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Hu X, Xu R, Ding H, Lv R, Yang L, Wang Y, Xie R. The total resection rate of glioma can be improved by the application of US-MRI fusion combined with contrast-enhanced ultrasound. Clin Neurol Neurosurg 2021; 208:106892. [PMID: 34425346 DOI: 10.1016/j.clineuro.2021.106892] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 07/10/2021] [Accepted: 08/12/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study was performed to evaluate the diagnostic performance of ultrasound-magnetic resonance imaging (MRI) fusion combined with contrast-enhanced ultrasound and to explore its role in improving the total tumor resection rate. METHODS Between January 2018 and December 2018, 16 patients in the observation group and 23 patients in the control group were enrolled in this study. The tumor depth and brain shift distance were analyzed, as well as the peak intensity and microvessel density of different grades of gliomas in the observation group. Finally, we compared the difference in total resection rate between the observation and control groups. RESULTS Using ultrasound during operations, we found a significant negative correlation between brain shift distance and tumor depth, with correlation coefficient r=-0.868(P<0.05). In glioma, the peak intensity and microvessel density increased synchronously with glioma grade(r=0.806, P<0.05). The total resection rate of lesions was significantly higher in the observation group than in the control group (P<0.05). CONCLUSIONS The application of ultrasound-MRI fusion combined with contrast-enhanced ultrasound can improve the total resection rate of lesions, thus playing an important role in clinical practice.
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Affiliation(s)
- Xing Hu
- Department of Ultrasonic medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China
| | - Rong Xu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China
| | - Hong Ding
- Department of Ultrasonic medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China
| | - Renhua Lv
- Department of Ultrasonic medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China
| | - Liusong Yang
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China.
| | - Yong Wang
- Department of Ultrasonic medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China.
| | - Rong Xie
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China.
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Ishikawa M, Ota Y, Nagai M, Kusaka G, Tanaka Y, Naritaka H. Ultrasonography Monitoring with Superb Microvascular Imaging Technique in Brain Tumor Surgery. World Neurosurg 2017; 97:749.e11-749.e20. [DOI: 10.1016/j.wneu.2016.10.111] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Revised: 10/21/2016] [Accepted: 10/22/2016] [Indexed: 01/16/2023]
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Prada F, Del Bene M, Casali C, Saladino A, Legnani FG, Perin A, Moiraghi A, Richetta C, Rampini A, Mattei L, Vetrano IG, Fornaro R, Saini M, Martegani A, DiMeco F. Intraoperative Navigated Angiosonography for Skull Base Tumor Surgery. World Neurosurg 2015; 84:1699-707. [PMID: 26193670 DOI: 10.1016/j.wneu.2015.07.025] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 07/04/2015] [Accepted: 07/07/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND One of the main challenges during skull base tumor surgery is identifying the relationships between the lesion and the principal intracranial vessels. To this end, neuronavigation systems based on preoperative imaging lack accuracy because of brain shift and brain deformation. Intraoperative navigated B-mode ultrasonography is useful in defining the extent of brain tumor. Doppler imaging adds information regarding flow entity in neighboring vessels. Second-generation ultrasound contrast agents improve the signal-to-noise ratio of B-mode imaging and permit the study of the vessel's course, blood flow, and perfusion characteristics of focal lesions. We report our experience using intraoperative navigated contrast-enhanced ultrasound to perform a navigated angiosonography (N-ASG) for the visualization of vessels in a series of 18 skull base tumors. METHODS We performed N-ASG in a series of 18 skull base tumors (10 meningiomas, 3 craniopharyngiomas, 2 giant pituitary adenomas, 1 posterior fossa epidermoid, 2 dermoid cysts). N-ASG was obtained after craniotomy before resecting each lesion and during tumor removal, after intravenous injection of ultrasound contrast agent. RESULTS In all 18 cases, major vessels and their branches were simultaneously identified (both high and low flow) using N-ASG, which allowed to visualize the whole length of each vessels. N-ASG was also useful in highlighting the lesion, compared with standard B-mode imaging, and showing its perfusion patterns. CONCLUSIONS N-ASG can be applied to skull base tumor surgery, providing helpful information about the relationship between principal intracranial vessels and tumors. This technique could be of assistance in approaching the tumor and avoiding vascular damages.
