Translational Neurosonology

Description

Diagnostic ultrasound has become an elementary tool for evaluating cerebrovascular diseases and plays a prominent role in routine clinical practice. Many publications attempt to cover the continuous progress of its diagnostic and even therapeutic applications. However, the impact ultrasound has made in recent years in the fields of animal studies and human research is less well known. This publication provides an overview on exciting current attempts in neurological diseases, ranging from experimental approaches to established imaging modes ready to be incorporated into the routine of daily practice. The first part of the book concentrates on basic principles of neurosonology and focuses on contrast imaging, specific ultrasound contrast agents and safety aspects. The following chapters deal with different vascular ultrasound applications, allowing an optimized characterization of atherosclerotic disease and monitoring of cerebral autoregulation. In addition, the role of parenchymal ultrasound imaging in cerebrovascular diseases and movement disorders is illustrated. The final chapters look at promising new therapeutic approaches implementing ultrasound although they are still no more than experimental. The book can be highly recommended to clinical neurologists with good knowledge in clinical ultrasound who wish to gain a compact and updated insight into the plethora of capabilities of neurosonology in the future.

Informations

• Publié par: S. Karger AG
• Date de parution: 16 décembre 2014
• Nombre de lectures: 0
• EAN13: 9783318027914
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

Translational Neurosonology
Frontiers of Neurology and Neuroscience
Vol. 36
Series Editor
J. Bogousslavsky Montreux
Translational Neurosonology
Volume Editors
A. Alonso Mannheim
M.G. Hennerici Mannheim
S. Meairs Mannheim
22 figures, 6 in color, and 1 table, 2015
Frontiers of Neurology and Neuroscience Vols. 1-18 were published as Monographs in Clinical Neuroscience
_______________________ PD Dr. Angelika Alonso Prof. Dr. Michael G. Hennerici Prof. Dr. Stephen Meairs Department of Neurology Universitätsmedizin Mannheim University of Heidelberg Theodor-Kutzer-Ufer 1-3 DE-68167 Mannheim (Germany)
Library of Congress Cataloging-in-Publication Data
Translational neurosonology / volume editors, A. Alonso, M.G. Hennerici, S. Meairs.
p.; cm. –– (Frontiers of neurology and neuroscience, ISSN 1660-4431 ; vol. 36)
Includes bibliographical references and indexes.
ISBN 978-3-318-02790-7 (hard cover: alk. paper) –– ISBN 978-3-318-02791-4 (e-ISBN)
I. Alonso, A. (Angelika), editor. II. Hennerici, M. (Michael), editor. III. Meairs, Stephen P. (Stephen Philip), 1952-, editor. IV. Series: Frontiers of neurology and neuroscience; v. 36.1660-4431
[DNLM:1. Nervous System Diseases––ultrasonography. 2. Nervous System––ultrasonography. 3. Translational Medical Research. 4. Vascular Diseases––ultrasonography. W1 MO568C v.36 2015/WL 141]
RC349.U47
616.8'047543––dc23
2014038454
Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents ® and Index Medicus.
Disclaimer. The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
© Copyright 2015 by S. Karger AG, P.O. Box, CH-4009 Basel (Switzerland)
www.karger.com
Printed in Germany on acid-free and non-aging paper (ISO 9706) by Kraft Druck, Ettlingen
ISSN 1660-4431
e-ISSN 1662-2804
ISBN 978-3-318-02790-7
e-ISBN 978-3-318-02791-4
Contents
Preface
Hennerici, M.G. (Mannheim)

