Real-time 3-D contrast-enhanced transcranial ultrasound and aberration correction

Abstract

Contrast-enhanced (CE) transcranial ultrasound (US) and reconstructed 3-D transcranial ultrasound have shown advantages over traditional methods in a variety of cerebrovascular diseases. We present the results from a novel ultrasound technique, namely real-time 3-D contrast-enhanced transcranial ultrasound. Using real-time 3-D (RT3D) ultrasound and microbubble contrast agent, we scanned 17 healthy volunteers via a single temporal window and nine via the suboccipital window and report our detection rates for the major cerebral vessels. In 71% of subjects, both of our observers identified the ipsilateral circle of Willis from the temporal window, and in 59% we imaged the entire circle of Willis. From the suboccipital window, both observers detected the entire vertebrobasilar circulation in 22% of subjects, and in 44%, the basilar artery. After performing phase aberration correction on one subject, we were able to increase the diagnostic value of the scan, detecting a vessel not present in the uncorrected scan. These preliminary results suggest that RT3D CE transcranial US and RT3D CE transcranial US with phase aberration correction have the potential to greatly impact the field of neurosonology.

Figures

Fig. 1

Schematic of 2D matrix array scanning a pyramid and displaying simultaneous axial, coronal, and parasagittal scans, as well as steerable spectral Doppler (red).

Fig. 2

Flowchart of signal processing for offline 3D Doppler volume rendering.

Fig. 3

Typical Temporal Window Findings. (a) Axial scan showing the circle of Willis comprised of the ispilateral A1, M1, P1 and P2, as well as the contralateral A1, and P1. (b) Coronal scan showing the BA bifurcating to the P1 segments of the PCAs. (c) 3D color Doppler rendering of the cerebrovascular tree. (d) Schematic of (c). (e) Spectral Doppler trace from an M1 showing velocity over the full cardiac cycle.

Fig. 3

Typical Temporal Window Findings. (a) Axial scan showing the circle of Willis comprised of the ispilateral A1, M1, P1 and P2, as well as the contralateral A1, and P1. (b) Coronal scan showing the BA bifurcating to the P1 segments of the PCAs. (c) 3D color Doppler rendering of the cerebrovascular tree. (d) Schematic of (c). (e) Spectral Doppler trace from an M1 showing velocity over the full cardiac cycle.

Fig. 3

Typical Temporal Window Findings. (a) Axial scan showing the circle of Willis comprised of the ispilateral A1, M1, P1 and P2, as well as the contralateral A1, and P1. (b) Coronal scan showing the BA bifurcating to the P1 segments of the PCAs. (c) 3D color Doppler rendering of the cerebrovascular tree. (d) Schematic of (c). (e) Spectral Doppler trace from an M1 showing velocity over the full cardiac cycle.

Fig. 3

Typical Temporal Window Findings. (a) Axial scan showing the circle of Willis comprised of the ispilateral A1, M1, P1 and P2, as well as the contralateral A1, and P1. (b) Coronal scan showing the BA bifurcating to the P1 segments of the PCAs. (c) 3D color Doppler rendering of the cerebrovascular tree. (d) Schematic of (c). (e) Spectral Doppler trace from an M1 showing velocity over the full cardiac cycle.

Fig. 3

Typical Temporal Window Findings. (a) Axial scan showing the circle of Willis comprised of the ispilateral A1, M1, P1 and P2, as well as the contralateral A1, and P1. (b) Coronal scan showing the BA bifurcating to the P1 segments of the PCAs. (c) 3D color Doppler rendering of the cerebrovascular tree. (d) Schematic of (c). (e) Spectral Doppler trace from an M1 showing velocity over the full cardiac cycle.

Fig. 4

Typical Sub-Occipital Window Findings. (a) Sub-occipital coronal scan showing the junction of the left and right vertebral arteries (LVA and RVA, respectively) into the basilar artery (BA). (b) Sub-occipital parasaggital scan showing the PICA bifurcating from the LVA. (c) 3D Doppler rendering of vertebrobasilar circulation. (d) Schematic of (c). (e) Spectral Doppler trace from a BA showing velocity over the full cardiac cycle.

Fig. 4

Typical Sub-Occipital Window Findings. (a) Sub-occipital coronal scan showing the junction of the left and right vertebral arteries (LVA and RVA, respectively) into the basilar artery (BA). (b) Sub-occipital parasaggital scan showing the PICA bifurcating from the LVA. (c) 3D Doppler rendering of vertebrobasilar circulation. (d) Schematic of (c). (e) Spectral Doppler trace from a BA showing velocity over the full cardiac cycle.

Fig. 4

Typical Sub-Occipital Window Findings. (a) Sub-occipital coronal scan showing the junction of the left and right vertebral arteries (LVA and RVA, respectively) into the basilar artery (BA). (b) Sub-occipital parasaggital scan showing the PICA bifurcating from the LVA. (c) 3D Doppler rendering of vertebrobasilar circulation. (d) Schematic of (c). (e) Spectral Doppler trace from a BA showing velocity over the full cardiac cycle.

Fig. 4

Typical Sub-Occipital Window Findings. (a) Sub-occipital coronal scan showing the junction of the left and right vertebral arteries (LVA and RVA, respectively) into the basilar artery (BA). (b) Sub-occipital parasaggital scan showing the PICA bifurcating from the LVA. (c) 3D Doppler rendering of vertebrobasilar circulation. (d) Schematic of (c). (e) Spectral Doppler trace from a BA showing velocity over the full cardiac cycle.

Fig. 4

Typical Sub-Occipital Window Findings. (a) Sub-occipital coronal scan showing the junction of the left and right vertebral arteries (LVA and RVA, respectively) into the basilar artery (BA). (b) Sub-occipital parasaggital scan showing the PICA bifurcating from the LVA. (c) 3D Doppler rendering of vertebrobasilar circulation. (d) Schematic of (c). (e) Spectral Doppler trace from a BA showing velocity over the full cardiac cycle.

Fig 5

Phase Aberration Correction Results. Uncorrected (a) and Corrected (b) 3D Doppler volume renderings. Note the presence of the contralateral A1 and more Doppler signal in the corrected image.

Fig 5

Phase Aberration Correction Results. Uncorrected (a) and Corrected (b) 3D Doppler volume renderings. Note the presence of the contralateral A1 and more Doppler signal in the corrected image.