Echoenhancers and Transcranial Color Duplex Sonography

, by Bogdahn, Ulrich; Becker, Georg; Schlachetzki, Felix

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ISBN: 9780632048564 | 0632048565
Cover: Hardcover
Copyright: 12/23/1998

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With Transcranial color sonography (TCCS), developed at the end of the eighties, the sonographic diagnostic spectrum for the central nervous system could be extended considerably. In intensive care and emergency situations an overview of the cerebral vascular system can be obtained extremely quickly.

Preface

(9)

Contributors

XIV

Part A: Basic Principles

(216)

1 Historical Development of Transcranial Color-Coded Tomography

(14)

H. Furuhata

1.1 Introduction

(1)

1.2 Problems in the Transcranial Application of Real-time Duplex and Color Doppler Tomography

(1)

1.3 Study of Echo Window Size

(4)

1.4 Selection of Ultrasonic Frequency

(1)

1.5 Measurement of Intracranial Blood Flow by Duplex Sonography

(1)

1.6 Transcranial Color Doppler Tomography

(4)

1.7 Conclusions -- Improvement of Transcranial Color Doppler Imaging

(3)

1.8 References

(2)

2 Physics of Sonographic Imaging, Ultrasound-Tissue Interactions and Safety Issues

(20)

R. Soldner

2.1 Propagation of Sound

(5)

2.2 Scanner Systems

(6)

2.3 Image Quality

(5)

2.4 Patient Safety

(1)

2.5 Suggested Reading

(2)

3 Transducer Technology

(15)

H. Kaarmann

3.1 Introduction

(1)

3.2 Functional Principle of Ultrasound Transducers

(7)

3.3 Transducer Characteristics

(2)

3.4 Signal Processing (Preprocessing)

(1)

3.5 Artifacts

(4)

3.6 Suggested Reading

(1)

4 Signal Processing in Functional and Morphological Ultrasound Imaging

(26)

H. Ermert

4.1 Introduction

(1)

4.2 Morphological Imaging

(13)

4.3 Functional Imaging (Doppler Flow Imaging)

(5)

4.4 Histological Imaging (Ultrasound Tissue Characterization)

(3)

4.5 Concluding Remarks

(1)

4.6 References

(3)

5 Techniques of Doppler Sonography and Color Duplex Sonography

(15)

R. Haerten

5.1 The Doppler Effect

(2)

5.2 Continuous-Wave and Pulsed-Wave Doppler

(7)

5.3 Color Duplex Sonography

(4)

5.4 Summary

(1)

5.5 Suggested Reading

(1)

6 Power Doppler Imaging

(7)

R. Haerten

6.1 Flow Velocity, Variance and Power

(2)

6.2 Technical Principles

(2)

6.3 Performance Features of Power Doppler Imaging

(2)

6.4 Suggested Reading

(1)

7 Technical Aspects of the Clinical Examination

100

(12)

F. Schlachetzki

7.1 Technical Aspects of Color Duplex Sonography

100

(7)

7.2 General Aspects of Equipment Operation and Imaging

107

(4)

7.3 Suggested Reading

111

(1)

8 Artifacts

112

(9)

G. Becker

8.1 Artifacts in B-mode Imaging

112

(6)

8.2 Artifacts in Color Duplex Sonography

118

(2)

8.3 Suggested Reading

120

(1)

9 3-D Sonography -- Technical Aspects

121

(20)

A. Fenster

9.1 Introduction

121

(1)

9.2 Acquisition Techniques

121

(8)

9.3 Reconstruction

129

(1)

9.4 3-D Ultrasound Image Rendering

130

(6)

9.5 Conclusions

136

(1)

9.6 References

136

(5)

10 Three-Dimensional Transcranial Duplex Sonography With and Without Contrast Enhancement

141

(11)

E. Bauer

U. Bogdahn

R. Soldner

A. Hutzelmeyer

A. Haase

10.1 Introduction

141

(1)

10.2 System Requirements

142

(1)

10.3 Anatomic Requirements for Transcranial Access

143

(1)

10.4 Ultrasound System

143

(1)

10.5 Echo Signal Enhancement

144

(1)

10.6 3-D Data Acquisition and Image Processing

144

(1)

10.7 Segmentation and Visualization

145

(1)

10.8 Reconstruction of the 3-D Dataset

146

(1)

10.9 Preliminary Clinical Results

147

(2)

10.10 Potentials of 3-D Contrast-Enhanced Transcranial Sonography

149

(1)

10.11 References

150

(2)

11 Ultrasound Contrast Agents

152

(5)

T. Holscher

11.1 Development of Ultrasound Contrast Agents

152

(1)

11.2 Mode of Action

152

(1)

11.3 Current Developments

153

(2)

11.4 Further Developments

155

(1)

11.5 References

155

(2)

12 Galactose-Based Echo Contrast Agents in Diagnostic Ultrasound

157

(11)

R. Schlief

12.1 Introduction

157

(1)

