New 3D ultrasound technology could improve stroke diagnosis, care
Duke University bioengineers can compensate for the thickness and unevenness of the skull using 3D ultrasound technology to see in real time the arteries within the brain that most often clog up and cause strokes, according to research published online April 18 in Ultrasound in Medicine & Biology.

The researchers said that the advances will ultimately improve the treatment of stroke patients, whether by giving emergency medical technicians (EMT) the ability to quickly scan the heads of potential stroke victims while in the ambulance or allowing physicians to easily monitor in real time the patients’ response to therapy at the bedside.

“To our knowledge, this is the first time that real-time 3D ultrasound provided clear images of the major arteries within the brain,” said author Nikolas Ivancevich, graduate student in Duke’s Pratt School of Engineering. “Also for the first time, we have been able overcome the most challenging aspect of using ultrasound to scan the brain – the skull.”

The Duke laboratory, led by biomedical engineering professor Stephen Smith, has a history of modifying traditional 2D ultrasound – like that used to image babies in utero – into more advanced 3D scans, which can provide more detailed information.

After inventing the technique in 1991, the team has shown its utility in developing specialized catheters and endoscopes for imaging the heart and blood vessels.

“This is an important step forward for scanning the vessels of the brain through the skull, and we believe that there are now no major technological barriers to ultimately using 3D ultrasound to quickly diagnose stroke patients,” said Smith, senior author of the paper.

For the experiments, the Duke team studied 17 healthy people. After injecting them with a contrast dye to enhance the images, the researchers aimed ultrasound transducers, into the brain from three vantage points – the temples on each side of the head and upwards from the base of the neck.

“I think it’s safe to say that within five to 10 years, the technology will be miniaturized to the point where EMTs in an ambulance can scan the brain of a stroke patient and transmit the results ahead to the hospital,” Smith continued. “Speed is important because the only approved medical treatment for stroke must be given within three hours of the first symptoms.”

National Institutes of Health and the Duke Translational Medicine Institute, with assistance from the Duke Echocardiography Laboratory, funded the research.