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The use of ultrasound contrast agents has increased over recent years. The Contrast Media Safety Committee (CMSC) of the European Society of Urogenital Radiology (ESUR) decided to review the safety of ultrasound contrast agents in humans and to draw up guidelines. A comprehensive literature search and review was carried out. The resulting report was discussed by the CMSC of ESUR and at the 11th European Symposium on Urogenital Radiology in Santiago de Compostela, Spain, in 2004. Ultrasound contrast agents approved for clinical use are well tolerated, and serious adverse reactions are rarely observed. Adverse events are usually minor (e.g. headache, nausea, altered taste, sensation of heat) and self-resolving. These symptoms may not be related to the ultrasound contrast materials as they have also been observed in placebo-control groups. Intolerance to some components may occur. Generalized allergy-like reactions occur rarely. Ultrasound contrast agents are generally safe. The ultrasound scanning time and the acoustic output should be kept to the lowest level consistent with obtaining diagnostic information. Adverse reactions should be treated symptomatically. [ABSTRACT FROM AUTHOR]

Abstract: In recent years, iodinated contrast media (CM) have been optimized to improve medical imaging and to provide safer, more tolerable compounds for patients. The properties of an ideal CM include general safety, physiological inertness, minimal discomfort during administration, good tolerability if extravasation occurs, no nephrotoxic potential, a predictable bolus form, and provision of optimal arterial, venous, and parenchymal enhancement. This article will review the properties of different types of CM and comparative clinical findings for iodixanol and other CM as they relate to these proposed properties of an ideal CM for multidetector row computed tomography (MDCT). [Copyright &y& Elsevier]

Presents a letter to the editor published in the April 2004 issue of the journal "Acta Radiologica" which responds to comments on the article "Doppler Examination of the Allografted Kidney".

Presents a letter to the editor in response to an article which focuses on the utility of doppler examination in the evaluation of renal transplants published in previous issues of "Acta Radiologica."

Kristiansen, M, Sydow Krogh Pedersen, A-M, Sandvej, G, Jørgensen, P, Jakobsen, JV, de Zee, M, Hansen, EA, and Klitgaard, KK. Enhanced maximal upper-body strength increases performance in sprint kayaking. J Strength Cond Res 37(4): e305–e312, 2023—The association between upper-body strength and performance in 200-m flat-water sprint kayak is not fully elucidated. Therefore, the aim of study 1 was to investigate the relationship between upper-body strength and kayaking performance. In study 2, the aim was to perform a randomized training intervention to investigate whether a causal relationship was present between an increase in strength and an actual change in 200-m kayaking performance. In study 1, 37 (22 men and 15 women) elite kayak paddlers performed tests of maximal power output, isometric force, 1 repetition maximum (1RM), and 40 seconds of maximal repetition number in bench press and bench pull and a 30-second all-out on-water sprint kayak test. In study 2, 26 (16 men and 10 women) national elite junior A, U23, and senior kayak paddlers were allocated into 2 groups: a training group (TRAIN) and a maintenance group (MAIN). Each group completed a 6-week strength training intervention with the purpose of either increasing 1RM in bench press (TRAIN) or maintaining strength (MAIN). Pre- and posttests were performed in 200-m kayak ergometer sprint, 1RM bench press, and 1RM bench pull. In study 1, 1RM in bench press was the best predictor of 30-second on-water kayaking performance with a regression coefficient of 0.474. In study 2, TRAIN significantly increased 1RM strength in bench press (pre: 87.3 ± 21.2 kg, post: 93.9 ± 21.3 kg, p = 0.001) and bench pull (pre: 84.2 ± 15.3 kg, post: 86.0 ± 15.1 kg, p = 0.025). In the 200-m kayak ergometer sprint test, TRAIN significantly decreased the time to complete the test (pre: 44.8 ± 4.3 seconds, post: 44.3 ± 4.3 seconds, p = 0.042). In bench press, 1RM was the best predictor of 200-m kayaking, and an increase in bench press 1RM resulted in increased kayaking performance. [ABSTRACT FROM AUTHOR]

