00765293

00765293 - Ultrasound contrast agents: clinical...

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Ultrasound contrast agents: clinical applications JM. Correas, 0. HClCnon, M. Cherkaoui, JF. Moreau Necker Hospital Department of Radiology 149 rue de Shvres 75743 Paris, France Abstract: Ultrasound contrast agents (USCAs) are now becoming commercially available. During the past decade, both tolerance and efficacy of microbubble USCAs increased in conjunction with the ultrasound instrumentation. Specific contrast image sequences have been developed to take advantage of the specific microbubble ultrasonic properties. USCAs are well tolerated and do not exhibit allergic reactions or renal toxicity. USCAs increase the Doppler signal intensity from vessels of deep location, small caliber, or in case of reduced and/or slow blood flow. They improve the detection of vessels with limited access due to anatomic limitations. Under certain circumstances, they can alter the texture of parenchyma (myocardium, renal cortex, liver) to provide tissue perfusion information. In peripheral artery disease, USCAs help identify subocclusive lesions and grade stenoses due to calcified plaques that may prevent from flow recording. In transcranial Doppler, they reduce the technical failure rate due to the attenuation of the ultrasound beam through the temporal window. In renal Doppler ultrasonography (US), they improve the detection and recording of the renal arteries, and thus reduce the rate of technical failure due to anatomic limitations. Thus, USCA increase the role of color Doppler sonography as the primary modality in the screening of renovascular hypertension. Con tras t-enhanced color Doppler US provides additional information from cortical blood supply that improves the evaluation of ischemic and non occlusive vascular disorders. In liver US, USCAs improve the visualization of the blood flow within the portal and hepatic veins and from porto- hepatic shunts. They increase the diagnostic confidence in evaluating their patency in challenging cases. In liver transplants, they 0-7803-4095-7/98/$10.00 0 1998 IEEE improve the detection of anastomotic vessel occlusive disorders. Some studies also investigated the potentials of USCA in detecting and characterizing liver, renal, breast and prostate tumors. Quantification of USCA effect is a preliminary step toward functional imaging. Preliminary studies showed promising results in the assessment of liver and renal diseases. However, specific tools should be developed and implemented in ultrasound units before routine clinical practice can be reached. INTRODUCTION The concept of contrast enhancement using pharmaceutical agents is widely developed and applied to all medical imaging modalities, including X-ray, computed tomography), magnetic resonance imaging, or nuclear medicine. The clinical development of ultrasound contrast agents (USCAs) has been reduced by the non invasive reputation of US and the lack of an
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00765293 - Ultrasound contrast agents: clinical...

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