Skip to main content

Intraoperative Contrast-Enhanced Ultrasound in the Pediatric Neurosurgical Patient

  • Chapter
  • First Online:
Contrast-Enhanced Ultrasound in Pediatric Imaging

Abstract

B-mode represents the main imaging modality used during neurosurgical procedures. This chapter reviews our previous experiences in adult neurosurgery, in particular regarding intraoperative neoplastic evaluation, characterization and vessel visualization, applied during different paediatric neurosurgical procedures. We illustrate how CEUS can be employed in different intra-operative settings in paediatric neurosurgical patients and describe various conditions in which CEUS proved to be feasible and useful for cerebral and spinal cord malformation, neoplastic and vascular diseases. As contrast media is beneficial for the diagnosis and understanding with traditional neuroradiological imaging, ultrasound contrast agents should be included for completeness in most ultrasound studies, particularly in the paediatric population.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Kanno H, Ozawa Y, Sakata K, Sato H, Tanabe Y, Shimizu N, Yamamoto I. Intraoperative power Doppler ultrasonography with a contrast-enhancing agent for intracranial tumours. J Neurosurg. 2005;102:295–301.

    Article  Google Scholar 

  2. Engelhardt M, Hansen C, Eyding J, Wilkening W, Brenke C, Krogias C, Scholz M, Harders A, Ermert H, Schmieder K. Feasibility of contrast-enhanced sonography during resection of cerebral tumours: initial results of a prospective study. Ultrasound Med Biol. 2007;33:571–5.

    Article  Google Scholar 

  3. He W, Jiang X, Wang S, Zhang M, Zhao J, Liu H, Ma J, Xiang D, Wang L. Intraoperative contrast-enhanced ultrasound for brain tumors. Clin Imaging. 2008;32:419–24.

    Google Scholar 

  4. Hölscher T, Ozgur B, Singel S, Wilkening WG, Mattrey RF, Sang H. Intraoperative ultrasound using phase inversion harmonic imaging. Oper Neurosurg. 2007;60:382–7.

    Article  Google Scholar 

  5. Prada F, Bene MD, Casali C, et al. Intraoperative navigated angiosonography for skull base tumor surgery. World Neurosurg. 2015;84:1699. https://doi.org/10.1016/j.wneu.2015.07.025.

  6. Vetrano IG, Prada F, Nataloni IF, Del Bene M, DiMeco F, Valentini LG. Discrete or diffuse intramedullary tumor? Contrast-enhanced intraoperative ultrasound in a case of intramedullary cervicothoracic hemangioblastomas mimicking a diffuse infiltrative glioma: technical note and case report. Neurosurg Focus. 2015;39:E17. https://doi.org/10.3171/2015.5.FOCUS15162.

  7. Prada F, Mattei L, Del Bene M, et al. Intraoperative cerebral glioma characterization with contrast enhanced ultrasound. Biomed Res Int. 2014;2014:1. https://doi.org/10.1155/2014/484261.

    Article  Google Scholar 

  8. Sidhu P, Cantisani V, Dietrich C, et al. The EFSUMB guidelines and recommendations for the clinical practice of contrast-enhanced ultrasound (CEUS) in non-hepatic applications: update 2017 (long version). Ultraschall Med—Eur J Ultrasound. 2018;39:e2–e44.

    Article  Google Scholar 

  9. Prada F, Del Bene M, Saini M, Ferroli P, DiMeco F. Intraoperative cerebral angiosonography with ultrasound contrast agents: how I do it. Acta Neurochir. 2015;157:1025–9.

    Article  Google Scholar 

  10. Prada F, Perin A, Martegani A, et al. Intraoperative contrast-enhanced ultrasound for brain tumor surgery. Neurosurgery. 2014;74:542–52.

    Google Scholar 

  11. Kastler A, Manzoni P, Chapuy S, Cattin F, Billon-Grand C, Aubry S, Biondi A, Thiriez G, Kastler B. Transfontanellar contrast enhanced ultrasound in infants: initial experience. J Neuroradiol. 2014;41:251–8.

    Article  Google Scholar 

  12. Hwang M, De Jong RM, Herman S, et al. Novel contrast-enhanced ultrasound evaluation in neonatal hypoxic ischemic injury: clinical application and future directions. J Ultrasound Med. 2017;36:2379–86.

