Bogdahn U, Becker G, Schlief R, Reddig J, Hassel W
Department of Neurology, University of Würzburg, FRG.
Stroke. 1993 May;24(5):676-84. doi: 10.1161/01.str.24.5.676.
Transcranial color-coded real-time sonography has been developed as a promising new bedside procedure to monitor central nervous system parenchymal and vascular pathology; the present study was designed to investigate the potential role of galactose microparticles (SH U 508 A) as a new ultrasound contrast-enhancing agent for transcranial sonography.
Ten patients (four women and six men, 24-63 years of age) with a broad spectrum of central nervous system pathology were investigated by transcranial color-coded real-time sonography in a phase-two clinical study. After conventional ultrasound examination, all patients received a maximum of six injections of 10 ml with 200, 300, or 400 mg/mL SH U 508 A. The intracranial vessels were scanned by color flow imaging in the axial and coronal planes through a transtemporal acoustic bone window; in addition, the vertebrobasilar system was followed through the foramen magnum.
SH U 508 A was well tolerated without side effects. In axial and coronal scans, the application of SH U 508 A resulted in detection of peripheral branches of the anterior, middle, and posterior cerebral arteries, as well as the posterior communicating and superior cerebellar arteries. In addition, the deep cerebral veins (i.e., inferior sagittal sinus, internal cerebral veins, great cerebral vein of Galen, straight sinus, and the confluence sinuum) were revealed. The transforaminal approach led to detection of the main infratentorial branches (anterior inferior, posterior inferior, and superior cerebellar arteries). One patient could not be insonated without contrast, but after SH U 508 A the trunks of the large intracranial arteries were detected. No obvious changes in the ultrasound pattern of the central nervous system parenchyma were observed.
These preliminary data indicate that the use of a transpulmonary ultrasound contrast agent (SH U 508 A) may substantially broaden the spectrum and potential diagnostic utility of transcranial ultrasound by allowing detection of supratentorial peripheral central nervous system arteries, deep cerebral veins, and (through the foramen magnum) the entire vertebrobasilar system, including the cerebellar arteries.
经颅彩色编码实时超声检查已发展成为一种很有前景的新型床边检查方法，用于监测中枢神经系统实质和血管病变；本研究旨在探讨半乳糖微粒（SH U 508 A）作为一种新型经颅超声造影剂的潜在作用。
在一项二期临床研究中，对10例（4名女性和6名男性，年龄24 - 63岁）患有多种中枢神经系统病变的患者进行经颅彩色编码实时超声检查。在常规超声检查后，所有患者最多接受6次10 ml、浓度为200、300或400 mg/mL的SH U 508 A注射。通过经颞骨声学骨窗在轴向和冠状平面用彩色血流成像扫描颅内血管；此外，通过枕骨大孔追踪椎基底系统。
SH U 508 A耐受性良好，无副作用。在轴向和冠状扫描中，应用SH U 508 A可检测到大脑前、中、后动脉的外周分支，以及后交通动脉和小脑上动脉。此外，还可显示大脑深部静脉（即下矢状窦、大脑内静脉、大脑大静脉、直窦和窦汇）。经枕骨大孔途径可检测到幕下主要分支（小脑前下、后下和上动脉）。1例患者在未使用造影剂时无法进行超声检查，但在使用SH U 508 A后检测到了颅内大动脉主干。未观察到中枢神经系统实质超声图像有明显变化。
这些初步数据表明，使用经肺超声造影剂（SH U 508 A）可通过检测幕上中枢神经系统外周动脉、大脑深部静脉以及（通过枕骨大孔）整个椎基底系统，包括小脑动脉，从而大幅拓宽经颅超声的检查范围和潜在诊断效用。
