Stroick Mark, Alonso Angelika, Fatar Marc, Griebe Martin, Kreisel Stefan, Kern Rolf, Gaud Emmanuel, Arditi Marcel, Hennerici Michael, Meairs Stephen
Department of Neurology, Universitätsklinikum Mannheim, University of Heidelberg, Mannheim, Germany.
Ultrasound Med Biol. 2006 Sep;32(9):1377-82. doi: 10.1016/j.ultrasmedbio.2006.05.027.
Microbubble-enhanced sonothrombolysis (MEST) may be an alternative therapeutic option in ischemic stroke. Clinical study of the efficacy of MEST as an adjunct stroke therapy, before imaging with CT or MRI, requires experimental data on the safety of this approach in the presence of hemorrhagic stroke. We, therefore, investigated the effect of diagnostic transcranial ultrasound combined with microbubbles (US + MB) in an experimental animal model of intracerebral hemorrhage (ICH). ICH was induced in anesthetized rats by intracerebral collagenase injection. Transcranial ultrasound (2 MHz, mechanical index 1.3, 1051 kPa) was applied 3 h after ICH induction to rat brains for 30 min during a continuous IV infusion of sulfur hexafluoride microbubbles (SonoVue). The size of cerebral hemorrhage, the extent of brain edema, and the amount of apoptosis were compared with those from control rats with ICH but without US + MB. Results showed no significant effect of US + MB on hemorrhage size (control 23.3 +/- 10.7 mm(3), US + MB 20.3 +/- 5.8 mm(3)), on the extent of brain edema (control 3.3 +/- 2.0%, US +MB 3.5 +/- 1.9%), or on the rate of apoptosis (control 5.2 +/- 1.5%, US + MB 5.2 +/- 1.0%). We conclude that diagnostic ultrasound in combination with microbubbles does not cause additional damage to the rat brain during ICH in our experimental set-up. This finding provides support for the use of MEST as an early stroke therapy.
微泡增强超声溶栓（MEST）可能是缺血性卒中的一种替代治疗选择。在进行CT或MRI成像之前，对MEST作为辅助卒中治疗的疗效进行临床研究，需要关于这种方法在出血性卒中存在时安全性的实验数据。因此，我们在实验性脑出血（ICH）动物模型中研究了诊断性经颅超声联合微泡（US + MB）的效果。通过脑内注射胶原酶在麻醉大鼠中诱导ICH。在ICH诱导后3小时，对大鼠大脑应用经颅超声（2 MHz，机械指数1.3，1051 kPa），在持续静脉输注六氟化硫微泡（声诺维）期间持续30分钟。将脑出血的大小、脑水肿的程度和凋亡量与未接受US + MB的ICH对照大鼠进行比较。结果显示，US + MB对出血大小（对照组23.3±10.7 mm³，US + MB组20.3±5.8 mm³）、脑水肿程度（对照组3.3±2.0%，US + MB组3.5±1.9%）或凋亡率（对照组5.2±1.5%，US + MB组5.2±1.0%）均无显著影响。我们得出结论，在我们的实验设置中，诊断性超声联合微泡在ICH期间不会对大鼠脑造成额外损伤。这一发现为MEST作为早期卒中治疗的应用提供了支持。
