造影超音波検査およびMRI所見と相関させた症候性新生児脳卒中のベッドサイド超音波検査および造影超音波検査所見：症例シリーズ研究

The purpose of this study was to evaluate bedside cranial ultrasound (CUS) and contrast-enhanced ultrasound (CEUS) for demonstrating changes in neonatal arterial ischemic stroke (NAIS). Fifteen newborns with symptomatic NAIS underwent a cranial ultrasound examination and subsequently confirmed by magnetic resonance imaging (MRI), were enrolled. Color Doppler Flow Imaging (CDFI) and Pulsed-Wave Doppler (PW) were performed to acquire data from 6 coronal, 5 sagittal, and 3 cerebellar planes through the anterior or mastoid fontanelle. For CEUS, a 2-minute wash-in cine clip and static images were captured. CUS showed all lesions in the blood-supplying region of the middle cerebral artery (MCA), with 10(66.7%) located on the left hemisphere, and on the right. CEUS was performed on 3 neonates to evaluate microvascular perfusion. Two cases showed a large area of non-enhancement on the lesion side, while the third case showed significantly higher enhancement on the lesion side. MRI confirmed all lesions in the MCA blood-supplying region, with 10 on the left hemisphere and 5 on the right. Magnetic resonance angiography (MRA) identified abnormalities in the trunk or branches of the MCA in 8 neonates. Our preliminary results suggest that CUS can evaluate NAIS in conjunction with MRI and CEUS metrics may have potential for clinical quantification, warranting future validation studies.