Echoenhancers in Transcranial Sonography.

Abstract

The introduction of transpulmonary stable echoenhancing agents offer new perspectives for transcranial ultrasound. Improving signal intensity and therefore signal to noise ratio enables to perform Doppler sonography according to established clinical criteria in patients with insufficient acoustic bone window. The complete asessment of the circle of Willis is achievable and the number of non-diagnostic scans is reduced. Echoenhancement also offers new perspectives, increasing the sensitivity of ultrasound scanning for low volume flow as in high grade stenosis, and for low velocity flow as in the cerebral venous system. These improvements support the analysis of vascular pathologies such as stenosis, occlusion, AV malformations, aneurysms and cavernomas. The vascularity of tumors, with low velocity and low flow volume, can be assessed, and new diagnostic opportunities arise from the transcranial analysis of the venous system for thrombosis. Additionally, new approches such as three-dimensional vascular imaging are enabled by the iv. application of echoenhancers. With an excellent safety profile, echoenhancers add to diagnostic capabilities of transcranial Doppler ultrasound, resulting in less non-diagnostic scans, improved accuracy of diagnosis and novel diagnostic opportunities.