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Diagnostic efficacy of SonoVue®, a second generation contrast agent, in the assessment of extracranial carotid or peripheral arteries using colour and spectral Doppler ultrasound: a multicentre study

¹ Department of Radiology, King's College Hospital, Denmark Hill, London SE5 9RS, UK, ² Department of Radiology, Edinburgh Royal Infirmary, Edinburgh, Lothian, UK, ³ CHU de Besancon, Service de Radiologie B, Boulevard Fleming, F-25030 Besancon, Belgium, ⁴ Department of Imaging, Royal Postgraduate Medical School, Hammersmith Hospitals Trust, Du Cane Road, London W12 OHS, UK, ⁵ Department of Surgery, Imperial College School of Science, Technology & Medicine, Charing Cross Hospital, Fulham Palace Road, London W6 8RP, UK, ⁶ Inselspital-Division of Angiology, Department of Internal Medicine, University of Berne, Freiburgstarsse 10, 3010 Berne, Switzerland, ⁷ Department of Surgery, Uppsala University Hospital, Akademiska sjukhuset, 75185 Uppsala, Sweden, ⁸ Schwerpunktpraxis für Angiologie, Wilsnacker Strae 14, 10559, Berlin, Germany, ⁹ Department of Vascular Surgery, Academic Medical Centre, Meibergdreef 9, NL-1105 AC DE Amsterdam, The Netherlands, ¹⁰ Servizio di Radiologia, Ospedale Valduce, Via Dante Alighieri, 11, 22100 Como, Italy, ¹¹ Bracco Diagnostics Inc., 107 College Road East Princeton, Princeton, NJ 08540, USA and ¹² Bracco Imaging SpA, Via E. Folli 50, 20134 Milan, Italy

View larger version (58K): [in a new window]   Figure 1. Illustration of the "blooming" artefact. (a) Following the administration of SonoVue 1.2 ml, extensive blooming at 36 s obscures the arterial anatomy precluding diagnostic interpretation. (b) Without adjustment of the ultrasound machine imaging parameters, at 63 s blooming has subsided and there is better delineation of the arterial anatomy.

View larger version (23K): [in a new window]   Figure 2. Bar chart diagram demonstrating the alteration in the number of inconclusive off-site Doppler ultrasound assessments at the dose of 2.4 ml of SonoVue (entire population: all patients in the study, n=82; population with ref. std: patients with the reference gold standard, n=46).

View larger version (84K): [in a new window]   Figure 3. (a) Baseline unenhanced colour and spectral Doppler ultrasound examination of a patient right lower limb. Insufficient information for a firm conclusion about patency of the anterior tibial artery. (b) Following the administration of 2.4 ml of SonoVue, clear depiction of a patent anterior tibial artery is seen (long arrow) with a large collateral artery seen in a superior position (short arrow). (c) Spectral Doppler contrast ultrasound confirms a monophasic abnormal arterial trace. (d) Corresponding arteriogram confirms the patent anterior tibial artery (long arrow) and the collateral artery (short arrow). Collateral arteries have formed around an occluded popliteal artery. (Courtesy of Dr J Langholz).