Contrast-Enhanced Ultrasound (CEUS) in Neurosurgery

Contrast-enhanced ultrasound (CEUS) is a harmonic imaging technique that permits to study tissue perfusion and vascularization using a purely intravascular ultrasound contrast agent (UCA). CEUS is a real-time, dynamic, continuous, and repeatable modality, applicable in neurosurgery for tumors and vessels study. In oncological surgery, CEUS permits to highlight and characterize the lesion through the study of its micro- and macro-circulation. Moreover, it allows to assess the degree of tumor removal and to plan the surgical strategy, highlighting the lesion feeders, drainage vessels, and neighboring vital vascular structures. In vascular surgery, CEUS permits to study the entire vascular tree from arteries, through capillaries, to veins simultaneously without the need to set multiple parameters. It also allows to assess vessel location, dimension, and flow entity and direction without the need of vessel direct exposure, being CEUS a tomographic representation. This leads to protect vital structures preservation and also to evaluate the effect of a procedure on the blood circulation.