Abstract
This study tried to quantify spinal cord perfusion by using contrast-enhanced ultrasound (CEUS) in rhesus monkey models with acute spinal cord injury. Acute spinal cord perfusion after injury was detected by CEUS, coupling with conventional ultrasound (US) and Color Doppler US (CDFI). Time-intensity curves and perfusion parameters were obtained by autotracking contrast quantification (ACQ) software in the epicenter and adjacent regions of injury, respectively. Neurological and histological examinations were performed to confirm the severity of injury. US revealed spinal cords were hypoechoic and homogeneous, whereas dura maters, pia maters, and cerebral aqueducts were hyperechoic. After spinal cord contusion, the injured spinal cord was hyperechoic on US, and intramedullary vessels of adjacent region of injury were increased and dilated on CDFI. On CEUS hypoperfusion were found in the epicenter of injury, while hyperperfusion in its adjacent region. Quantitative analysis showed that peak intensity (PI) decreased in epicenters of injury but significantly increased in adjacent regions at all time points (p < 0.05). Functional evaluation demonstrated significant deterioration compared to pre-contusion (p < 0.05). Quantitative analysis with CEUS is a promising method for monitoring perfusion changes of spinal cord injury in overall views and real-time.
Highlights
Vascular events have critical effects on spinal cord in primary and secondary injury
Hypoechoic and homogeneous echo pattern was found in parenchyma of all intact spinal cords (Figure 2A)
We demonstrated that intramedullary blood flow dramatically increased and vessels obviously dilated in regions close to injury immediately after contusion (Figure 2E) by color Doppler flow imaging (CDFI)
Summary
Vascular events have critical effects on spinal cord in primary and secondary injury. The initially mechanical insults primarily cause vessel disruption and damage blood supply of the spinal cord. Quantitative measurement of spinal cord blood flow (SCBF) is valuable for understanding pathophysiologic mechanisms of spinal cord injury (SCI) [1, 2]. Progressive “posttraumatic ischemia” has been recorded in a number of studies by using various methods for SCBF [1,2,3,4]. These techniques include hydrogen clearance, radioactive tracer microsphere and laser Doppler flowmetry. Few studies show perfusion changes in parenchyma of contusive spinal cord in overall views and real-time [5]
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