Cerebral microcirculation mapped by echo particle tracking velocimetry quantifies the intracranial pressure and detects ischemia

Zeng Zhang, Misun Hwang, Todd J. Kilbaugh, Anush Sridharan and Joseph Katz ()
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Zeng Zhang: Johns Hopkins University
Misun Hwang: Children’s Hospital of Philadelphia
Todd J. Kilbaugh: Children’s Hospital of Philadelphia
Anush Sridharan: Children’s Hospital of Philadelphia
Joseph Katz: Johns Hopkins University

Nature Communications, 2022, vol. 13, issue 1, 1-15

Abstract: Abstract Affecting 1.1‰ of infants, hydrocephalus involves abnormal accumulation of cerebrospinal fluid, resulting in elevated intracranial pressure (ICP). It is the leading cause for brain surgery in newborns, often causing long-term neurologic disabilities or even death. Since conventional invasive ICP monitoring is risky, early neurosurgical interventions could benefit from noninvasive techniques. Here we use clinical contrast-enhanced ultrasound (CEUS) imaging and intravascular microbubble tracking algorithms to map the cerebral blood flow in hydrocephalic pediatric porcine models. Regional microvascular perfusions are quantified by the cerebral microcirculation (CMC) parameter, which accounts for the concentration of micro-vessels and flow velocity in them. Combining CMC with hemodynamic parameters yields functional relationships between cortical micro-perfusion and ICP, with correlation coefficients exceeding 0.85. For cerebral ischemia cases, the nondimensionalized cortical micro-perfusion decreases by an order of magnitude when ICP exceeds 50% of the MAP. These findings suggest that CEUS-based CMC measurement is a plausible noninvasive method for assessing the ICP and detecting ischemia.

Date: 2022
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DOI: 10.1038/s41467-022-28298-5

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