Update on ultrasound brain perfusion imaging

Several studies have demonstrated the value of ultrasound perfusion imaging to visualize the area of perfusion deficit in patients with acute ischemic stroke.

Triggered high mechanical index (MI) imaging, which uses contrast microbubble destruction to analyze bolus contrast kinetics in the brain parenchyma, was used in these studies. Recently high sensitive, low MI imaging was introduced. With this new technology real-time bolus kinetics as well as refill kinetics could be analyzed without triggering. In the early phase of ischemic stroke, ultrasound perfusion imaging is useful in detecting the area of perfusion deficit and to assess outcome prognosis of the patient. This bedside technology is available for use in the stroke unit when patients with acute ischemic stroke undergo a color-coded duplex work-up to evaluate their vascular status.