Background Cardiac allograft vasculopathy (CAV) is an accelerated form of atherosclerosis unique to heart transplant (HTX) patients. Purpose To investigate the detection of significant coronary artery stenosis and CAV, determinants of image quality, and the radiation dose in coronary computed tomography angiography (CCTA) of HTX patients with 64-slice multidetector CT (64-MDCT). Material and Methods Fifty-two HTX recipients scheduled for invasive coronary angiography (ICA) were prospectively enrolled and underwent CCTA before ICA with intravascular ultrasound (IVUS). Results Interpretable CCTA images were acquired in 570 (95%) coronary artery segments ≥2 mm in diameter. Sensitivity, specificity, and positive and negative predictive values of CCTA for the detection of segments with significant stenosis (lumen reduction ≥50%) on ICA were 100%, 98%, 7.7%, and 100%, respectively. Twelve significant stenoses were located in segments with uninterpretable image quality or vessel diameter <2 mm; only one was eligible for intervention. IVUS detected CAV (maximal intimal thickness ≥0.5 mm) in 33/41 (81%) patients; CCTA and ICA identified CAV (any wall or luminal irregularity) in 18 (44%) and 14 (34%) of these 33 patients, respectively. The mean estimated radiation dose was 19.0 ± 3.4 mSv for CCTA and 5.7 ± 3.3 mSv for ICA ( P < 0.001). Conclusion CCTA with interpretable image quality had a high negative predictive value for ruling out significant stenoses suitable for intervention. The modest detection of CAV by CCTA implied a limited value in identifying subtle CAV. The high estimated radiation dose for 64-MDCT is of concern considering the need for repetitive examinations in the HTX population. [ABSTRACT FROM AUTHOR]

Purpose: If β-alanine supplementation counteracts muscular fatigue development or improves athletic performance was investigated. Methods: Elite kayak rowers (10 men and 7 women) were supplemented with either 80 mg⋅kg-1 body massIdj1 of β-alanine or placebo for 8 wk. Muscular fatigue development was investigated by applying a 2-min elbow flexor maximal voluntary contraction (MVC). EMG was recorded continuously, and voluntary activation was determined 30, 60, 90, and 115 s into the 2-min MVC. In addition, performance was evaluated as 1000-m and 5 _ 250-m kayak ergometer rowing. Results: Force reduction during the 2-min MVC was similar before and after supplementation with β-alanine (30.9% ± 10.3% vs 36.0% ± 14.1%) and placebo (35.5% ± 7.7% vs 35.1% ± 8.0%). No time effect was apparent in voluntary activation during the 2-min MVC. In addition, there was no detectable effect of β-alanine supplementation on 1000-m kayak ergometer performance (β-alanine: 0.26% ± 0.02% vs placebo: -0.18% ± 0.02%) or accumulated 5 x 250-m time (β-alanine: -1.0% ± 0.3% vs placebo: -1.0% ± 0.2%). In 5 x 250 m, mean power output was reduced to a similar extent from first to fifth interval before and after supplementation with A-alanine (23% ± 11% vs 22% ± 10%) and placebo (26% ± 13% vs 20% ± 5%). Conclusions: Two-minute MVC characteristics are unaffected by β-alanine supplementation in elite kayakers, and likewise, both a 1000-m kayak ergometer time trial lasting 4-5 min and a 5 x 250-m repeated sprint ability were unaltered by supplementation. [ABSTRACT FROM AUTHOR]

