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(Circulation. 2001;104:2582.)
© 2001 American Heart Association, Inc.

Basic Science Reports

Quantification of Cerebral Perfusion With "Real-Time" Contrast-Enhanced Ultrasound

Se-Joong Rim, MD; Howard Leong-Poi, MD; Jonathan R. Lindner, MD; Daniel Couture, MD; Dilantha Ellegala, MD; Holland Mason, MD; Marcel Durieux, MD; Neal F. Kassel, MD; Sanjiv Kaul, MD

From the Cardiovascular Imaging Center, Cardiovascular Division, Department of Internal Medicine (S.-J.R., H.L.-P., J.R.L., S.K.), the Department of Neurosurgery (D.C., D.E., N.F.K.), and the Division of Neurosurgical Anesthesia, Department of Anesthesia (H.M., M.D.), University of Virginia, Charlottesville.

Correspondence to Sanjiv Kaul, MD, Box 158, Cardiovascular Division, University of Virginia Health Sciences Center, Charlottesville, VA 22908. E-mail sk{at}virginia.edu

Background No noninvasive technique is currently capable of "real-time" assessment and monitoring of cerebral blood flow (CBF). We hypothesized that cerebral perfusion could be accurately measured and monitored in "real time" with contrast-enhanced ultrasound (CEU).

Methods and Results Cerebral perfusion was assessed in 9 dogs through a craniotomy with CEU at baseline and during hypercapnia and hypocapnia while normoxia was maintained. Cerebral microvascular blood volume (A), microbubble velocity (ß), and blood flow (Axß) were calculated from time-versus–acoustic intensity relations. Compared with baseline, hypercapnia and hypocapnia significantly increased and decreased CBF, respectively, as measured by CEU. These changes in blood flow were mediated by changes in both A and ß. A good correlation was found between Axß derived from CEU and CBF measured by radiolabeled microspheres (y=0.67x-0.04, r=0.91, P<0.001).

Conclusions Changes in both cerebral microvascular blood volume and red blood cell velocity can be accurately assessed with CEU. Thus, CEU has the potential for bedside measurement and monitoring of cerebral perfusion in real time in patients with craniotomies or burr holes.

Key Words: cerebrovascular circulation • contrast media • ultrasonics

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