Is ultrasound perfusion imaging capable of detecting mismatch? A proof-of-concept study in acute stroke patients

In this study, we compared contrast-enhanced ultrasound perfusion imaging with magnetic resonance perfusion-weighted imaging or perfusion computed tomography for detecting normo-, hypo-, and nonperfused brain areas in acute middle cerebral artery stroke. We performed high mechanical index contrast-enhanced ultrasound perfusion imaging in 30 patients. Time-to-peak intensity of 10 ischemic regions of interests was compared to four standardized nonischemic regions of interests of the same patient. A time-to-peak >3 s (ultrasound perfusion imaging) or >4 s (perfusion computed tomography and magnetic resonance perfusion) defined hypoperfusion. In 16 patients, 98 of 160 ultrasound perfusion imaging regions of interests of the ischemic hemisphere were classified as normal, and 52 as hypoperfused or nonperfused. Ten regions of interests were excluded due to artifacts. There was a significant correlation of the ultrasound perfusion imaging and magnetic resonance perfusion or perfusion computed tomography (Pearson's chi-squared test 79.119, p < 0.001) (OR 0.1065, 95% CI 0.06–0.18). No perfusion in ultrasound perfusion imaging (18 regions of interests) correlated highly with diffusion restriction on magnetic resonance imaging (Pearson’s chi-squared test 42.307, p < 0.001). Analysis of receiver operating characteristics proved a high sensitivity of ultrasound perfusion imaging in the diagnosis of hypoperfused area under the curve, (AUC = 0.917; p < 0.001) and nonperfused (AUC = 0.830; p < 0.001) tissue in comparison with perfusion computed tomography and magnetic resonance perfusion. We present a proof of concept in determining normo-, hypo-, and nonperfused tissue in acute stroke by advanced contrast-enhanced ultrasound perfusion imaging.

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Dynamic Contrast Enhanced Magnetic Resonance Perfusion Imaging in High-Risk Smokers and Smoking-Related COPD: Correlations with Pulmonary Function Tests and Quantitative Computed Tomography

COPD Journal of Chronic Obstructive Pulmonary Disease ◽

10.3109/15412555.2014.948990 ◽

2014 ◽

Vol 11 (5) ◽

pp. 510-520 ◽

Cited By ~ 14

Author(s):

Yi Xia ◽

Yu Guan ◽

Li Fan ◽

Shi-Yuan Liu ◽

Hong Yu ◽

...

Keyword(s):

Computed Tomography ◽

High Risk ◽

Magnetic Resonance ◽

Pulmonary Function ◽

Perfusion Imaging ◽

Pulmonary Function Tests ◽

Quantitative Computed Tomography ◽

Magnetic Resonance Perfusion ◽

Dynamic Contrast Enhanced ◽

Contrast Enhanced

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Diagnostic accuracy of flat-panel computed tomography in assessing cerebral perfusion in comparison with perfusion computed tomography and perfusion magnetic resonance: a systematic review

Neuroradiology ◽

10.1007/s00234-019-02285-y ◽

2019 ◽

Vol 61 (12) ◽

pp. 1457-1468 ◽

Cited By ~ 1

Author(s):

Ernst L. Stille ◽

Ilaria Viozzi ◽

Mark ter Laan ◽

Frederick J.A. Meijer ◽

Jurgen J. Futterer ◽

...

Keyword(s):

Computed Tomography ◽

Systematic Review ◽

Magnetic Resonance ◽

Diagnostic Accuracy ◽

Cerebrovascular Disease ◽

Blood Volume ◽

Perfusion Imaging ◽

Cerebral Perfusion ◽

Flat Panel ◽

Perfusion Computed Tomography

Abstract Purpose Flat-panel computed tomography (FP-CT) is increasingly available in angiographic rooms and hybrid OR’s. Considering its easy access, cerebral imaging using FP-CT is an appealing modality for intra-procedural applications. The purpose of this systematic review is to assess the diagnostic accuracy of FP-CT compared with perfusion computed tomography (CTP) and perfusion magnetic resonance (MRP) in cerebral perfusion imaging. Methods We performed a systematic literature search in the Cochrane Library, MEDLINE, Embase, and Web of Science up to June 2019 for studies directly comparing FP-CT with either CTP or MRP in vivo. Methodological quality was assessed using the QUADAS-2 tool. Data on diagnostic accuracy was extracted and pooled if possible. Results We found 11 studies comparing FP-CT with CTP and 5 studies comparing FP-CT with MRP. Most articles were pilot or feasibility studies, focusing on scanning and contrast protocols. All patients studied showed signs of cerebrovascular disease. Half of the studies were animal trials. Quality assessment showed unclear to high risks of bias and low concerns regarding applicability. Five studies reported on diagnostic accuracy; FP-CT shows good sensitivity (range 0.84–1.00) and moderate specificity (range 0.63–0.88) in detecting cerebral blood volume (CBV) lesions. Conclusions Even though FP-CT provides similar CBV values and reconstructed blood volume maps as CTP in cerebrovascular disease, additional studies are required in order to reliably compare its diagnostic accuracy with cerebral perfusion imaging.

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Comparison of Diagnostic Medical Sonography, Computed Tomography, Magnetic Resonance Imaging, and Contrast-Enhanced Ultrasound in the Investigation of Renal Lesions

Journal of Diagnostic Medical Sonography ◽

10.1177/8756479319882015 ◽

2019 ◽

Vol 36 (1) ◽

pp. 37-44

Author(s):

Jessica T. Prince

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Magnetic Resonance ◽

Imaging Techniques ◽

Imaging Modalities ◽

Contrast Enhanced Ultrasound ◽

Resonance Imaging ◽

Renal Masses ◽

Renal Lesions ◽

Contrast Enhanced

This review explores the classification and evaluation of suspicious renal lesions across several radiologic imaging modalities. Diagnostic medical sonography (DMS), computed tomography (CT), magnetic resonance imaging (MRI), and contrast-enhanced ultrasound (CEUS) are the primary modalities used to investigate questionable lesions found within the kidneys. Renal masses may range from completely benign to malignant. They are classified based on many different features and characteristics. These lesions may be simple cystic, complex cystic, or solid in nature. Masses may also exhibit varying degrees of vascularity, septations, and calcifications. The discussed imaging modalities have varying strengths, limitations, and implications for use. Imaging techniques may be used independently or in conjunction to best diagnose and treat a patient with a suspicious renal mass. The aim of this review was to describe the diagnostic value of the imaging modalities (DMS, CT, MRI, and CEUS) and their role in the evaluation of suspicious renal lesions.

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