    Article  Google Scholar 

  13. Hwang M. Introduction to contrast-enhanced ultrasound of the brain in neonates and infants: current understanding and future potential. Pediatr Radiol. 2018;49:254. https://doi.org/10.1007/s00247-018-4270-1.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Bailey C, Huisman TAGM, de Jong RM, Hwang M. Contrast-enhanced ultrasound and elastography imaging of the neonatal brain: a review. J Neuroimaging. 2017;27:437–41.

    Article  Google Scholar 

  15. Prada F, Del Bene M, Mattei L, Lodigiani L, DeBeni S, Kolev V, Vetrano I, Solbiati L, Sakas G, DiMeco F. Preoperative magnetic resonance and intraoperative ultrasound fusion imaging for real-time neuronavigation in brain tumor surgery. Ultraschall Med—Eur J Ultrasound. 2014;36:174–86.

    Google Scholar 

  16. Vetrano IG, Prada F, Erbetta A, DiMeco F. Intraoperative ultrasound and contrast-enhanced ultrasound (CEUS) features in a case of intradural extramedullary dorsal schwannoma mimicking an intramedullary lesion. Ultraschall Med. 2015;36:307–10.

    Article  Google Scholar 

  17. Sidhu P, Cantisani V, Deganello A, et al. Role of contrast-enhanced ultrasound (CEUS) in Pediatric practice: an EFSUMB position statement. Ultraschall Med—Eur J Ultrasound. 2016;38:33–43.

    Google Scholar 

  18. Rossi Espagnet MC, Bernardi B, Pasquini L, Figà-Talamanca L, Tomà P, Napolitano A. Signal intensity at unenhanced T1-weighted magnetic resonance in the globus pallidus and dentate nucleus after serial administrations of a macrocyclic gadolinium-based contrast agent in children. Pediatr Radiol. 2017;47:1345–52.

    Article  Google Scholar 

  19. Costa AF, van der Pol CB, Maralani PJ, McInnes MDF, Shewchuk JR, Verma R, Hurrell C, Schieda N. Gadolinium deposition in the brain: a systematic review of existing guidelines and policy statement issued by the Canadian Association of Radiologists. Can Assoc Radiol J. 2018;69:373–82.

    Article  Google Scholar 

  20. Selbekk T, Jakola AS, Solheim O, Johansen TF, Lindseth F, Reinertsen I, Unsgård G. Ultrasound imaging in neurosurgery: approaches to minimize surgically induced image artifacts for improved resection control. Acta Neurochir. 2013;155:973–80.

    Google Scholar 

  21. Prada F, Del Bene M, Moiraghi A, et al. From grey scale B-mode to elastosonography: multimodal ultrasound imaging in meningioma surgery-pictorial essay and literature review. Biomed Res Int. 2015;2015:925729.

    Article  Google Scholar 

  22. Prada F, Del Bene M, Mattei L, et al. Fusion imaging for intra-operative ultrasound-based navigation in neurosurgery. J Ultrasound. 2014;17:243. https://doi.org/10.1007/s40477-014-0111-8.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Prada F, Del Bene M, Rampini A, et al. Intraoperative strain elastosonography in brain tumor surgery. Oper Neurosurg. 2018;17:227. https://doi.org/10.1093/ons/opy323.

  24. Ntoulia A, Anupindi SA, Darge K, Back SJ. Applications of contrast-enhanced ultrasound in the Pediatric abdomen. Abdom Radiol. 2018;43:948–59.

    Google Scholar 

  25. Ostrom QT, de Blank PM, Kruchko C, et al. Alex’s Lemonade stand foundation infant and childhood primary brain and central nervous system tumors diagnosed in the United States in 2007-2011. Neuro-Oncology. 2015;16(Suppl 10):x1–x36.

    Google Scholar 

  26. Ostrom QT, Gittleman H, Liao P, Vecchione-Koval T, Wolinsky Y, Kruchko C, Barnholtz-Sloan JS. CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2010-2014. Neuro-Oncology. 2017;19:v1–v88.

    Google Scholar 

  27. Tringali G, Bono B, Dones I, Cordella R, Didato G, Villani F, Prada F. Multimodal approach for radical excision of focal cortical dysplasia by combining advanced magnetic resonance imaging data to intraoperative ultrasound, electrocorticography, and cortical stimulation: a preliminary experience. World Neurosurg. 2018;113:e738–46.

    Google Scholar 

  28. Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, Ohgaki H, Wiestler OD, Kleihues P, Ellison DW. The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol. 2016;131:803–20.

