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Open AccessFeature PaperReview

Twenty Years of Cerebral Ultrasound Perfusion Imaging—Is the Best yet to Come?

1
Department of Neurology, Klinikum Dortmund gGmbH, Beurhausstr 40, 44137 Dortmund, Germany
2
Department of Neurology, University Hospital Knappschaftskrankenhaus, Ruhr University Bochum, 44892 Bochum, Germany
3
Department of Neurosurgery, Universityhospital, University of Freiburg, 79106 Freiburg, Germany
4
Department of Neurology, Universityhospital, University of Freiburg, 79106 Freiburg, Germany
5
Department of Neurology, St. Josef-Hospital, Ruhr University Bochum, 44791 Bochum, Germany
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(3), 816; https://doi.org/10.3390/jcm9030816
Received: 10 February 2020 / Revised: 6 March 2020 / Accepted: 10 March 2020 / Published: 17 March 2020
(This article belongs to the Special Issue Diagnosis, Prevention and Treatment for Stroke)
Over the past 20 years, ultrasonic cerebral perfusion imaging (UPI) has been introduced and validated applying different data acquisition and processing approaches. Clinical data were collected mainly in acute stroke patients. Some efforts were undertaken in order to compare different technical settings and validate results to gold standard perfusion imaging. This review illustrates the evolution of the method, explicating different technical aspects and milestones achieved over time. Up to date, advancements of ultrasound technology as well as data processing approaches enable semi-quantitative, gold standard proven identification of critically hypo-perfused tissue in acute stroke patients. The rapid distribution of CT perfusion over the past 10 years has limited the clinical need for UPI. However, the unexcelled advantage of mobile application raises reasonable expectations for future applications. Since the identification of intracerebral hematoma and large vessel occlusion can also be revealed by ultrasound exams, UPI is a supplementary multi-modal imaging technique with the potential of pre-hospital application. Some further applications are outlined to highlight the future potential of this underrated bedside method of microcirculatory perfusion assessment. View Full-Text
Keywords: ultrasound; acute ischemic stroke; perfusion imaging; contrast agent; intracerebral hematoma; subarachnoid hemorrhage ultrasound; acute ischemic stroke; perfusion imaging; contrast agent; intracerebral hematoma; subarachnoid hemorrhage
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Eyding, J.; Fung, C.; Niesen, W.-D.; Krogias, C. Twenty Years of Cerebral Ultrasound Perfusion Imaging—Is the Best yet to Come? J. Clin. Med. 2020, 9, 816.

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