Evaluating perfusion of thoracic spinal cord blood using CEUS during thoracic spinal stenosis decompression surgery

Study design:A clinical study in human spinal cord.Objectives:To evaluate changes in spinal cord blood perfusion in patients with thoracic spinal stenosis using contrast-enhanced ultrasonography and to semiquantitatively analyze blood perfusion changes in compressed spinal cord before and after ventral decompression.Setting:Ultrasound department of a university hospital.Methods:Twelve patients with confirmed thoracic spinal stenosis who needed decompression surgery participated. They underwent an intravenous injection of a contrast agent before and after ventral decompression. Quantitative analysis software (Philips Healthcare, Bothell, WA, USA) was used to perform time-intensity curve (TIC) analysis. The enhanced intensity (ΔI), rise time (ΔT) and slope of the TIC (β) were separately calculated; t-tests of the independent samples were performed on the indicators.Results:The TICs showed no significant differences between compressed spinal cord and normal spinal cord in ΔT, enhanced ΔI and β (P= 0.46, P=0.23 and P=0.16, respectively). After ventral decompression, ΔI of the originally compressed spinal cord increased substantially (P= 0.04) compared with ΔI of the normal spinal cord; however, the ΔT and β showed no significant differences (P= 0.18 and P=0.09, respectively). Comparison of the blood perfusion parameters (that is, ΔT and ΔI) of the compressed spinal cords before and after ventral decompression showed no significant differences (P=0.14 and P=0.12, respectively), but β showed significant difference (P=0.02).Conclusion:Contrast-enhanced ultrasonography can dynamically display spinal cord blood perfusion. The characteristics of blood perfusion can be semiquantitatively analyzed using a software technique.Spinal Cord advance online publication, 13 January 2015; doi:10.1038/sc.2014.213.