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Validation of the Depletion Kinetic in Semiquantitative Ultrasonographic Cerebral Perfusion Imaging Using 2 Different Techniques of Data Acquisition

Department of Neurology, St Josef Hospital, Ruhr-University, Bochum, Germany (J.E., C.K., H.P., S.M., T.P.); Department of Electrical Engineering, Institute of High Frequency Engineering, Ruhr-University, Bochum, Germany (W.W.); Department of Radiology, USCD Healthcare, University of California, San Diego, California USA (T.H.); and Department of Neurology, St Vincenz Hospital, Paderborn, Germany (T.P.).

Address correspondence and reprint requests to Jens Eyding, MD, Neurologische Klinik der Ruhr-Universität, St Josef Hospital, Gudrunstrasse 56, D-44791 Bochum, Germany. E-mail: jeyding{at}web.de.

Objective.To validate the potential of ultrasonographic depletion imaging for semiquantitatively visualizing cerebral parenchymal perfusion with contrast burst depletion imaging (CODIM) in comparison with phase inversion harmonic depletion imaging (PIDIM) in healthy volunteers. Methods.Thirteen healthy adults were examined with both CODIM and PIDIM in accordance with previously described criteria. In addition to the perfusion coefficient, the time to decrease image intensity to 10% above equilibrium intensity from the initial value and the relative error (deviation of measured data from the fitted model) were evaluated to compare the reliability of both techniques in 3 different regions of interest. Results.Perfusion coefficient values did not show significantly differing values in both groups (1.57–1.64 • 10^–2 s^–1 for CODIM and 1.42–1.58 • 10^–2 s^–1 for PIDIM). The relative error was significantly smaller in the PIDIM group (0.38–0.53 for CODIM and 0.18–0.25 for PIDIM; P < .002). Conclusions. Phase inversion harmonic depletion imaging proved to be more reliable than CODIM because values of the relative error were significantly lower in PIDIM even in this relatively small cohort. This is of interest because the underlying technique, phase inversion harmonic imaging, is more widely available than contrast burst imaging.

Key Words: cerebral perfusion • depletion kinetic • harmonic imaging • ultrasonography

Abbreviations: CBI, contrast burst imaging • CODIM, contrast burst depletion imaging • cT, contralateral thalamus • HI, harmonic imaging • iLN, ipsilateral lentiform nucleus • iT, ipsilateral thalamus • PC, perfusion coefficient • PIDIM, phase inversion harmonic depletion imaging • PIHI, phase inversion harmonic imaging • RE, relative error • ROI, region of interest • T_min, minimal observation time • UCA, ultrasonographic contrast agent

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