Shiogai Toshiyuki, Takayasu Natsuko, Mizuno Toshiki, Nakagawa Masanori, Furuhata Hiroshi
Department of Clinical Neurosciences, Kyoto Takeda Hospital, Minamikinuta-cho 11, Nishinanajo, Shimogyo-ku, Kyoto 600-8884, Japan.
Stroke. 2004 Mar;35(3):687-93. doi: 10.1161/01.STR.0000116102.15636.65. Epub 2004 Feb 12.
To clarify optimal brain tissue perfusion images visualized by transcranial ultrasound harmonic imaging, we compared gray-scale integrated backscatter (IBS) images of new ultraharmonic imaging (UHI) and conventional second harmonic imaging (SHI) with power harmonic imaging (PHI) (harmonic B-mode with harmonic power Doppler images) in 10 patients with and 4 without a temporal skull.
Using a SONOS 5500 (Philips), we evaluated transient response images taken after a bolus Levovist injection at a horizontal diencephalic plane via temporal windows. Based on transmitting/receiving frequencies (MHz), 4 imaging procedures using an S3 transducer (SHI2.6 [1.3/2.6], UHI [1.3/3.6], PHI2.6 [1.3/2.6], and PHI3.2 [1.6/3.2]) and 2 imaging procedures using an S4 transducer (SHI3.6 [1.8/3.6] and PHI3.6 [1.8/3.6]) were compared in terms of size and location, peak intensity (PI), contrast area demarcation, and background image quality.
In intact skull cases, gray-scale imaging tended to show larger contrast areas than PHI. A large contrast area was most frequently observed in SHI2.6 images, despite there being more high-PI cases in UHI. No contrast area with unclear background was observed in a few cases. In craniectomized cases, all contrast images tended to have large and high PI compared with the intact skull cases. PHI, particularly PHI3.6, demonstrated sharper demarcation and a clearer background than gray-scale imaging.
Transcranial gray-scale SHI using a low receiving frequency of 2.6 MHz is the superior method. PHI identifies contrast area localization better than gray-scale imaging and is particularly suitable for intraoperative and postoperative cases.
为了明确经颅超声谐波成像所显示的最佳脑组织灌注图像,我们将新型超谐波成像(UHI)和传统二次谐波成像(SHI)的灰阶背向散射积分(IBS)图像与10例有颞骨和4例无颞骨患者的能量谐波成像(PHI)(谐波B模式与谐波能量多普勒图像)进行了比较。
使用SONOS 5500(飞利浦),我们通过颞窗评估了在水平间脑平面注射团注声诺维后获得的瞬态响应图像。基于发射/接收频率(MHz),比较了使用S3换能器的4种成像程序(SHI2.6 [1.3/2.6]、UHI [1.3/3.6]、PHI2.6 [1.3/2.6]和PHI3.2 [1.6/3.2])以及使用S4换能器的2种成像程序(SHI3.6 [1.8/3.6]和PHI3.6 [1.8/3.6])在大小和位置、峰值强度(PI)、对比区域分界以及背景图像质量方面的差异。
在颅骨完整的病例中,灰阶成像显示的对比区域往往比PHI更大。尽管UHI中有更多高PI病例,但在SHI2.6图像中最常观察到较大的对比区域。少数病例中未观察到背景不清晰的对比区域。在颅骨切除的病例中,与颅骨完整的病例相比,所有对比图像的对比区域往往更大且PI更高。PHI,尤其是PHI3.6,与灰阶成像相比,显示出更清晰的分界和更清晰的背景。
使用2.6 MHz低接收频率的经颅灰阶SHI是更好的方法。PHI在识别对比区域定位方面比灰阶成像更好,特别适用于术中及术后病例。