Sonographic parenchymal and brain perfusion imaging: Preliminary results in four patients following decompressive surgery for malignant middle cerebral artery infarct
F. Schlachetzki et al., Sonographic parenchymal and brain perfusion imaging: Preliminary results in four patients following decompressive surgery for malignant middle cerebral artery infarct, ULTRASOUN M, 27(1), 2001, pp. 21-31
To investigate new methods of diagnostic transcranial sonography for brain
parenchymal, vascular and perfusion imaging, we performed 3-D native tissue
harmonic transcranial sonography (3D-nthTCS), 3-D transcranial color-coded
duplex sonography (3D-TCCS), and "loss-of-correlation" imaging (LOC-TCCS)
in four patients following early hemicraniectomy due to space-occupying "ma
lignant" middle cerebral artery infarction (MMCAI). Three-dimensional datas
ets, utilizing 3D-nthTCS and 3D-TCCS, were created and up to 10 axial 2-D B
-mode image planes, similar to CCT, reconstructed in each patient. Three-di
mensional reconstructions of the circle of Willis documented one, persisten
t carotid-T occlusion and three recanalizations of the MCA. LOC-TCCS, based
on stimulated acoustic emission from an ultrasound (US) contrast agent, de
monstrated a perfusion deficit in 2 of 3 patients, with regard to their inf
arcts. Concluding, 3D-nthTCS, 3D-TCCS and LOC-TCCS are promising tools for
bedside monitoring, early prognosis and treatment evaluation for MMCAI in t
he postoperative period. Further studies should be performed to standardize
these new methods and evaluate their applications through the intact calva
rina. (E-mail: felix.schlachetzki@klinik.uniregensburg.de) (C) 2001 World F
ederation for Ultrasound in Medicine & Biology.