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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
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 36:2379–2386
Hwang M, Riggs BJ, Katz J et al (2018) Advanced pediatric neurosonography techniques: contrast-enhanced ultrasonography, elastography, and beyond. J Neuroimaging 28:150–157
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 98:459–465
Okereafor A, Allsop J, Counsell SJ et al (2008) Patterns of brain injury in neonates exposed to perinatal sentinel events. Pediatrics 121:906–914
Chugani HT, Phelps ME (1986) Maturational changes in cerebral function in infants determined by 18FDG positron emission tomography. Science 231:840–843
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 49:495–501
Kastler A, Manzoni P, Chapuy S et al (2014) Transfontanellar contrast enhanced ultrasound in infants: initial experience. J Neuroradiol 41:251–258
Apfel RE, Holland CK (1991) Gauging the likelihood of cavitation from short-pulse, low-duty cycle diagnostic ultrasound. Ultrasound Med Biol 17:179–185
Talu E, Powell RL, Longo ML, Dayton PA (2008) Needle size and injection rate impact microbubble contrast agent population. Ultrasound Med Biol 34:1182–1185
Eisenbrey JR, Daecher A, Kramer MR, Forsberg F (2015) Effects of needle and catheter size on commercially available ultrasound contrast agents. J Ultrasound Med 34:1961–1968
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 11:591–610
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 36:2132–2137
Berner LP, Cho TH, Haesebaert J et al (2016) MRI assessment of ischemic lesion evolution within white and gray matter. Cerebrovasc Dis 41:291–297
de Vries LS, Groenendaal F (2010) Patterns of neonatal hypoxic-ischaemic brain injury. Neuroradiology 52:555–566
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 60:359–363
Prada F, Perin A, Martegani A et al (2014) Intraoperative contrast-enhanced ultrasound for brain tumor surgery. Neurosurgery 74:542–552
Prada F, Mattei L, Del Bene M et al (2014) Intraoperative cerebral glioma characterization with contrast enhanced ultrasound. Biomed Res Int:484261
Volpe JJ (2001) Neurology of the newborn, 4th edn. W.B. Saunders, Philadelphia
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 114:611–618
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 119:606–614
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 12:27–33
International PHVD Drug Trial Group (1998) International randomised controlled trial of acetazolamide and furosemide in posthaemorrhagic ventricular dilatation in infancy. Lancet 352:433–440
Borgesen SE, Gjerris F (1987) Relationships between intracranial pressure, ventricular size, and resistance to CSF outflow. J Neurosurg 67:535–539
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 1:49–52
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
Brawanski A, Soerensen N (1985) Increased ICP without ventriculomegaly. Diagnostic and therapeutic problems in a 1-year-old boy. Childs Nerv Syst 1:66–68
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest
None
Rights and permissions
About this article
Cite this article
Hwang, M. Introduction to contrast-enhanced ultrasound of the brain in neonates and infants: current understanding and future potential. Pediatr Radiol 49, 254–262 (2019). https://doi.org/10.1007/s00247-018-4270-1
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00247-018-4270-1