Fig. 5.

Multiple sclerosis with corresponding iCEUS and perfusion data. A: Axial T1-weighted contrast-enhanced MR image shows an incompletely ring-enhancing multiple sclerosis lesion in the cerebellar white matter (asterisk). B: Axial T2-weighted MR image of the same lesion shows surrounding edema (thick arrow). C: Axial T2-weighted MR image more inferiorly shows the first biopsy site (arrow), which missed the lesion of interest when using neuronavigation without iCEUS. D: iCEUS (left) and corresponding B-mode US (right) images demonstrating the previous failed biopsy site (circle) and a biopsy needle (arrows) en route to contrast-enhancing lesion of interest (blue square). Second area of interest is demarcated over an area of normal cerebellar parenchyma (orange square). E: TIC demonstrated delayed USCA uptake in the enhancing lesion (blue curve) with prolonged retention of contrast and a delayed washout phase. The TIC for the adjacent normal cerebellar parenchyma (orange curve) displays gradual contrast enhancement without washout.