Medical Ultrasound Imaging
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Searchterm 'Levovist' found in 3 articles
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Levovist®
From Bayer Schering Pharma AG:
Available in Europe since 1996 and in Japan since 1999. Currently, the marketing situation is unclear.
Levovist® is a first generation USCA consisting of galactose (milk sugar) ground into tiny crystals whose irregular surfaces act as nidation sites on which air pockets form when it is suspended in water, much as soda water bubbles form at small irregularities on the surface of the glass. A trace of palmitic acid is added as a surfactant to stabilize the resultant microbubbles. When Levovist® dissolves in blood, air trapped inside the galactose is released as free gas bubbles. These bubbles have a weak encapsulating shell and are easily destroyed by ultrasound.
Different contrast ultrasonography methods have been developed since the introduction of Levovist®. Initially, Levovist® was an echo contrast medium for improving sensitivity in color Doppler and Power Doppler examinations, but was found to suffer from significant blooming, making it difficult to observe small blood vessels. However, Levovist® improves the accuracy of echocardiographic examinations in such indications as assessment of left ventricular function.
In addition to their vascular phase, some ultrasound contrast agents (USCAs) can exhibit a tissue- or organ-specific phase. Levovist® can accumulate within the liver and the spleen for up to 20 min once it has disappeared from the blood pool and improves the detectability of focal liver lesions and allows more reliable control of interventional tumor treatments. Varied types of information can be obtained by applying contrast imaging at different times after the injection using Levovist® in both the arterial phase and the late organ-specific phase.
1 g Levovist® granules contain 999 mg D-galactose and 1 mg palmitic acid.
Brand names in other countries: Levovist/Levograf
Drug Information and Specification
RESEARCH NAME
SHU 508A
INDICATION
APPLICATION
Intravenous injection
TYPE
Microbubble
Galactose/Palmitic acid
CHARGE
Negative
Air
MICROBUBBLE SIZE
95% < 10μm
PRESENTATION
Vials of 2.5 g and 4.0 g incl. one plastic ampoule containing 20 ml water for injection, one mini-spike and one disposable syringe of 20 ml
STORAGE
Room temp 15−30°C
PREPARATION
Reconstitute with 5 to 17 ml water
DO NOT RELY ON THE INFORMATION PROVIDED HERE, THEY ARE
NOT A SUBSTITUTE FOR THE ACCOMPANYING PACKAGE INSERT!
Bayer Schering Pharma AG
www.schering.de The Germany-based pharmaceutical company is the result of the take-over of Schering AG by Bayer AG in 2006. The Bayer Schering Pharma AG is part of the Bayer HealthCare AG, which represents the pharmaceutical part of the Bayer Group.
The company makes ultrasound, x-ray and MRI contrast media, drugs for treating cancer, multiple-sclerosis, heart and nervous system disorders and severe skin conditions.
In general, its activities are focused on four business areas: Fertility control & hormone therapy, diagnostics & radiopharmaceuticals, dermatology as well as specialized therapeutics for disabling diseases in the fields of the central nervous system, oncology and cardiovascular system.
Currently, Bayer Schering Pharma discontinued the manufacturing and development of ultrasound contrast agents.


Ultrasound Contrast Agents:
Contact Information
MAIL
Bayer Schering Pharma AG
51368 Leverkusen
GERMANY
PHONE
+49-30-46-81-2431
FAX
+49-30-46-81-8195
History of Ultrasound Contrast Agents
The earliest introduction of vascular ultrasound contrast agents (USCA) was by Gramiak and Shah in 1968, when they injected agitated saline into the ascending aorta and cardiac chambers during echocardiographic to opacify the left heart chamber. Strong echoes were produced within the heart, due to the acoustic mismatch between free air microbubbles in the saline and the surrounding blood.
The disadvantage of this microbubbles produced by agitation, was that the air quickly leak from the thin bubble shell into the blood, where it dissolved. In addition, the small bubbles that were capable of traversing the capillary bed did not survive long enough for imaging because the air quickly dissipated into the blood. Aside from agitated saline, also hydrogen peroxide, indocyanine green dye, and iodinated contrast has been tested. The commercial development of contrast agents began in the 1980s with greatest effort to the stabilization of small microbubbles.

The development generations by now:
first generation USCA = non-transpulmonary vascular;;
second generation USCA = transpulmonary vascular, with short half-life (less than 5 min);
third generation USCA = transpulmonary vascular, with longer half-life (greater than 5 min).

To pass through the lung capillaries and enter into the systemic circulation, microspheres should be less than 10 μm in diameter. Air bubbles in that size range persist in solution for only a short time; too short for systemic vascular use.
The first developed agent was Echovist (1982), which enabled the enhancement of the right heart. The second generation of echogenic agents, sonicated 5% human albumin-containing air bubbles (Albunex), were capable of transpulmonary passage but often failed to produce adequate imaging of the left heart. Both Albunex and Levovist utilize air as the gas component of the microbubble.
In the 1990s newer developed agents with fluorocarbon gases and albumin, surfactant, lipid, or polymer shells have an increased persistence of the microspheres. This smaller, more stable microbubble agents, and improvements in ultrasound technology, have resulted in a wider range of application including myocardial perfusion.

See also First Generation USCA, Second Generation USCA, and Third Generation USCA.
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