast-enhanced ultrasound perfusion imaging in 30 patients. Time-to-peak intensity of 10 ischemic regions of interests was compared to four standardized nonischemic regions of interests of the same patient. A time-to-peak >3 s (ultrasound perfusion imaging) or >4 s (perfusion computed tomography and magnetic resonance perfusion) defined hypoperfusion. In 16 patients, 98 of 160 ultrasound perfusion imaging regions of interests of the ischemic hemisphere were classified as normal, and 52 as hypoperfused or nonperfused. Ten regions of interests were excluded due to artifacts. There was a significant correlation of the ultrasound perfusion imaging and magnetic resonance perfusion or perfusion computed tomography (Pearson`s chi-squared test 79.119, p < 0.001) (OR 0.1065, 95% CI 0.06-0.18). No perfusion in ultrasound perfusion imaging (18 regions of interests) correlated highly with diffusion restriction on magnetic resonance imaging (Pearson's chi-squared test 42.307, p < 0.001). Analysis of receiver operating characteristics proved a high sensitivity of ultrasound perfusion imaging in the diagnosis of hypoperfused area under the curve, (AUC = 0.917; p < 0.001) and nonperfused (AUC = 0.830; p < 0.001) tissue in comparison with perfusion computed tomography and magnetic resonance perfusion. We present a proof of concept in determining normo-, hypo-, and nonperfused tissue in acute stroke by advanced contrast-enhanced ultrasound perfusion imaging.

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 10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Image Guided Therapy 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, Wiest, Roland Gerhard Rudi, Gralla, Jan, Fischer, Urs Martin, Weber, Stefan (B), Raabe, Andreas, Mattle, Heinrich, Z'Graggen, Werner Josef, Beck, Jürgen
Subjects:	600 Technology > 610 Medicine & health
ISSN:	0271-678X
Publisher:	Sage
Language:	English
Submitter:	Stefanie Hetzenecker
Date Deposited:	27 Jul 2016 07:54
Last Modified:	29 Mar 2023 23:34
Publisher DOI:	10.1177/0271678X16657574
PubMed ID:	27389180
Uncontrolled Keywords:	Acute ischemic stroke; brain imaging; cerebral perfusion; neurosonology; ultrasound perfusion imaging
URI:	https://boris.unibe.ch/id/eprint/84406