Intraoperative cerebral perfusion monitoring with ultrafast power doppler imaging

Abstract Brain perfusion monitoring during cerebrovascular surgery is highly desirable; however, this technology is not yet available to surgeons. Our center has developed and implemented a dedicated ultrafast power Doppler imaging (UPDI) sequence along with a novel postprocessing analysis. This met...

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Main Authors: Hamid Reza Niknejad, Yizhou Huang, Anna Maria Auricchio, Albert van der Zwan, Massimo Mischi
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-04338-0
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author Hamid Reza Niknejad
Yizhou Huang
Anna Maria Auricchio
Albert van der Zwan
Massimo Mischi
author_facet Hamid Reza Niknejad
Yizhou Huang
Anna Maria Auricchio
Albert van der Zwan
Massimo Mischi
author_sort Hamid Reza Niknejad
collection DOAJ
description Abstract Brain perfusion monitoring during cerebrovascular surgery is highly desirable; however, this technology is not yet available to surgeons. Our center has developed and implemented a dedicated ultrafast power Doppler imaging (UPDI) sequence along with a novel postprocessing analysis. This method enables intraoperative, real-time (1 Hz) detection of changes in cerebral blood volume (CBV) at high spatial resolution (100 μm). We performed continuous UPDI acquisitions in 10 patients undergoing surgery for intracranial aneurysm clipping, AVM resection, or cerebrovascular bypass surgery. When temporary clipping was required during surgery, we recorded perfusion in the parenchyma within the vascular territory of the affected artery. Recordings began with a 30-second baseline and continued for up to 60 s after clip release. The UPDI sequence successfully demonstrated cerebral perfusion up to the level of the penetrating arterioles. The time-series data captured vascular phenomena such as ischemia, collateral recruitment, and hyperperfusion in both the cortex and white matter following the placement and removal of temporary clips. UPDI shows promise as a tool for continuous CBV monitoring during (cerebrovascular) surgery, as it enables quantitative vascular monitoring of the parenchyma.
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spelling doaj-art-716ecc54b4cc4f79ba84ecabdecd1eec2025-08-20T03:37:22ZengNature PortfolioScientific Reports2045-23222025-07-0115111010.1038/s41598-025-04338-0Intraoperative cerebral perfusion monitoring with ultrafast power doppler imagingHamid Reza Niknejad0Yizhou Huang1Anna Maria Auricchio2Albert van der Zwan3Massimo Mischi4Department of Neurosurgery, University Medical Center UtrechtSignal Processing Systems Unit, Eindhoven University of TechnologyDepartment of Neurosurgery, University Medical Center UtrechtDepartment of Neurosurgery, University Medical Center UtrechtSignal Processing Systems Unit, Eindhoven University of TechnologyAbstract Brain perfusion monitoring during cerebrovascular surgery is highly desirable; however, this technology is not yet available to surgeons. Our center has developed and implemented a dedicated ultrafast power Doppler imaging (UPDI) sequence along with a novel postprocessing analysis. This method enables intraoperative, real-time (1 Hz) detection of changes in cerebral blood volume (CBV) at high spatial resolution (100 μm). We performed continuous UPDI acquisitions in 10 patients undergoing surgery for intracranial aneurysm clipping, AVM resection, or cerebrovascular bypass surgery. When temporary clipping was required during surgery, we recorded perfusion in the parenchyma within the vascular territory of the affected artery. Recordings began with a 30-second baseline and continued for up to 60 s after clip release. The UPDI sequence successfully demonstrated cerebral perfusion up to the level of the penetrating arterioles. The time-series data captured vascular phenomena such as ischemia, collateral recruitment, and hyperperfusion in both the cortex and white matter following the placement and removal of temporary clips. UPDI shows promise as a tool for continuous CBV monitoring during (cerebrovascular) surgery, as it enables quantitative vascular monitoring of the parenchyma.https://doi.org/10.1038/s41598-025-04338-0Surgery related strokeUltrafast power Doppler imagingPerfusion
spellingShingle Hamid Reza Niknejad
Yizhou Huang
Anna Maria Auricchio
Albert van der Zwan
Massimo Mischi
Intraoperative cerebral perfusion monitoring with ultrafast power doppler imaging
Scientific Reports
Surgery related stroke
Ultrafast power Doppler imaging
Perfusion
title Intraoperative cerebral perfusion monitoring with ultrafast power doppler imaging
title_full Intraoperative cerebral perfusion monitoring with ultrafast power doppler imaging
title_fullStr Intraoperative cerebral perfusion monitoring with ultrafast power doppler imaging
title_full_unstemmed Intraoperative cerebral perfusion monitoring with ultrafast power doppler imaging
title_short Intraoperative cerebral perfusion monitoring with ultrafast power doppler imaging
title_sort intraoperative cerebral perfusion monitoring with ultrafast power doppler imaging
topic Surgery related stroke
Ultrafast power Doppler imaging
Perfusion
url https://doi.org/10.1038/s41598-025-04338-0
work_keys_str_mv AT hamidrezaniknejad intraoperativecerebralperfusionmonitoringwithultrafastpowerdopplerimaging
AT yizhouhuang intraoperativecerebralperfusionmonitoringwithultrafastpowerdopplerimaging
AT annamariaauricchio intraoperativecerebralperfusionmonitoringwithultrafastpowerdopplerimaging
AT albertvanderzwan intraoperativecerebralperfusionmonitoringwithultrafastpowerdopplerimaging
AT massimomischi intraoperativecerebralperfusionmonitoringwithultrafastpowerdopplerimaging