12.2 Basic Pharmaceutical Properties of Echovist(R) and Levovist(R)

157

(3)

12.3 Toxicology

160

(1)

12.4 Clinical Indications

160

(4)

12.5 Tolerance and Safety

164

(1)

12.6 Dosing

164

(2)

12.7 Microbubble-Specific Ultrasound Scanning

166

(1)

12.8 Summary and Conclusions

166

(1)

12.9 References

166

(2)

13 Assessment of Cerebral Perfusion Using Echo Contrast Agents

168

(15)

G. Seidel

13.1 Defining Cerebral Perfusion in Neurosonography

168

(1)

13.2 Mathematical Models for Echo Contrast Agent Kinetics

168

(4)

13.3 Echo Contrast Agents

172

(1)

13.4 Technical Requirements for Measuring Changes in Cerebral Perfusion

173

(2)

13.5 Experimental Data

175

(5)

13.6 References

180

(3)

14 Harmonic Imaging

183

(9)

P. von Behren

14.1 Ultrasound Contrast Agents

183

(1)

14.2 Bubble Contrast

183

(1)

14.3 Bubble Resonance Frequency

184

(1)

14.4 Harmonic Imaging

184

(1)

14.5 Harmonic Doppler and Harmonic Color Flow Imaging

185

(2)

14.6 Ultrasound System Requirements for Harmonic Imaging

187

(4)

14.7 References

191

(1)

15 Transient Response Imaging

192

(12)

T. R. Porter

15.1 Introduction

192

(2)

15.2 Transient Response Imaging: Background

194

(1)

15.3 In Vitro Studies With Intermittent Harmonic Imaging

195

(2)

15.4 Intermittent Harmonic Imaging in Animal Studies

197

(2)

15.5 Transient Response Imaging in Humans: Validation and Clinical Applications

199

(2)

15.6 Intermittent Harmonic Imaging: Future Directions

201

(1)

15.7 References

202

(2)

16 New Concepts for Ultrasound Contrast Imaging

204

(15)

A. Bauer

M. Zomack

S. Hilgenfeldt

D. Lohse

A. Urbank

R. Schlief

16.1 Introduction

204

(1)

16.2 Linear Response: The Basis of Echo Enhancement

204

(2)

16.3 Microbubble Resonances

206

(2)

16.4 Stimulated Acoustic Emission and the Generation of Harmonics

208

(2)

16.5 Specific Detection by LOC Imaging

210

(4)

16.6 Summary and Future Developments

214

(2)

16.7 References

216

(3)

Part B: Clinical Applications

219

(188)

17 Examination Techniques

219

(13)

G. Becker

B. Griewing

17.1 Problems of the Bone Window

219

(3)

17.2 Transducer Selection

222

(1)

17.3 Important Data for Practical Application of Different Color Coding and Doppler Techniques

222

(2)

17.4 Adaptation of Receiver and Instrument Parameters

224

(3)

17.5 Examination Procedure

227

(3)

17.6 References

230

(2)

18 Parenchymal Anatomy

232

(19)

U. Bogdahn

J. Winkler

S. Schwab

H. Adolf

18.1 Axial Sections Through Mesencephalic Structures at the Level of the Cerebral Peduncles

233

(5)

18.2 Axial Sections Through the Pontine Brainstem

238

(2)

18.3 Axial Sections Through Diencephalic Structures at the Level of the Thalamus -- Third Ventricle

240

(10)

18.4 Axial Sections Through the Cella Media

250

(1)

18.5 Coronal Planes

250

(1)

19 Vascular Anatomy and Flow Velocities

251

(9)

B. Griewing

G. Becker

19.1 Anatomical Principles

251

(2)

19.2 Examination of the Basilar Arteries

253

(4)

19.3 Color Flow Imaging Methods (Color Doppler, Power Doppler, Echo Contrast Agents)

257

(1)

19.4 Closing Remarks

258

(1)

19.5 References

259

(1)

20 Pathological Findings in the Intracranial Arterial System

260

(5)

M. Kaps

20.1 Hemodynamic Effects of Extracranial Obstruction

260

(1)

20.2 Intracranial Stenosis

260

(1)

20.3 Cerebral Vasospasm Secondary to Subarachnoid Hemorrhage

261

(1)

20.4 Intracranial Artery Occlusion

262

(2)

20.5 Brain Death

264

(1)

20.6 References

264

(1)

21 Intracranial Veins

265

(11)

G. Becker

M. Maurer

U. Bogdahn

21.1 Introduction

265

(1)

21.2 Features of the Ultrasonic Anatomy of the Venous System

265

(1)

21.3 Examination Procedure

266

(6)

21.4 Blood Flow Velocities in the Cerebral Venous System -- Normal Values

272

(1)

21.5 Sonographic Findings in Patients With Venous Thrombosis

273

(1)

21.6 References

274

(2)

22 Aneurysms and Arteriovenous Malformations (AVMs)

276

(22)

