Journal Article Ahead of print 1 citation
PubMed: 42310131 DOI: 10.1038/s41551-026-01714-7
Clinically translatable ultrasound localization microscopy reveals cerebrovascular remodelling and prognosis in patients with traumatic brain injury.
Nat Biomed Eng
Authors: Maoyao Li, Wenxuan Wang, Ziyang Su, Jingjing Wu, Yang Yang, Longchen Wang, Yi Wang, Mickaël Tanter, Zeng Zhang, Fang Yuan, Yuanyi Zheng
Affiliations
- Shanghai Key Laboratory of Neuro-Ultrasound for Diagnosis and Treatment, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. Department of Ultrasound in Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. Faculty of Medical Imaging Technology, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- School of Biomedical Engineering and State Key Laboratory of Advanced Medical Materials and Devices, ShanghaiTech University, Shanghai, China. Shanghai Clinical Research and Trial Center, Shanghai, China.
- Department of Neurosurgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Institute Physics for Medicine, Inserm, ESPCI PSL, CNRS, Parisanté Campus, Paris, France.
- School of Biomedical Engineering and State Key Laboratory of Advanced Medical Materials and Devices, ShanghaiTech University, Shanghai, China. Shanghai Clinical Research and Trial Center, Shanghai, China.
- Department of Neurosurgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Shanghai Key Laboratory of Neuro-Ultrasound for Diagnosis and Treatment, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. Department of Ultrasound in Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. Faculty of Medical Imaging Technology, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Abstract
Cerebral microcirculation critically determines tissue viability and recovery in neurocritical disorders, yet bedside assessment remains unavailable, forcing intuition-based clinical decisions. Here, in this prospective observational study of 20 patients with traumatic brain injury following decompressive craniectomy, we show that ultrasound localization microscopy (ULM) enables bedside cerebral microvascular assessment in neurocritical care. Conventional ULM requires ultrafast imaging, limiting clinical translation; here we overcome this by implementing an efficient multihypothesis, multiframe global-optimization algorithm suitable for a clinical system, achieving ~139 μm resolution (~1/4 wavelength). Longitudinal imaging on postoperative days 3 and 14 revealed severity-dependent remodelling: moderate injuries demonstrated superior structural recovery, whereas severe cases exhibited higher early vascular resistance and persistent flow deficits. Furthermore, composite ULM metrics correlated negatively with invasive intracranial pressure, and the microvascular perfusion efficiency coefficient robustly stratified 6-month outcomes. These results establish ULM as a clinically translatable bedside platform for microcirculation-guided neurocritical care.
MeSH
Brain Injuries, Microcirculation, Brain, Recycling, Biomedical Engineering, Microscopy, Brain Injuries, Traumatic, Prognosis