Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA.
Department of Radiology, University of Pennsylvania Health System, Philadelphia, PA, USA.
J Ultrasound. 2023 Mar;26(1):201-210. doi: 10.1007/s40477-022-00713-z. Epub 2022 Aug 27.
To evaluate the use of transtemporal brain contrast-enhanced ultrasound (CEUS) to assess cerebral blood perfusion in a cohort of children without neurological disorders.
We included pediatric patients who were undergoing a clinically-indicated CEUS study. Brain scans were performed with a Siemens Sequoia scanner and a 4V1 transducer, that was placed on the left transtemporal bone. Brain scans were performed simultaneously with the images of the clinically-indicated organ of interest. Qualitative and quantitative analysis was performed to evaluate the hemispherical blood flow at the level of the midbrain during the wash-in and wash-out phases of the time-intensity curve. Clinical charts were reviewed to evaluate post-CEUS adverse events.
Five patients were evaluated (mean age 5.8 ± 5.1 years). Qualitatively, more avid enhancement in the midbrain than the cortex was observed. Structures depicted ranged between the centrum semiovale at the level of the lateral ventricles and the midbrain. A quantitative analysis conducted on four patients demonstrated less avid perfusion on the contralateral (i.e. right) side, with a mean left/right ratio ranging between 1.51 and 4.07. In general, there was a steep positive wash-in slope starting at approximately 10 s after contrast injection, reaching a peak intensity around 15-26 s on the left side, and 17-29 s on the right side. No adverse events were reported.
Transtemporal brain CEUS is feasible and safe in the pediatric population and allows qualitative and quantitative assessment of cerebral perfusion.
评估经颞窗脑对比增强超声（CEUS）在无神经疾病的儿童队列中评估脑血流灌注的应用。
我们纳入了正在进行临床指示性 CEUS 研究的儿科患者。使用西门子 Sequoia 扫描仪和放置在左颞骨上的 4V1 换能器进行脑扫描。脑扫描与临床指示的感兴趣器官的图像同时进行。进行定性和定量分析，以评估时间-强度曲线的洗脱期和洗脱期内中脑的半球血流。回顾临床图表以评估 CEUS 后的不良事件。
评估了 5 名患者（平均年龄 5.8±5.1 岁）。定性上，观察到中脑比皮质增强更明显。所描绘的结构范围从侧脑室水平的半卵圆中心到中脑。对 4 名患者进行的定量分析显示，对侧（即右侧）的灌注不那么活跃，左/右比值在 1.51 到 4.07 之间。一般来说，在造影剂注射后约 10 秒开始出现陡峭的正洗脱斜率，左侧在 15-26 秒左右达到峰值强度，右侧在 17-29 秒左右达到峰值强度。未报告不良事件。
经颞窗脑 CEUS 在儿科人群中是可行且安全的，可用于定性和定量评估脑灌注。
