Contrast-Enhanced Transcranial Two-Dimensional Ultrasound Imaging Using Shear-Mode Conversion at Low Frequency

The distortion and attenuation of transcranial ultrasound (US) signals are significant problems in US imaging of the brain. Of the variety of proposed solutions, shear-mode transmission through the skull is one of the more recent options and has been shown to reduce distortion of the US beam. This study examined the effects of transcranial shear-mode transmission on the images of a contrast-agent-filled polytetrafluoroethylene tube produced by a 32-element 750 kHz linear phased array transducer through an ex vivo human skull section. Although the tube was successfully imaged using shear-mode transmission with subharmonic imaging in 6 of 9 cases, the tube was visible in only 1 of 9 cases for both the fundamental and the second harmonic frequencies. Some improvement in the location of the axial image was seen at the fundamental frequency using shear mode. No improvement was seen at the other two frequencies, but this may be due to low transducer sensitivity. As well, neither the presence of the skull nor the incident angle changed the distance at which signals from the two tubes could be resolved. With this transducer, these distances were found to be 5 mm laterally and 3 mm axially for the fundamental and second harmonic images, and 10 mm and 5 mm for the subharmonic images. The results show that the subharmonic signal was the most successful of the three examined in penetrating a thick skull but that the success comes at the cost of image resolution.