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Affiliation(s)
- Francesco Prada
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy.
| | - Massimiliano Del Bene
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Cecilia Casali
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Andrea Saladino
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | | | - Alessandro Perin
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Alessandro Moiraghi
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Carla Richetta
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Angela Rampini
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Luca Mattei
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | | | - Riccardo Fornaro
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Marco Saini
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | | | - Francesco DiMeco
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy; Department of Neurological Surgery, Johns Hopkins Medical School, Baltimore, Maryland, USA
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From Grey Scale B-Mode to Elastosonography: Multimodal Ultrasound Imaging in Meningioma Surgery-Pictorial Essay and Literature Review. BIOMED RESEARCH INTERNATIONAL 2015; 2015:925729. [PMID: 26101779 PMCID: PMC4458537 DOI: 10.1155/2015/925729] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 01/10/2015] [Indexed: 11/17/2022]
Abstract
The main goal in meningioma surgery is to achieve complete tumor removal, when possible, while improving or preserving patient neurological functions. Intraoperative imaging guidance is one fundamental tool for such achievement. In this regard, intra-operative ultrasound (ioUS) is a reliable solution to obtain real-time information during surgery and it has been applied in many different aspect of neurosurgery. In the last years, different ioUS modalities have been described: B-mode, Fusion Imaging with pre-operative acquired MRI, Doppler, contrast enhanced ultrasound (CEUS), and elastosonography.
In this paper, we present our US based multimodal approach in meningioma surgery. We describe all the most relevant ioUS modalities and their intraoperative application to obtain precise and specific information regarding the lesion for a tailored approach in meningioma surgery. For each modality, we perform a review of the literature accompanied by a pictorial essay based on our routinely use of ioUS for meningioma resection.
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Park SB, Kim JK, Cho KS. Complications of renal transplantation: ultrasonographic evaluation. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2007; 26:615-33. [PMID: 17460004 DOI: 10.7863/jum.2007.26.5.615] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
OBJECTIVE The purpose of this presentation is to show the ultrasonographic findings of complications of renal transplantation. METHODS We reviewed the ultrasonographic findings of complications of renal transplantation, including urologic complications, fluid collections, graft dysfunction, vascular complications, neoplasms, and recurrent native renal disease. RESULTS Specific ultrasonographic features of complications of renal transplantation have been illustrated. CONCLUSIONS Familiarity with the clinical setting and the appearance of potential renal transplant complications as depicted with the most commonly used modality, ultrasonography, will facilitate prompt, accurate diagnosis and treatment.
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Affiliation(s)
- Sung Bin Park
- Department of Radiology, Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
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Rygh OM, Nagelhus Hernes TA, Lindseth F, Selbekk T, Brostrup Müller T, Unsgaard G. Intraoperative navigated 3-dimensional ultrasound angiography in tumor surgery. ACTA ACUST UNITED AC 2006; 66:581-92; discussion 592. [PMID: 17145316 DOI: 10.1016/j.surneu.2006.05.060] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2006] [Accepted: 05/23/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND Avoiding damage to blood vessels is often the concern of the neurosurgeon during tumor surgery. Using angiographic image data in neuronavigation may be useful in cases where vascular anatomy is of special interest. Since 2003, we have routinely used 3D ultrasound angiography in tumor surgery, and between January 2003 and May 2005, 62 patients with different tumors have been operated using intraoperative 3D ultrasound angiography in neuronavigation. METHODS An ultrasound-based neuronavigation system was used. In addition to 3D ultrasound tissue image data, 3D ultrasound angiography (power Doppler) image data were acquired at different stages of the operation. The value and role of navigated 3D ultrasound angiography as judged by the surgeon were recorded. RESULTS We found that intraoperative ultrasound angiography was easy to acquire and interpret, and that image quality was sufficient for neuronavigation. In 26 of 62 cases, ultrasound angiography was found to be helpful by visualizing hidden vessels adjacent to and inside the tumor, facilitating tailored approaches and safe biopsy sampling. CONCLUSIONS Intraoperative 3D ultrasound angiography is straightforward to use, image quality is sufficient for image guidance, and it adds valuable information about hidden vessels, increasing safety and facilitating tailored approaches. Furthermore, with updated 3D ultrasound angiography imaging, accuracy of neuronavigation may be maintained in cases of brain shift.
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Affiliation(s)
- Ola M Rygh
- Department of Neurosurgery, St. Olav University Hospital, 7006 Trondheim, Norway.