    Google Scholar 

  29. Strahle J, Muraszko KM, Kapurch J, Bapuraj JR, Garton HJL, Maher CO. Chiari malformation type I and syrinx in children undergoing magnetic resonance imaging. J Neurosurg Pediatr. 2011;8:205–13.

    Article  Google Scholar 

  30. Curone M, Valentini LG, Vetrano I, Beretta E, Furlanetto M, Chiapparini L, Erbetta A, Bussone G. Chiari malformation type 1-related headache: the importance of a multidisciplinary study. Neurol Sci. 2017;38:91. https://doi.org/10.1007/s10072-017-2915-8.

    Article  PubMed  Google Scholar 

  31. Smith BW, Strahle J, Bapuraj JR, Muraszko KM, Garton HJL, Maher CO. Distribution of cerebellar tonsil position: implications for understanding Chiari malformation. J Neurosurg. 2013;119:812–9.

    Article  Google Scholar 

  32. Brock RS, Taricco MA, de Oliveira MF, de Lima OM, Teixeira MJ, Bor-Seng-Shu E. Intraoperative ultrasonography for definition of less invasive surgical technique in patients with Chiari type I malformation. World Neurosurg. 2017;101:466–75.

    Article  Google Scholar 

  33. McGirt MJ, Attenello FJ, Datoo G, Gathinji M, Atiba A, Weingart JD, Carson B, Jallo GI. Intraoperative ultrasonography as a guide to patient selection for duraplasty after suboccipital decompression in children with Chiari malformation type I. J Neurosurg Pediatr. 2008;2:52–7.

    Article  Google Scholar 

  34. Scott RM, Smith ER. Moyamoya disease and moyamoya syndrome. N Engl J Med. 2009;360:1226–37.

    Article  CAS  Google Scholar 

  35. Ibrahimi DM, Tamargo RJ, Ahn ES. Moyamoya disease in children. Childs Nerv Syst. 2010;26:1297–308.

    Article  Google Scholar 

  36. Smith ER, Scott RM. Spontaneous occlusion of the circle of Willis in children: Pediatric moyamoya summary with proposed evidence-based practice guidelines. A review. J Neurosurg Pediatr. 2012;9:353–60.

    Google Scholar 

  37. Sahu RK, Das KK, Bhaisora KS, Singh AK, Mehrotra A, Srivastava AK, Sahu RN, Jaiswal AK, Behari S. Pediatric intramedullary spinal cord lesions: pathological spectrum and outcome of surgery. J Pediatr Neurosci. 2015;10:214–21.

    Google Scholar 

  38. Steinbok P, Cochrane DD, Poskitt K. Intramedullary spinal cord tumors in children. Neurosurg Clin N Am. 1992;3:931–45.

    Google Scholar 

  39. Crawford JR, Zaninovic A, Santi M, Rushing EJ, Olsen CH, Keating RF, Vezina G, Kadom N, Packer RJ. Primary spinal cord tumors of childhood: effects of clinical presentation, radiographic features, and pathology on survival. J Neuro-Oncol. 2009;95:259–69.

    Google Scholar 

  40. Guss ZD, Moningi S, Jallo GI, Cohen KJ, Wharam MD, Terezakis SA. Management of Pediatric spinal cord astrocytomas: outcomes with adjuvant radiation. Int J Radiat Oncol Biol Phys. 2013;85:1307–11.

    Google Scholar 

  41. Mitchell LE, Adzick NS, Melchionne J, Pasquariello PS, Sutton LN, Whitehead AS. Spina bifida. Lancet. 2004;364:1885–95.

    Article  Google Scholar 

  42. Northrup H, Volcik KA. Spina bifida and other neural tube defects. Curr Probl Pediatr. 2000;30:313–32.

    CAS  PubMed  Google Scholar 

  43. Bond AE, Zada G, Bowen I, McComb JG, Krieger MD. Spinal arachnoid cysts in the Pediatric population: report of 31 cases and a review of the literature. J Neurosurg Pediatr. 2012;9:432–41.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Francesco Prada .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Vetrano, I.G., Valentini, L.G., DiMeco, F., Prada, F. (2021). Intraoperative Contrast-Enhanced Ultrasound in the Pediatric Neurosurgical Patient. In: Sidhu, P., Sellars, M., Deganello, A. (eds) Contrast-Enhanced Ultrasound in Pediatric Imaging. Springer, Cham. https://doi.org/10.1007/978-3-030-49691-3_19

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-49691-3_19

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-49690-6

  • Online ISBN: 978-3-030-49691-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics