Skip Navigation

This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow References
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Request Permissions
Google Scholar
Right arrow Articles by Ringelstein, E.B.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Ringelstein, E.B.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?


Echocontrast agents in neurovascular ultrasound

E.B. Ringelstein*

Klinik and Poliklinik für Neurologie, Munster, Germany

* Correspondence: Prof Dr med E. Bernd Ringelstein, Westf. Wilhelms-Universität Münster, Klinik and Poliklinik für Neurologie, Albert- Schweitzer-Str. 33, D-48129 Münster, Germany.

Abstract

Cerebrovascular ultrasound is the method of first choice in many stroke centres for both the extra-cranial and intra-cranial cerebral arteries. This is due to its general availability, its high reliability in experienced hands and its relatively low costs. The state-of-the-art technique is colour-coded Duplex sonography. However, these tests may be hampered by unfavourable anatomical conditions in up to 20% of patients. To overcome these drawbacks, echocontrast-enhancing agents (EEAs) are extremely useful. SonoVue (Bracco, Milan, Italy) is made of stabilized, phospholipid-encapsulated, sulphurhexafluoride microbubbles that survive pulmonary passage and enhance the echogenicity of brain arteries. In acute stroke patients, clinically useful indications for the application of EEAs include: more detailed visualization of middle cerebral artery occlusions in the M1 or M2 segments; differentiation of basilar artery thrombosis or mid-basilar or top-of-the-basilar embolus; differentiation of very high great stenosis (i.e. pseudoocclusion) or complete occlusion; visualization of cervical artery dissections; and diagnosis of transverse sinus thrombosis and the monitoring of occluded artery recanalization (‘tailored thrombolysis’). In the chronic phase, EEAs help to identify the general burden of cerebrovascular occlusive disease and to monitor its progression. Future promissing new applications are harmonic imaging by visualization of the emitted harmonics of the basal ultrasound frequency by the ‘swinging bubbles’ to overcome tissue-related noise and artifacts, ‘triggered ultrasound imaging’ in order to visualize brain perfusion in humans (still experimental) and the use of echocontrast bubbles as a vehicle for specific therapeutic compounds with the bubbles being destroyed by ultrasound at pre-defined sites.

Key Words: Cerebrovascular disease • cerebrovascular ultrasound • colour-coded Duplex sonography • echocontrast agents • stroke


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.