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IMO 1802 Value of contrast-enhanced color and power Doppler ultrasound in the evaluation of portal venous system
INTERNAL
IMO 1611 Stimulated acousticemission(“Sono-scintigraphy”) imagingwith the echo-enhancingagent Levovist@: a reproducible Doppler ultrasound effect with pobntial cllinicalutility. M Blomlel,. T Albrecht. D Cosnrove,V Javaram,Na Patel, A E&r*, R Schiicf*. Himmdrsmitli Ho.$tal, LondonUK and*ScheringAG, Berlin,Germany PURPOSE.To analysea characteristiccolor Doppler appearance (stimulatedacousticemission:SAEor sonoscintigraphy) observed on ultrasound following administration of Levovist@(ScherincAG, Berlin). PATIENTS AND METHODS: -1-d intravenous iniections .>f 2.5~ Levovist were riven to 3 healths v&teerS and 2j patientsand 2 iljections of lg of Levovist were given to 2 healthy dogs.Subjectswere scannedw’th the sameultrasoundmachine(Acuson Sequoia51:h) Studieswereevaluatedby wnsenkusof 2 exueriencel observers for SAE signal, defined as a chkacterisric highly transientvel&ity color Doppler mosaicappcaranccin the parenchyma with strong dependent;on focal?Aneandothermachinesettings. RESULTS:SAE effects.lastinnut) to 30 minutes.were seenin all subjectsin the live;&d spleen.Somerenal SAE wasnoted,lastingup to 6 minutesafter injection, but no renatenhancen;niwasseenafter this. Ho focal Liverlesion:;in theDatientstudieswasshowedSAE. and the effect gene&y increased iesion conspicuity including raetastases (n=S), haemangiuma(n=3) and cysl~ (n=2,) Oplimnl imaging required high kansmil powers,low Dopplerfrequencies,high Dopplerspatial resoluhonandhigh pulserepetitionfrcqucncies. CONCLUSION: This effect is reproducibleand can improvethevisualisationof focal liver lesions.
s33
MEDICINE
IMO 1802 VALUE OF CONTRAST-ENHANCED COLOR AND POWER DOPPLER ULTRASOUND IN THE EVALUATION OF PORTAL VENOUS SYSTEM PaoloRicci,GiuseppePizzi, FrancescoM. Drudi, Flaminia Arata,AlfonsoRusso,Plinio Rossi,RobertoPassariello Departmentof Radiology, University “La Sapienza”, Rome,Italy Purpose:to testtheefficacy of Levovist, a galactose-based microbubblepreparation,in enhancingthe diagnostic qualityof equivocalcolorDopplerstudiesof portalvenous system. Materials and Methods: 25 patients(selectedin a multicenterrandomized controlledstudy),with equivocalor non-diagnostic color Dopplerstudy of the portal venous system,underwentcontrastenhanced US evaluation.After the initial Doppler study, Levovist was intravenously injected(200 mg/mL) through a peripheralvein. More injections,UP to four, at differentconcentrations, could he mgdeto gainthehigherdiagnosticquality. All the contrastenhanced US examinations were followed within 10 davs by dynamicCT, consideredas gold standardin the study protocol.Other 12 patients,out of the protocol and with different selectioncriteria, underwentcontrast enhanced examinations, in orderto validatethe combinationof colorDoppler+power-Doppler+ Levovist. Results: In all casesthe contrast-enhanced US increased the diagnosticquality of color Dopplerstudy, with clear depictionof the equivocalor non-diagnosticpreliminary evaluations. Wehadnomajoror minorcomplications. Conclusions: The useof echo-enhancing contrastagent can significantly improve the visualization of vessels, allowing more accurate Doppler interrogations and increasing the diagnosticconfidence. The combinationof Power-Doppler andLevovist allowsthe highestdiagnostic confidence.
IMO 1801 THEEFFECTOF CONTRAST AGENTFORTHEDIAGNOSIS OF HEPATOCELLULAR CARCINOMA ON COLOR I)OPPLER IMAGlNG
IMO 1803 SONOGRAPHICEVALUATION OF THE EFFECTS OF INTRAVENOUSIODINATED CONTRAST
Seigo Sakaguchi. Kei j i Tohara, Yasushi Miyajima. Masahiko Tanaka, Tomoko Mitsuyasu, Nagafusa Hatono. Shouichi Nakabayashi and Tsuneyoshi Yao Department of Gastroenterology. Chikushi Hospital. Fukuoka University, Fukuoka.Japan,818
AGENTS
Abhanq V.,Khan O.,Mohammed L.,Holder E. Chatoor K.,Archibald A.,Maharaj P. Eric Williams Medical Sciences Complex Champs Fleurs Trinidad West Indies.