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Kim JH, Eun HW, Lee HJ, Goo DE, Choi DL. Clinical use of renal perfusion imaging by means of harmonic sonography with a microbubble contrast agent in patients after renal transplantation: preliminary study. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2005; 24:755-62. [PMID: 15914679 DOI: 10.7863/jum.2005.24.6.755] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
OBJECTIVE The purpose of this research was to determine the feasibility of renal perfusion imaging by means of harmonic sonography with a microbubble contrast agent for the evaluation of renal perfusion after renal transplantation compared with technetium Tc 99m diethylenetriamine pentaacetic acid ((99m)Tc-DTPA) scans. METHODS During a 10-month period, 100 patients with renal transplantation that included normal perfusion (n=68) and delayed perfusion including chronic rejection (n=19), acute rejection (n=9), arterial stenosis (n=2), and urinary stricture (n=2) underwent sonographic renal perfusion imaging and (99m)Tc-DTPA scans. Sonographic images were obtained every 3 seconds for a total of 3 minutes after administration of a bolus injection of 4 g of the microbubble contrast agent at a concentration of 300 mg/mL. Sonographic renal perfusion images were converted into a renal perfusion curve, and the calculated time at the peak of the curve (T(peak)) was compared with that of the (99m)Tc-DTPA scan. RESULTS The T(peak) with the (99m)Tc-DTPA scan was 14.9 seconds in the normal group and 33 seconds in the delayed perfusion group. The T(peak) on sonographic renal perfusion images was 25 seconds in the normal group and 44.8 seconds in the delayed perfusion group. Sonographic renal perfusion images showed good correlation with the (99m)Tc-DTPA scan (r=0.74; P=.0001). The cutoff value of the T(peak) on sonographic renal perfusion images was 35 seconds (sensitivity=85%; specificity=90%). CONCLUSIONS The renal perfusion images obtained by means of harmonic sonography with a microbubble contrast agent constitute an effective sonographic technique for the evaluation of renal perfusion abnormalities after renal transplantation compared with a (99m)Tc-DTPA scan.
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Affiliation(s)
- Jung Hoon Kim
- Department of Radiology, Soonchunhyang University Hospital, 657 Hannam-Dong, Youngsan-Ku, Seoul 140-743, Korea.
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Kanno H, Ozawa Y, Sakata K, Sato H, Tanabe Y, Shimizu N, Yamamoto I. Intraoperative power Doppler ultrasonography with a contrast-enhancing agent for intracranial tumors. J Neurosurg 2005; 102:295-301. [PMID: 15739558 DOI: 10.3171/jns.2005.102.2.0295] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object. The goal of this study was to evaluate intraoperative power Doppler ultrasonography when used with a contrast-enhancing agent for operations on intracranial tumors.
Methods. Forty intracranial tumors were examined using power Doppler ultrasonography with a galactose micro-particle—based ultrasonographic contrast-enhancing agent during operations on the brain. The tumors included 37 intracranial neoplasms (14 gliomas, six meningiomas, three hemangioblastomas, two malignant lymphomas, three other primary neoplasms, nine metastatic tumors, and three nonneoplastic lesions). All patients also underwent computerized tomography and magnetic resonance imaging, and all but three of the patients underwent digital subtraction (DS) angiography. Before injection of the ultrasonographic contrast agent, intra- and peritumoral power Doppler flow signals were detected in 32 of the intracranial tumors. After the injection, the signals were enhanced in blood vessels around the tumors and in the tumor parenchyma in 36 tumors. The duration of contrast enhancement continued for 70 to 365 seconds (mean 251.8 ± 69 seconds) after the injection. Among the tumors, hemangioblastomas displayed particularly strong contrast enhancement. In these intracranial tumors, the echo signals obtained using contrast-enhanced power Doppler ultrasonography correlated with DS angiographic staining. Power Doppler ultrasonograms with the appropriate contrast agent provided better data on the precise real-time position of the tumors and their relationship to adjacent vessels than ultrasonograms obtained before the injection of the contrast agent.
Conclusions. Intraoperative power Doppler ultrasonography performed using a contrast-enhancing agent can facilitate intraoperative real-time navigation and assessment of the intratumoral vasculature and peritumoral vessels, particularly for tumors having abundant vessels such as hemangioblastomas.
