Not provided
Not provided
| ID | Type | Description | Link |
|---|---|---|---|
| 2023-A00939-36 | Other Identifier | IDRCB number |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
The objective of the study is to assess brain tissue perfusion by contrast-enhanced ultrasound perfusion imaging (PerCEUS) in acute brain injuries. More precisely, it aims :
The main aim is to evaluate the heterogeneity of brain perfusion, thus diagnosing brain tissue hypoperfusion with PerCEUS, then to correlate it with the usual multimodal monitoring.
Earlier after hospitalization in neurointensive care, when the study physician needs to realize a contrast ultrasound imaging and without delaying any emergency procedure, a PerCEUS will be performed in patients with an acute brain injury. After acquisition, data from PerCEUS will be transferred to an external evaluation unit and analysed offline, using commercially available software Qlab (Philips ®). According to the localization of acute brain injuries with magnetic resonance imaging (MRI) and/or computed tomography (CT), several regions-of-interest (ROI, at least three in each area) will be chosen :
Every parameters of multimodal monitoring used at the moment of PerCEUS will be relieved :
The actual PerCEUS measurement takes place at the bedside, is performed by the study physician, and takes about 5 minutes.
The trial duration per patient is 30 minutes, ending after 25 minutes of oversight
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients with acute brain injuries when a contrast ultrasound imaging is requested by the physician | Contrast-enhanced ultrasound perfusion imaging (PerCEUS) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Measuring contrast-enhanced ultrasound perfusion with phase inversion harmonic imaging | Diagnostic Test | Contrast-enhanced ultrasound perfusion imaging (PerCEUS) will be performed by a dedicated study team. The transcranial color duplex sonography will be performed with a 1-5 MHz dynamic sector array (S5-1) from a Philips Epiq 7 ultrasound machine (Philips Healthcare, Andover, MA). The field-of-view will be set to an imaging depth of 150 mm in a sector angle of 90°. The imaging plane will be then tilted to the diencephalic, in which the frontal horns of the side ventricles and the third ventricle serve as landmarks and where the anterior and posterior middle cerebral artery (MCA) territory and the basal ganglia (BG) as region of interest could be identified without artefacts from major vessels. High mechanical index bolus imaging will be performed from the sanest side of the head. Data acquisition of 45 seconds will be recorded immediately after the beginning of the contrast ultrasound imaging, using a mechanical index (MI) setting of 1.1 and a frame rate of 33 Hz. |
| Measure | Description | Time Frame |
|---|---|---|
| Evaluation of the heterogeneity of brain perfusion by time-to-peak (TPI) measurement | Comparison between time-to-peak (TPI) intensities measured in ROIs in each area by PerCEUS | 30 minutes after PerCEUS |
| Evaluation of the heterogeneity of brain perfusion by peak-intensities (PI) measurement | Comparison between peak-intensities (PI) measured in ROIs in each area by PerCEUS | 30 minutes after PerCEUS |
| Measure | Description | Time Frame |
|---|---|---|
| Correlation between PerCEUS parameters and cerebral perfusion as assessed by ICP and MAP | Correlations test between TPI/PI and ICP/CPP/MAP | 30 minutes after PerCEUS |
| Correlation between PerCEUS parameters and cerebral perfusion as assessed by TCD |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Patients hospitalized in neurosurgical intensive care in Lariboisière Hospital, Paris, with acute brain injuries
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Romain BARTHELEMY, MD | Contact | +33 (0)1 49 95 85 15 | romain.barthelemy@aphp.fr | |
| Benjamin Glenn CHOUSTERMAN, MD PhD | Contact | +33 (0)1 49 95 85 18 | benjamin.chousterman@aphp.fr |
| Name | Affiliation | Role |
|---|---|---|
| Romain BARTHELEMY, MD | AP-HP Lariboisière Hospital, Department of Anaesthesia and Intensive Care | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Lariboisière Hospital | Recruiting | Paris | 75010 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 15146019 | Background | Eyding J, Krogias C, Wilkening W, Postert T. Detection of cerebral perfusion abnormalities in acute stroke using phase inversion harmonic imaging (PIHI): preliminary results. J Neurol Neurosurg Psychiatry. 2004 Jun;75(6):926-9. doi: 10.1136/jnnp.2003.026195. | |
| 32192077 | Background | Eyding J, Fung C, Niesen WD, Krogias C. Twenty Years of Cerebral Ultrasound Perfusion Imaging-Is the Best yet to Come? J Clin Med. 2020 Mar 17;9(3):816. doi: 10.3390/jcm9030816. |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| ID | Term |
|---|---|
| D002543 | Cerebral Hemorrhage |
| D013345 | Subarachnoid Hemorrhage |
| D000083242 | Ischemic Stroke |
| ID | Term |
|---|---|
| D020300 | Intracranial Hemorrhages |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
Not provided
Not provided
Not provided
Not provided
Not provided
|
Correlations test between TPI/PI and MFV
| 30 minutes after PerCEUS |
| Correlation between PerCEUS parameters and cerebral perfusion as assessed by NIRS | orrelations test between TPI/PI and rSO2 | 30 minutes after PerCEUS |
| Correlation between PerCEUS parameters and cerebral perfusion as assessed by SjvO2 | Correlations test between TPI/PI and SjvO2 | 30 minutes after PerCEUS |
| 28964614 | Background | Vinke EJ, Kortenbout AJ, Eyding J, Slump CH, van der Hoeven JG, de Korte CL, Hoedemaekers CWE. Potential of Contrast-Enhanced Ultrasound as a Bedside Monitoring Technique in Cerebral Perfusion: a Systematic Review. Ultrasound Med Biol. 2017 Dec;43(12):2751-2757. doi: 10.1016/j.ultrasmedbio.2017.08.935. Epub 2017 Sep 28. |
| 35211837 | Background | Fung C, Heiland DH, Reitmeir R, Niesen WD, Raabe A, Eyding J, Schnell O, Rolz R, Z Graggen WJ, Beck J. Ultrasound Perfusion Imaging for the Detection of Cerebral Hypoperfusion After Aneurysmal Subarachnoid Hemorrhage. Neurocrit Care. 2022 Aug;37(1):149-159. doi: 10.1007/s12028-022-01460-z. Epub 2022 Feb 24. |
| 27475927 | Background | Bilotta F, Robba C, Santoro A, Delfini R, Rosa G, Agati L. Contrast-Enhanced Ultrasound Imaging in Detection of Changes in Cerebral Perfusion. Ultrasound Med Biol. 2016 Nov;42(11):2708-2716. doi: 10.1016/j.ultrasmedbio.2016.06.007. Epub 2016 Jul 27. |
| D009422 | Nervous System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D006470 | Hemorrhage |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D020521 | Stroke |