Eleven patients with hepatocellular carcinoma (HCC) and 3 metastatic liver tumorwereexamined by I)oppler immediately before and after intravenous injection of the contrast agent (Levovist, Shering AC, Germany). (AC) and US under the In HCC. hepatic arteriography injection of CO,microbubbles into the hepatic artery (CO,-US) were examined furthermore. In 5 of HCC, hypervascular tumor was detected neither on AG nor COr-US [Group-O]. And, it was detected in 1 of HCC only on CO,-US[Group-II and in 5 on both [Group-Z]. In Group-O [size: MiSD; 1.2i0.2cm). Doppler signal CDS) was detected neither before nor after injection of Levovist. In Group-l 11.91, only spotty I1.S(SS) was detected in the tumor before, but feeding DS (FS), thought to be a part of the feeding artery of HCC, were detected after. In Group-2 {Z. 5+ I. 01, DS was not detected before in 2 tumors, however, in both tumors FS was detected after. In other 3 of Group-2. SS was detected before and FS was detected after. In metastasis, after the injection, characteristic marginal SS of the tumor was detected. In conclusion. the intravenous injection of contrast agent was useful1 for the detection of characteristic FS and marginal SS for the diagnosis of liver cancer without angiographic Seldinger’s technique.
The aim of the present study has been to sonographically evaulate for the first time the effects of intravenously administered water soluble iodinated contrast materials on gallbladder A total of 51 adult patients kinetics. (32 M, 19F) without cholelithiasis or known gallbladder disease referred for IVP participated in this prospective study. Gallbladder volume was measured before and after injection of contrast (1.5 cc/kg). Nineteen (19) patients received low osnolar non-ionic contrast 33 standard media, the remaining
ON GALLBLADDER
conventional media. The combined data for revealed a significant
KINETICS.
bo?:h agents change in
gall-
bladder volume (p < 0.01). was observed in 40 patients volume occurred
Contraction with a mean or‘ 24.8%. Expansion
contraction in 12 Ljatients
with
a mean
volume expansiotl of 39.6%. These findings indicate that gallbladder kinetics are altered after IV contrast media and simultaneous sonographic evaulation of the gallbladder may lead to erroneous aaca interpretation.
IMO 1611 Stimulated acousticemission(“Sono-scintigraphy”) imagingwith the echo-enhancingagent Levovist@: a reproducible Doppler ultrasound effect with pobntial cllinicalutility. M Blomlel,. T Albrecht. D Cosnrove,V Javaram,Na Patel, A E&r*, R Schiicf*. Himmdrsmitli Ho.$tal, LondonUK and*ScheringAG, Berlin,Germany PURPOSE.To analysea characteristiccolor Doppler appearance (stimulatedacousticemission:SAEor sonoscintigraphy) observed on ultrasound following administration of Levovist@(ScherincAG, Berlin). PATIENTS AND METHODS: -1-d intravenous iniections .>f 2.5~ Levovist were riven to 3 healths v&teerS and 2j patientsand 2 iljections of lg of Levovist were given to 2 healthy dogs.Subjectswere scannedw’th the sameultrasoundmachine(Acuson Sequoia51:h) Studieswereevaluatedby wnsenkusof 2 exueriencel observers for SAE signal, defined as a chkacterisric highly transientvel&ity color Doppler mosaicappcaranccin the parenchyma with strong dependent;on focal?Aneandothermachinesettings. RESULTS:SAE effects.lastinnut) to 30 minutes.were seenin all subjectsin the live;&d spleen.Somerenal SAE wasnoted,lastingup to 6 minutesafter injection, but no renatenhancen;niwasseenafter this. Ho focal Liverlesion:;in theDatientstudieswasshowedSAE. and the effect gene&y increased iesion conspicuity including raetastases (n=S), haemangiuma(n=3) and cysl~ (n=2,) Oplimnl imaging required high kansmil powers,low Dopplerfrequencies,high Dopplerspatial resoluhonandhigh pulserepetitionfrcqucncies. CONCLUSION: This effect is reproducibleand can improvethevisualisationof focal liver lesions.