The predictive value of coronary artery calcium (CAC) in heart transplant (HTX) patients is not established. We explored if the absence of CAC on computed tomography (CT) could exclude moderate and severe cardiac allograft vasculopathy [CAV2–3; the International Society for Heart and Lung Transplantation (ISHLT) recommended nomenclature] and significant coronary artery stenosis (diameter reduction ≥50%) and predict long‐term clinical outcomes. HTX recipients (n = 133) were prospectively included and underwent CT for CAC scoring and invasive coronary angiography (ICA) 7.8 ± 5.0 years after HTX. CAC was detected in 73 (55%) patients. The absence of CAC on CT had a negative predictive value of 97% for ISHLT CAV2–3 and 88% for significant stenosis on ICA. During 7.5 ± 2.6 years of follow‐up after CAC CT (n = 127), there were 57 (45%) nonfatal major adverse cardiac events and 23 (18%) deaths or graft losses registered as first events. Patients with CAC had significantly more events (P = 0.011). In an adjusted Cox regression analysis, the presence of CAC was significantly associated with a negative outcome (HR 1.8, 95% CI 1.1–3.0; P = 0.023). The absence of CAC predicted low prevalences of ISHLT CAV2–3 and significant coronary artery stenosis in HTX patients. The presence of CACS was significantly associated with a worse long‐term outcome. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to evaluate the feasibility and safety of the Sonalleve high-intensity focused ultrasound (HIFU; Philips Healthcare, Vantaa, Finland) system in ablating uterine fibroids in a 3T magnet. Material and methods: Seven women were included in this study. Treatment was performed according to the manufacturer's recommendation. Technical data describing the HIFU procedures were collected. On MR images at baseline, immediately and 30 days after ablation, we evaluated the volumes of the uterus, the dominant fibroid and the ablation zone. The Uterine Fibroid Symptom and Quality of Life (UFS-QOL) questionnaire was used to assess potential clinical response. Results: The procedure was technically feasible in all patients. The median number of sonications performed during each procedure was 20 (range 2-27) per patient, the maximum temperature in all sonication cells was about 68°C. The median procedure time was 156 minutes (range 95-164). The non-perfused volume after treatment ranged from 1 to 27 ml and was unchanged or decreased in all but one patient at 30 days follow-up. There were no major adverse events. Discussion: In our 3T magnet the system was able to heat tissue and induce areas of non-enhancement within uterine fibroids without major complications. Clinical benefit remains to be proven. [ABSTRACT FROM AUTHOR]

Background: In order to achieve sustained symptom control and minimize the risk of recurrence, uterine artery embolization (UAE) should aim at complete infarction of all fibroids. Purpose: To retrospectively evaluate the infarction rate of uterine fibroids in patients that had undergone uterine artery embolization (UAE) after the introduction of contrast-enhanced ultrasound (CEUS) during UAE procedures at our institution. Material and Methods: Thirty patients treated with UAE between February 2006 and August 2009 were included. MR images obtained before, at 3 months, and 12 months after the procedure were reviewed. We evaluated volume changes in dominant fibroids as well as the infarction rate of all fibroids in each patient. Clinical results were evaluated by reviewing the medical records. The study was approved by the institutional review board. Results: CEUS was technically successfully performed during the UAE procedure in all patients. In five cases the endpoint of embolization was adjusted based on findings at CEUS. The mean volume shrinkage of dominant fibroids was 39.8% after 3 months and 59.8% after 12 months. There was complete infarction of all fibroid tissue in 97% of patients at 3 months and 96% at 12 months. No major complications were observed. Conclusion: After the introduction of CEUS during UAE procedures in our institution, high infarction rates were achieved. [ABSTRACT FROM AUTHOR]

Chronic allograft nephropathy characterized by interstitial fibrosis and tubular atrophy is a major cause of renal transplant failure. Acoustic radiation force impulse (ARFI) quantification is a promising noninvasive method for assessing tissue stiffness. We evaluated if the method could reveal renal transplant fibrosis. In a prospective study, 30 adult renal transplant recipients were included. ARFI quantification, given as shear wave velocity (SWV), of the renal cortex was performed by two observers. SWV was compared to grade of fibrosis (0-3) in biopsies. The median SWV was 2.8 m/s (range: 1.6-3.6), 2.6 m/s (range: 1.8-3.5) and 2.5 m/s (range: 1.6-3) for grade 0 ( n = 12), 1 ( n = 10) and grades 2/3 ( n = 8) fibrosis respectively. SWV did not differ significantly in transplants without and with fibrosis (grade 0 vs. grade 1, P = 0.53 and grade 0 vs. grades 2/3, P = 0.11). The mean intraobserver coefficient of variation was 22% for observer 1 and 24% for observer 2. Interobserver agreement, expressed as intraclass correlation coefficient was 0.31 (95% CI: −0.03 to 0.60). This study does not support the use of ARFI quantification to assess low-grade fibrosis in renal transplants. ARFI quantification in its present stage of development has also high intra- and interobserver variation in renal transplants. [ABSTRACT FROM AUTHOR]

Abstract: This paper presents a practical questionnaire to be used when a contrast medium examination is requested. The questionnaire is based on the guidelines from the European Society of Urogenital Radiology. Its aim is to identify patients at increased risk of clinically relevant renal and non-renal adverse reactions to iodine-based and MRI contrast agents. The questionnaire should be completed by the referring physician when the examination is requested. [Copyright &y& Elsevier]