E. Bartels

22.1 Basal Aneurysm

276

(3)

22.2 Arteriovenous Malformation

279

(8)

22.3 Angioblastoma (Lindau's Tumor)

287

(1)

22.4 Cavernous Hemangioma

288

(1)

22.5 Arteriovenous Fistula

289

(4)

22.6 Conclusions

293

(1)

22.7 References

294

(4)

23 Detection of Cerebral Aneurysms by TCCS and Its Clinical Consequences

298

(8)

J. Wardlaw

23.1 Introduction

298

(1)

23.2 What Examination Should Be Done and What Do Aneurysms Look Like on TCCS?

298

(2)

23.3 Caveats and Pitfalls

300

(1)

23.4 Are Aneurysms Truly "Pulsatile"?

301

(1)

23.5 Applications of TCCS in Subarachnoid Hemorrhage and Aneurysms

302

(2)

23.6 Conclusions

304

(1)

23.7 References

304

(2)

24 Diagnosis of Acute Stroke

306

(11)

U. Bogdahn

F. Schlachetzki

T. Holscher

L. Rosin

24.1 Introduction

306

(1)

24.2 Cerebral Vascular Occlusion

307

(4)

24.3 Hemorrhagic Infarction, Massive Cerebral Hemorrhage

311

(4)

24.4 Limitations, Future Developments and Perspectives

315

(1)

24.5 References

315

(3)

25 Diagnosis of Head Trauma

317

(6)

M. Woydt

G. Becker

A. Krone

25.1 Introduction

317

(1)

25.2 Hemorrhage

318

(2)

25.3 Midline Displacement

320

(1)

25.4 Ventricular Size Measurement

321

(1)

25.5 References

321

(2)

26 Cerebrospinal Fluid (CSF) Circulation Disorders

323

(9)

M. Maurer

A. Lindner

G. Becker

26.1 Introduction

323

(1)

26.2 Diagnostic Procedures

324

(1)

26.3 Transcranial Sonography -- Ultrasound Anatomy of the Ventricular System

325

(2)

26.4 Pathological Findings

327

(1)

26.5 Dynamic Ultrasound Studies

328

(1)

26.6 Conclusions

329

(1)

26.7 References

329

(3)

27 Intracranial Tumors

332

(10)

G. Becker

M. Woydt

M. Maurer

A. Krone

27.1 Echomorphology of Cerebral Tumors

332

(2)

27.2 Sensitivity of TCS for Detection of Brain Tumors

334

(1)

27.3 Differentiation of Tumor Tissue Components -- Sensitivity and Specificity of TCS

334

(3)

27.4 Pathological Blood Flow -- Color Doppler and Color Duplex Sonography Findings

337

(1)

27.5 Sonographic Diagnosis of Tumor Recurrence

337

(1)

27.6 Conclusions

338

(1)

27.7 References

339

(3)

28 Intracranial Tumor Vascularization

342

(17)

U. Bogdahn

T. Frohlich

P. Jachimczak

28.1 Introduction

342

(1)

28.2 Vascularization of Tumor Parenchyma

343

(1)

28.3 Correlation Between Intraarterial Digital Subtraction Angiography and Contrast-Enhanced TCCS in Primary CNS Tumors

344

(1)

28.4 Correlation Between Histological and Contrast-Enhanced Ultrasound Findings

345

(6)

28.5 Discussion of Results

351

(6)

28.6 References

357

(2)

29 Pathological Findings in Neuropsychiatric Diseases

359

(10)

G. Becker

T. Becker

D. Berg

E. Hofmann

K. Lange

M. Struck

29.1 Imaging of Affective Disorders

359

(1)

29.2 Sonographic Identification of the Brainstem Raphe

359

(1)

29.3 Anatomic Correlate of the Brainstem Raphe

360

(1)

29.4 Findings in the Brainstem Raphe of Psychiatric and Neuropsychiatric Patients

361

(3)

29.5 Damage to the Basal Limbic System in Primary and Secondary Depression -- A Pathogenetic Hypothesis

364

(1)

29.6 References

365

(4)

30 Findings in Extrapyramidal Movement Disorders

369

(5)

G. Becker

D. Berg

30.1 Parkinson's Disease

369

(1)

30.2 Dystonia

370

(2)

30.3 References

372

(2)

31 Transcranial Functional Sonographic Imaging

374

(33)

J. Klingelhofer

D. Sander

I. Wittich

31.1 Introduction

374

(2)

31.2 Functional Tests in the PCA Territory

376

(9)

31.3 Functional Tests in the MCA Territory

385

(14)

31.4 Dynamic Aspects of PCA and MCA Territory Studies

399

(2)

31.5 Other Variables That Affect the Blood Flow Velocity Response

401

(1)

31.6 References

402

(5)

Index

407

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Echoenhancers and Transcranial Color Duplex Sonography

Summary

Author Biography

Table of Contents

Supplemental Materials