IJCNMH ARCpublishing

Issue: Issue 1 (2014) – Supplement 1

Original Article

Transcranial color coded sonography: advanced approach using ultrasound fusion imaging

Stephan J. Schreiber, José M. Valdueza, and Florian Doepp
Background: Transcranial color-coded sonography (TCCS) is a well established method to study intracranial parenchymal and vascular structures. It is, however, limited by the need to insonate through available bone windows, resulting in oblique imaging planes, which can hinder easy allocation, particularly within the brain parenchyma and limit the opportunity for direct comparison with other imaging techniques. The objective of this study was to analyze the diagnostic yield of the ultrasound fusion imaging (UFI) technique using standard diagnostic approaches.

Methods: UFI is a new technique, permitting an online matching and comparison of live ultrasound images with preregistered CT or MRI images by means of a local electromagnetic field. The principles and setup of the technique for transcranial UFI is demonstrated and examples of its use in assessing established insonation planes given.

Results: UFI is suitable for transcranial insonation and allows easy combination of live ultrasound with routine diagnostic CT or MRI image datasets in the classical TCCS transtemporal and transforaminal insonation planes. System setting and matching is fast and movement artifacts are eliminated by the use of a motion tracker correction. First application in patients demonstrates easy identification and comparison of structural lesions like dilated ventricles, arachnoid cyst, or subdural hematoma.

Conclusion: UFI offers a unique opportunity to study transcranial ultrasound and CT or MRI anatomy simultaneously. It seems therefore particularly promising to be further analyzed concerning its potentials in teaching and education as well as in any intracranial condition in which repetitive intracranial imaging is required.

Keywords: Ultrasound, Virtual navigation, Transcranial color-coded sonography, Duplex ultrasound, Imaging planes.

International Journal of Clinical Neurosciences and Mental Health 2014; 1(Suppl. 1):S16

Supplemental Material

Video 1: Ultrasound fusion imaging (UFI) with a T2-weighted MRI dataset. The video demonstrates an UFI example of color-mode ultrasound matched with a T2-weighted MRI dataset in a patient with no pathological findings.The sequence, using the axial transtemporal approach starts with the classical midbrain plane moving downwards to the upper and lower pons plane. Please note the simultaneous movements in both imaging modalities and the excellent correlation of color-mode ultrasound signal and the corresponding arterial flow-void in the MRI dataset.
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