Draganski, Bogdan and Blersch, Wendelin and Holmer, Stefan and Koch, Horst and May, Arne and Bogdahn, Ul and Hoelscher, Thilo and Schlachetzki, Felix (2005) Detection of cardiac right-to-left shunts by contrast-enhanced harmonic carotid duplex sonography. JOURNAL OF ULTRASOUND IN MEDICINE, 24 (8). pp. 1071-1076. ISSN 0278-4297,
Full text not available from this repository. (Request a copy)Abstract
Objective. Paradoxical embolization by cardiac right-to-left shunts (RLS) is increasingly recognized as an important factor for embolic stroke. Contrast-enhanced transcranial Doppler sonography (ce-TCDS) is an established diagnostic tool for RLS detection but is frequently limited because of an inadequate temporal acoustic bone window. The purpose of this study was to determine whether extracranial sonography (ECS) using harmonic frequencies improves detection of RLS. Methods. Extracranial color duplex sonography using harmonic frequencies enables visualization of even single ultrasound contrast agent microbubbles because of oscillation. Patients with stroke and positive RLS findings on transesophageal echocardiography underwent a simultaneous extracranial and transcranial sonographic examination of the proximal common carotid artery (CCA) and middle cerebral artery (MCA) on the same side. A Valsalva strain was performed for 10 seconds after intravenous bolus injection of a galactose-based nontranspulmonary contrast agent. The B-mode frame sequences of the transverse plane of the CCA obtained by harmonic ECS and the ce-TCDS recordings of high-intensity transient signals from the MCA were analyzed offline. Results. In all patients with RLS, the shunts could be identified by harmonic ECS. A close correlation could be seen between the count of visualized microbubbles in the CCA and the number of high-intensity transient signals detected on ce-TCDS in the ipsilateral MCA. Conclusions. The results of this study indicate that contrast-enhanced ultrasound harmonic imaging of the CCA using a Valsalva strain might be an optional screening tool for detection of cardiac RLS in patients with insufficient acoustic bone windows.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | PATENT FORAMEN OVALE; TRANSCRANIAL DOPPLER ULTRASOUND; COLOR-CODED SONOGRAPHY; TRANSESOPHAGEAL ECHOCARDIOGRAPHY; CRYPTOGENIC STROKE; TRANSTHORACIC ECHOCARDIOGRAPHY; EMBOLIC EVENTS; LIMITATIONS; DIAGNOSIS; AGENTS; cardiac right-to-left shunt; extracranial duplex sonography; harmonic imaging; stroke |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II Medicine > Lehrstuhl für Neurologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 03 May 2021 11:25 |
| Last Modified: | 03 May 2021 11:25 |
| URI: | https://pred.uni-regensburg.de/id/eprint/35831 |
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