Top

Published in:

01-02-2019 | Pictorial Essay

Introduction to contrast-enhanced ultrasound of the brain in neonates and infants: current understanding and future potential

Author: Misun Hwang

Published in: Pediatric Radiology | Issue 2/2019

Abstract

Contrast-enhanced ultrasound (CEUS) is a valuable bedside imaging technique that enables both qualitative and quantitative assessment of cerebral perfusion. In neonates and infants whose fontanelles remain open, the technique is particularly useful as it delineates cerebral pathology with high soft-tissue contrast. The technique has the potential to be a valuable alternative to computed tomography (CT) or magnetic resonance imaging (MRI) in critically ill neonates and infants in need of bedside imaging. While further studies are needed to validate the technique, preliminary data in this regard appear promising. This review introduces the current understanding and future potential of brain CEUS.

Hwang M, de Jong RM, Herman S et al (2016) Novel contrast ultrasound evaluation in neonatal hypoxic ischemic injury: case series and future directions. J Ultrasound Med 36:2379–2386CrossRef

Hwang M, Riggs BJ, Katz J et al (2018) Advanced pediatric neurosonography techniques: contrast-enhanced ultrasonography, elastography, and beyond. J Neuroimaging 28:150–157CrossRefPubMed

Ilves P, Lintrop M, Talvik I et al (2009) Low cerebral blood flow velocity and head circumference in infants with severe hypoxic ischemic encephalopathy and poor outcome. Acta Paediatr 98:459–465CrossRefPubMed

Okereafor A, Allsop J, Counsell SJ et al (2008) Patterns of brain injury in neonates exposed to perinatal sentinel events. Pediatrics 121:906–914CrossRefPubMed

Chugani HT, Phelps ME (1986) Maturational changes in cerebral function in infants determined by 18FDG positron emission tomography. Science 231:840–843CrossRefPubMed

Thorngren-Jerneck K, Ohlsson T, Sandell A et al (2001) Cerebral glucose metabolism measured by positron emission tomography in term newborn infants with hypoxic ischemic encephalopathy. Pediatr Res 49:495–501CrossRefPubMed

Kastler A, Manzoni P, Chapuy S et al (2014) Transfontanellar contrast enhanced ultrasound in infants: initial experience. J Neuroradiol 41:251–258CrossRefPubMed

Apfel RE, Holland CK (1991) Gauging the likelihood of cavitation from short-pulse, low-duty cycle diagnostic ultrasound. Ultrasound Med Biol 17:179–185CrossRefPubMed

Talu E, Powell RL, Longo ML, Dayton PA (2008) Needle size and injection rate impact microbubble contrast agent population. Ultrasound Med Biol 34:1182–1185CrossRefPubMedPubMedCentral

10.

Eisenbrey JR, Daecher A, Kramer MR, Forsberg F (2015) Effects of needle and catheter size on commercially available ultrasound contrast agents. J Ultrasound Med 34:1961–1968CrossRefPubMed

11.

Shin SS, Bales JW, Edward Dixon C, Hwang M (2017) Structural imaging of mild traumatic brain injury may not be enough: overview of functional and metabolic imaging of mild traumatic brain injury. Brain Imaging Behav 11:591–610CrossRefPubMed

12.

Koga M, Reutens DC, Wright P et al (2005) The existence and evolution of diffusion-perfusion mismatched tissue in white and gray matter after acute stroke. Stroke 36:2132–2137CrossRefPubMed

13.

Berner LP, Cho TH, Haesebaert J et al (2016) MRI assessment of ischemic lesion evolution within white and gray matter. Cerebrovasc Dis 41:291–297CrossRefPubMed

14.

de Vries LS, Groenendaal F (2010) Patterns of neonatal hypoxic-ischaemic brain injury. Neuroradiology 52:555–566CrossRefPubMedPubMedCentral

15.

Miranda MJ, Olofsson K, Sidaros K (2006) Noninvasive measurements of regional cerebral perfusion in preterm and term neonates by magnetic resonance arterial spin labeling. Pediatr Res 60:359–363CrossRefPubMed

16.

Prada F, Perin A, Martegani A et al (2014) Intraoperative contrast-enhanced ultrasound for brain tumor surgery. Neurosurgery 74:542–552CrossRefPubMed

17.

Prada F, Mattei L, Del Bene M et al (2014) Intraoperative cerebral glioma characterization with contrast enhanced ultrasound. Biomed Res Int:484261

18.

Volpe JJ (2001) Neurology of the newborn, 4th edn. W.B. Saunders, Philadelphia

19.

Dykes FD, Dunbar B, Lazarra A, Ahmann PA (1989) Posthemorrhagic hydrocephalus in high-risk preterm infants: natural history, management, and long-term outcome. J Pediatr 114:611–618CrossRefPubMed

20.

Msall ME, Buck GM, Rogers BT et al (1991) Risk factors for major neurodevelopmental impairments and need for special education resources in extremely premature infants. J Pediatr 119:606–614CrossRefPubMed

21.

Resch B, Gedermann A, Maurer U et al (1996) Neurodevelopmental outcome of hydrocephalus following intra−/periventricular hemorrhage in preterm infants: short- and long-term results. Childs Nerv Syst 12:27–33CrossRefPubMed

22.

International PHVD Drug Trial Group (1998) International randomised controlled trial of acetazolamide and furosemide in posthaemorrhagic ventricular dilatation in infancy. Lancet 352:433–440

23.

Borgesen SE, Gjerris F (1987) Relationships between intracranial pressure, ventricular size, and resistance to CSF outflow. J Neurosurg 67:535–539CrossRefPubMed

24.

Dahlerup B, Gjerris F, Harmsen A, Sorensen PS (1985) Severe headache as the only symptom of long-standing shunt dysfunction in hydrocephalic children with normal or slit ventricles revealed by computed tomography. Childs Nerv Syst 1:49–52CrossRefPubMed

25.

Ashley WW, McKinstry RC Jr, Leonard JR et al (2005) Use of rapid-sequence magnetic resonance imaging for evaluation of hydrocephalus in children. J Neurosurg 103:124–130

26.

Brawanski A, Soerensen N (1985) Increased ICP without ventriculomegaly. Diagnostic and therapeutic problems in a 1-year-old boy. Childs Nerv Syst 1:66–68CrossRefPubMed

Title: Introduction to contrast-enhanced ultrasound of the brain in neonates and infants: current understanding and future potential
Author: Misun Hwang
Publication date: 01-02-2019
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Radiology / Issue 2/2019
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI: https://doi.org/10.1007/s00247-018-4270-1

At a glance: The STEP trials

Springer Medicine

Introduction to contrast-enhanced ultrasound of the brain in neonates and infants: current understanding and future potential

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2019

Utility of Hounsfield unit and hematocrit values in the diagnosis of acute venous sinus thrombosis in unenhanced brain CTs in the pediatric population

Pediatric Radiology Continuing Medical Education Activity

Pilot study on renal magnetic resonance diffusion tensor imaging: are quantitative diffusion tensor imaging values useful in the evaluation of children with ureteropelvic junction obstruction?

Imaging features of extranodal involvement in paediatric Hodgkin lymphoma

Identification of clinical parameters to increase the diagnostic yield of the non-emergent upper gastrointestinal series in pediatric outpatients

Fetal brain morphometry on prenatal magnetic resonance imaging in congenital diaphragmatic hernia