Principles of Cerebral Ultrasound Contrast Imaging
Powers, J. (Bothell, Wash.); Averkiou, M. (Nicosia)
Physical Principles of Microbubbles for Ultrasound Imaging and Therapy
Stride, E. (London)
Ultrasound Bio-Effects and Safety Considerations
ter Haar, G. (Sutton)
Intima-Media Thickness of Carotid Arteries
Touboul, P.-J. (Paris)
Functional TCD: Regulation of Cerebral Hemodynamics - Cerebral Autoregulation, Vasomotor Reactivity, and Neurovascular Coupling
Wolf, M.E. (Mannheim)
Intracranial Perfusion Imaging with Ultrasound
Meairs, S.; Kern, R. (Mannheim)
Parenchymal Imaging in Movement Disorders
Fernandes, R.C.L. (Rio de Janeiro); Berg, D. (Tübingen)
Sonothrombolysis
Meairs, S. (Mannheim)
Non-Invasive Transcranial Brain Ablation with High-Intensity Focused Ultrasound
Jenne, J.W. (Bremen)
Ultrasound-Induced Blood-Brain Barrier Opening for Drug Delivery
Alonso, A. (Mannheim)
Author Index
Subject Index
Preface
Since the introduction of non-invasive ultrasound technologies in clinical practice in the early 1970s, the diagnosis and treatment of neurovascular diseases have made tremendous progress. Today, ultrasound is capable not only of monitoring the early silent stages of atherogenesis in infancy and atherosclerosis in very old age in an increasingly ageing population but also of identifying and evaluating the morphological patterns of plaque development and prognosis during progression and regression in most large arteries of the body. In addition, perfusion studies can be performed to assess arteriolar and capillary networks as well as collateral capacities in small vessel disease.
The ability of ultrasound to visualise both arterial and venous blood flow characteristics, including turbulence vortices and tortuosities, as well as vessel wall structures, thrombus formation and the generation of emboli during treatment or spontaneous fragmentation can be observed and quantified based on circulating microemboli. Translational studies have contributed to increasingly enormous knowledge about the underlying pathomechanisms and molecular biological processes. In line with other vascular imaging modalities, such as magnetic resonance angiography and computed tomography angiograms, vascular ultrasound studies are important tools in individual patients during follow-up. Indeed, ultrasound has become the stethoscope of the stroke physician and has widely replaced palpitation and auscultation in vascular medicine.
In addition, ultrasound has been implemented in prospective randomised clinical trials, both in epidemiological and in interventional studies. The standardisation of examination procedures and refined states of technology and data analysis has helped to identify new pathways for the best medical management of patients, e.g. lifestyle modification; treatment of the risk factors of atherosclerosis and thromboembolism; or interventional and surgical management, such as thrombectomies, stenting and dilatation. In addition, although not yet established in clinical practice, sonothrombolysis with or without drug application has made considerable progress. Catheterbased transcutaneous and intraarterial ultrasounds show enhancement of fibrinolytic agents, and in the early 20th century, the first clinical studies evaluated the adjunct effect of ultrasound in treating patients with acute ischaemic stroke, whether frank insonation of large vessels or by microbubble-enhanced thrombolysis with or without encapsulated tissue plasminogen activator was used.
The transport of microbubbles incorporating other drugs has been tested and is currently being developed to pass through the intact blood-brain barrier (BBB) in specific focused areas, sometimes combined with other neuroimaging technologies for the treatment of non-vascular diseases. Apart from the temporary destruction of the BBB, the closure of vascular leakage may be useful in patients suffering from intracerebral haemorrhage. Increasing knowledge also suggests that ultrasound may be applied for transient focal opening or closure of the BBB if combined with high-resolution MR imaging of brain tissue to facilitate ‘microscopic’ treatment; with very limited tissue damage, minimally invasive permanent or transient tissue modulation may be achieved, as recently shown for the treatment of essential tremor, Parkinson's disease and other brain disorders.
Animal models and randomised clinical trials are important tools in translational studies, contributing to our increasing knowledge, and will be reviewed in several sections in this book. New developments in technology and imaging refinement will be addressed in addition to supportive technologies used for neurovascular studies; a separate chapter deals with potential bioeffects and safety issues. New aspects of structural and functional imaging will be addressed based on useful information from experimental studies, leading to refined assessment of healthy subjects and of patients with cerebrovascular and neurodegenerative diseases. Finally, recently developed strategies will be presented for non-invasive ultrasound treatment, which is still limited in clinical application but ready to undergo properly designed trial evaluation.
Michael G. Hennerici , Mannheim
 
Alonso A, Hennerici MG, Meairs S (eds): Translational Neurosonology. Front Neurol Neurosci. Basel, Karger, 2015, vol 36, pp 1-10 (DOI: 10.1159/000366222)
______________________
Principles of Cerebral Ultrasound Contrast Imaging
Jeff Powers a Michalakis Averkiou b
a Philips Ultrasound, MS 1010, Bothell, Wash., USA; b Biomedical Engineering Program, Department of Mechanical Engineering, University of Cyprus, Nicosia, Cyprus
______________________
Abstract
Ultrasound contrast is gaining acceptance worldwide as an adjunct to conventional ultrasound imaging. It has clinical applications as diverse as liver disease detection and characterization, myocardial perfusion and wall motion studies, and imaging of cerebral vascularity and perfusion. This paper will focus on imaging techniques used for transcranial ultrasound contrast imaging. The interaction of ultrasound with the mic