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Purpose: To evaluate the feasibility of using contrast-enhanced ultrasound (CEUS) during uterine artery embolization (UAE) in order to define the correct end-point of embolization with complete devascularization of all fibroids. Methods: In this prospective study of 10 consecutive women undergoing UAE, CEUS was performed in the angiographic suite during embolization. When the angiographic end-point, defined as the "pruned-tree" appearance of the uterine arteries was reached, CEUS was performed while the angiographic catheters to both uterine arteries were kept in place. The decision whether or not to continue the embolization was based on the findings at CEUS. The results of CEUS were compared with those of contrast-enhanced magnetic resonance imaging (MRI) 1 day as well as 3 months following UAE. Results: CEUS was successfully performed in all women. In 4 cases injection of particles was continued based on the findings at CEUS despite angiographically complete embolization. CEUS imaging at completion of UAE correlated well with the findings at MRI. Conclusion: The use of CEUS during UAE is feasible and may increase the quality of UAE. [ABSTRACT FROM AUTHOR]

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]

Extravasation of contrast material is a well-recognized complication of contrast-enhanced imaging studies. The management of this complication is contentious; therefore, the Contrast Media Safety Committee of The European Society of Urogenital Radiology decided to review the literature and issue guidelines. A comprehensive literature search was carried out. The resulting report was discussed at the 8th European Symposium on Urogenital Radiology in Genoa, Italy. Automated power injection may result in extravasation of large volumes and may or can lead to severe tissue damage. Infants, young children and unconscious and debilitated patients are particularly at risk of extravasation during contrast media injection. Fortunately, most extravasations result in minimal swelling or erythema, with no long-term sequelae; however, severe skin necrosis and ulceration may occur. Large volumes of high osmolar contrast media are known to induce significant tissue damage. Compartment syndrome may be seen associated with extravasation of large volumes. Conservative management is often adequate, but in serious cases the advice of a plastic surgeon is recommended. Based on the review simple guidelines for prophylaxis and management of contrast medium extravasation injuries are proposed. [ABSTRACT FROM AUTHOR]

Ultrasound contrast agents (USCAs) for intravenous use are usually microbubbles with a mean diameter less than that of a red blood corpuscle and filled with gas. The USCAs may improve information about tissue characteristics and physiology by enhancing B-mode imaging, all Doppler modalities and by means of contrast-specific imaging, e.g. harmonic and stimulated acoustic imaging. Results from preclinical experiments have been promising, and several of these have been reproduced in clinical studies. This includes improved evaluation of renal vasculature and parenchyma, assessment of vesicoureteral reflux in children, assessment of tubal patency in women, and evaluation of prostate diseases and erectile dysfunction in men. Some of the physical limits of the ultrasound technology, as well as the operator-dependent factors, can probably never be overcome by the use of USCAs; however, the development of USCAs is now about to provide uroradiologists with potentially efficacious products for the benefit of the patient. [ABSTRACT FROM AUTHOR]

Ultrasound contrast agents (USCA) for intravenous injections are usually gas-filled microbubbles with a mean diameter less than that of a red blood corpuscle. There are only a few products on the market at the time of this writing, but several companies have various agents under development. This paper covers both established USCA on the market, and some new agents under clinical evaluation. The potential of improving ultrasound imaging using USCA depends on several factors. These factors include the pharmacokinetic and pharmacodynamic properties of the products, which determine the effects they have on various ultrasound imaging techniques. Furthermore, the proper clinical application of the agents requires a combination of technical and medical knowledge by the examiner, dedicated equipment, a disease that can be diagnosed or characterised by ultrasound and USCA, and a cooperative patient. Taking into account these factors, USCA can be used for improving the detection, characterisation and follow-up of diseases of several vascular beds and parenchymal organs from head to foot. [ABSTRACT FROM AUTHOR]

Purpose: To examine the effect of an ultrasound contrast medium (UCM), Infoson, on Doppler examination of stenotic arteries.Methods: Stenoses were created in the common carotid artery of six piglets, and examined with spectral Doppler and color Doppler imaging during UCM infusion in the left ventricle.Results: UCM caused a mean increase in recorded maximal systolic and end-diastolic velocities of 5% and 6%, respectively, while blood flow remained constant. Increased spectral intensity with UCM was accompanied by spectral broadening. Reduction of spectral intensity by adjustment of Doppler gain counteracted the velocity effects and the spectral broadening. With color Doppler, UCM caused dose-dependent color artifacts outside the artery. Flow in narrow stenoses could be visualized with UCM.Conclusion: The effects of UCM on velocity measurements were slight, and were related to changes in spectral intensity. With color Doppler, UCM may facilitate flow detection, but color artifacts may interfere. [ABSTRACT FROM AUTHOR]