s33
MEDICINE
IMO 1802 VALUE OF CONTRAST-ENHANCED COLOR AND POWER DOPPLER ULTRASOUND IN THE EVALUATION OF PORTAL VENOUS SYSTEM PaoloRicci,GiuseppePizzi, FrancescoM. Drudi, Flaminia Arata,AlfonsoRusso,Plinio Rossi,RobertoPassariello Departmentof Radiology, University “La Sapienza”, Rome,Italy Purpose:to testtheefficacy of Levovist, a galactose-based microbubblepreparation,in enhancingthe diagnostic qualityof equivocalcolorDopplerstudiesof portalvenous system. Materials and Methods: 25 patients(selectedin a multicenterrandomized controlledstudy),with equivocalor non-diagnostic color Dopplerstudy of the portal venous system,underwentcontrastenhanced US evaluation.After the initial Doppler study, Levovist was intravenously injected(200 mg/mL) through a peripheralvein. More injections,UP to four, at differentconcentrations, could he mgdeto gainthehigherdiagnosticquality. All the contrastenhanced US examinations were followed within 10 davs by dynamicCT, consideredas gold standardin the study protocol.Other 12 patients,out of the protocol and with different selectioncriteria, underwentcontrast enhanced examinations, in orderto validatethe combinationof colorDoppler+power-Doppler+ Levovist. Results: In all casesthe contrast-enhanced US increased the diagnosticquality of color Dopplerstudy, with clear depictionof the equivocalor non-diagnosticpreliminary evaluations. Wehadnomajoror minorcomplications. Conclusions: The useof echo-enhancing contrastagent can significantly improve the visualization of vessels, allowing more accurate Doppler interrogations and increasing the diagnosticconfidence. The combinationof Power-Doppler andLevovist allowsthe highestdiagnostic confidence.
IMO 1801 THEEFFECTOF CONTRAST AGENTFORTHEDIAGNOSIS OF HEPATOCELLULAR CARCINOMA ON COLOR I)OPPLER IMAGlNG
IMO 1803 SONOGRAPHICEVALUATION OF THE EFFECTS OF INTRAVENOUSIODINATED CONTRAST
Seigo Sakaguchi. Kei j i Tohara, Yasushi Miyajima. Masahiko Tanaka, Tomoko Mitsuyasu, Nagafusa Hatono. Shouichi Nakabayashi and Tsuneyoshi Yao Department of Gastroenterology. Chikushi Hospital. Fukuoka University, Fukuoka.Japan,818
AGENTS
Abhanq V.,Khan O.,Mohammed L.,Holder E. Chatoor K.,Archibald A.,Maharaj P. Eric Williams Medical Sciences Complex Champs Fleurs Trinidad West Indies.
Eleven patients with hepatocellular carcinoma (HCC) and 3 metastatic liver tumorwereexamined by I)oppler immediately before and after intravenous injection of the contrast agent (Levovist, Shering AC, Germany). (AC) and US under the In HCC. hepatic arteriography injection of CO,microbubbles into the hepatic artery (CO,-US) were examined furthermore. In 5 of HCC, hypervascular tumor was detected neither on AG nor COr-US [Group-O]. And, it was detected in 1 of HCC only on CO,-US[Group-II and in 5 on both [Group-Z]. In Group-O [size: MiSD; 1.2i0.2cm). Doppler signal CDS) was detected neither before nor after injection of Levovist. In Group-l 11.91, only spotty I1.S(SS) was detected in the tumor before, but feeding DS (FS), thought to be a part of the feeding artery of HCC, were detected after. In Group-2 {Z. 5+ I. 01, DS was not detected before in 2 tumors, however, in both tumors FS was detected after. In other 3 of Group-2. SS was detected before and FS was detected after. In metastasis, after the injection, characteristic marginal SS of the tumor was detected. In conclusion. the intravenous injection of contrast agent was useful1 for the detection of characteristic FS and marginal SS for the diagnosis of liver cancer without angiographic Seldinger’s technique.
The aim of the present study has been to sonographically evaulate for the first time the effects of intravenously administered water soluble iodinated contrast materials on gallbladder A total of 51 adult patients kinetics. (32 M, 19F) without cholelithiasis or known gallbladder disease referred for IVP participated in this prospective study. Gallbladder volume was measured before and after injection of contrast (1.5 cc/kg). Nineteen (19) patients received low osnolar non-ionic contrast 33 standard media, the remaining
ON GALLBLADDER
conventional media. The combined data for revealed a significant
KINETICS.
bo?:h agents change in
gall-
bladder volume (p < 0.01). was observed in 40 patients volume occurred
Contraction with a mean or‘ 24.8%. Expansion
contraction in 12 Ljatients
with
a mean
volume expansiotl of 39.6%. These findings indicate that gallbladder kinetics are altered after IV contrast media and simultaneous sonographic evaulation of the gallbladder may lead to erroneous aaca interpretation.