Neurology, Charite Campus Benjamin Franklin, Berlin.
Ultraschall Med. 2009 Oct;30(5):466-70. doi: 10.1055/s-2008-1027440. Epub 2008 Jun 5.
Ultrasound (US) perfusion imaging of ischemic stroke has mainly been applied to large middle cerebral artery infarction. We investigated whether small stroke involving the thalamus can also be detected.
Phase inversion harmonic imaging (PIHI) was applied to patients with small infarctions involving the thalamus (maximal longitudinal infarct diameter less than 3 cm). PIHI was performed from both the left and right side in axial diencephalic planes. Infarct size and location as well as perfusion properties (MTT maps) were known from MRI. US perfusion parameters were derived from the signal enhancement time course (bolus kinetics, SonoVue for peak-signal increase and time-to-peak.
Seventeen patients (52 +/- 11 years, 24% female) with 18 strokes (16 unilateral, 1 bilateral) were included. Six US examinations (18%) were inadequate for analysis due to an insufficient transtemporal bone window. US perfusion depicted 90 % of infarcts with a longitudinal diameter of more than 2 cm. Infarcts with a longitudinal diameter of less than 2 cm were hardly identified.
PIHI allows identification of a small infarction involving the thalamus subject to infarct size.
超声（US）灌注成像是一种应用于缺血性脑卒中的技术，主要用于治疗大脑中动脉大面积梗死。本研究旨在探讨其是否也适用于较小的丘脑梗死。
对累及丘脑的小梗死患者（最大长径＜3cm）进行反转谐波成像（PIHI）。在轴位间脑平面上从左侧和右侧进行 PIHI。通过 MRI 确定梗死大小和位置以及灌注特性（MTT 图）。从信号增强时间曲线中得出 US 灌注参数（团注动力学、SonoVue 用于峰值信号增加和达峰时间）。
17 例患者（52±11 岁，24%为女性），18 例脑卒中（16 例单侧，1 例双侧）。6 次超声检查（18%）因颞骨窗不足而无法进行分析。PIHI 可显示＞2cm 长径的 90%的梗死灶，而＜2cm 长径的梗死灶则难以识别。
PIHI 可以根据梗死大小来识别累及丘脑的小梗死灶。