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Affiliation(s)
- Hiroshi Kanno
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
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Furuse J, Nagase M, Ishii H, Yoshino M. Contrast enhancement patterns of hepatic tumours during the vascular phase using coded harmonic imaging and Levovist to differentiate hepatocellular carcinoma from other focal lesions. Br J Radiol 2003; 76:385-92. [PMID: 12814924 DOI: 10.1259/bjr/14206699] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
The purpose of the study was to assess contrast enhancement patterns of hepatic tumours during the vascular phase using contrast-enhanced ultrasound and Levovist to differentiate hepatocellular carcinoma from other hepatic tumours. 89 hepatic tumours in 82 consecutive patients were evaluated using coded harmonic ultrasound imaging. The procedure used a phase inversion harmonic technique and coded technology. We observed images for 2 min from the beginning of the administration as the vascular phase using continuous transmission and intermittent transmissions of 1 s or 2 s. The contrast agent Levovist was administered intravenously as a bolus infusion of 2.5 g. Tumour vessels with flow spreading into the tumour and/or homogeneously stained hyperechoic images were observed in 34 of the 41 hepatocellular carcinomas (sensitivity, 82.9%; specificity, 93.8%). Peripheral enhancements were characteristic of intrahepatic cholangiocarcinoma and metastatic hepatic tumours (sensitivity, 60.0% and 83.3%; specificity, 65.5% and 76.4%, respectively). Pooling at the periphery or throughout the tumour was apparent only in haemangioma (sensitivity, 76.5%; specificity, 100%). A tortuous feeding artery and spoke-like vascularization were evident only in the two focal nodular hyperplasias. Contrast-enhanced ultrasound using coded harmonic ultrasound imaging and Levovist provided detailed information about tumour vascularity and contrast enhancement patterns in hepatic tumours.
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Affiliation(s)
- J Furuse
- Division of Hepatobiliary Pancreatic Medical Oncology, National Cancer Centre Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
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Salwei RM, O'Brien RT, Matheson JS. Use of contrast harmonic ultrasound for the diagnosis of congenital portosystemic shunts in three dogs. Vet Radiol Ultrasound 2003; 44:301-5. [PMID: 12816372 DOI: 10.1111/j.1740-8261.2003.tb00459.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Contrast harmonic ultrasound was used to determine macrovascular and perfusion patterns in three dogs with congenital extrahepatic solitary portosystemic shunts (PSS). With coded harmonic angiographic ultrasound, the size and tortuosity of the hepatic arteries were subjectively increased. Single pulse intermittent low-amplitude harmonic perfusion imaging provided contrast enhancement time-intensity curves from regions of interest in the liver. Mean (+/- standard deviation) peak perfusion times of dogs with PSS were significantly shorter (p = 0.01; 7.0 +/- 2.0 s) than reported in normal dogs (22.8 +/- 6.8 s). The contrast inflow slope for the dogs with PSS (14.6 +/- 3.7 pixel intensity units [PIU] was significantly (p = 0.05) larger than reported for normal dogs (3.6 +/- 1.4 PIU/s). These results indicate that combined coded harmonic angiographic and contrast harmonic perfusion sonography can be used to detect increased hepatic arterial blood flow as an indicator of PSS in dogs.
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Affiliation(s)
- Rochelle M Salwei
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706, USA
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Kim JH, Kim TK, Kim BS, Eun HW, Kim PN, Lee MG, Ha HK. Enhancement of hepatic hemangiomas with levovist on coded harmonic angiographic ultrasonography. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2002; 21:141-148. [PMID: 11833870 DOI: 10.7863/jum.2002.21.2.141] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
OBJECTIVE To evaluate the pattern of contrast enhancement with Levovist on coded harmonic angiographic ultrasonography of hepatic hemangiomas. METHODS Twenty hemangiomas were evaluated with coded harmonic angiographic ultrasonography and a microbubble contrast agent. Verification of the diagnosis of a hemangioma was made by means of dynamic computed tomography (n = 8), dynamic magnetic resonance imaging (n = 1), radionuclide scanning (n = 6), or follow-up ultrasonography (n = 5). Ultrasonographic images were obtained before contrast agent administration and with a bolus injection of 2.5 g of a microbubble contrast agent (300 mg/mL Levovist; Schering AG, Berlin, Germany) every 10 to 15 seconds for 5 minutes. The contrast enhancement patterns of the 20 hemangiomas were assessed. RESULTS The tumor diameters as measured on ultrasonography were 7 to 97 mm (mean, 26.7 mm). Of the 20 hemangiomas, peripheral globular enhancement with progressive centripetal fill-in was shown in 15 (75%), rimlike enhancement with progressive centripetal fill-in was shown in 2 (10%), and homogeneous enhancement was shown in 1 (5%). In the remaining 2 lesions (10%), the enhancement patterns could not be seen, because they were not found on coded harmonic angiographic ultrasonography. CONCLUSIONS Coded harmonic angiographic ultrasonography with a microbubble contrast agent can depict the typical enhancement pattern in most hepatic hemangiomas.
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Affiliation(s)
- Jung Hoon Kim
- Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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