Medical Ultrasound Imaging
Monday, 20 May 2024
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A liver sonography is a diagnostic tool to image the liver and adjoining upper abdominal organs such as the gallbladder, spleen, and pancreas. Deeper structures such as liver and pancreas are imaged at a lower frequency 1-6 MHz with lower axial and lateral resolution but greater penetration. The diagnostic capabilities in this area can be limited by gas in the bowel scattering the sound waves. The application of microbubbles may be useful for detection of liver lesions and for lesion characterization. Some microbubbles have a liver-specific post vascular phase where they appear to be taken up by the reticuloendothelial system (RES). Dynamic contrast enhanced scans in a similar way as with CT or MRI can be used to studying the arterial, venous and tissue phase. After a bolus injection, early vascular enhancement is seen at around 30sec in arterialized lesions (e.g., hepatocellular carcinomas (HCC), focal nodular hyperplasia (FNH)). Later enhancement is typical of hemangiomas with gradually filling towards the center. In the late phase at around 90sec, HCCs appear as defects against the liver background. Most metastases are relatively hypovascular and so do not show much enhancement and are seen as signal voids in the different phases. Either with an intermittent imaging technique or by continuous scanning in a nondestructive, low power mode, characteristic time patterns can be used to differentiate lesions. See also Medical Imaging, B-Mode, High Intensity Focused Ultrasound, Ultrasound Safety and Contrast Medium.  Further Reading: Basics:
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From Bayer Schering Pharma AG:
Sonovist® (sometimes found as Sonavist) is an investigational ultrasound contrast agent with a biodegradable synthetic capsule filled with sulphur hexafluoride. The biodegradable shell of Sonovist is so stable that it can be taken up by Kupffer cells of the reticuloendothelial system or accumulate in the sinusoids. Therefore, Sonovist® has an additional hepato-splenic parenchymal phase following the blood pool phase, analog to the superparamagnetic iron oxide agents used in liver MRI. The microbubbles are stationary in this phase and generate no conventional Doppler signals. This tissue-specific phase has a variable duration and can be imaged by bubble specific imaging modes.
Drug Information and Specification
RESEARCH NAME
SHU 563A
DEVELOPER
INDICATION
APPLICATION
Intravenous
TYPE
Microbubble
Cyanoacrylate (polymer sheIl)
CHARGE
-
Sulphur hexafluoride
MICROBUBBLE SIZE
-
PRESENTATION
-
STORAGE
-
PREPARATION
-
DO NOT RELY ON THE INFORMATION PROVIDED HERE, THEY ARE
NOT A SUBSTITUTE FOR THE ACCOMPANYING PACKAGE INSERT! •
Tissue-specific ultrasound contrast agents improve the image contrast resolution through differential uptake. The concentration of microbubble contrast agents within the vasculature, reticulo-endothelial, or lymphatic systems produces an effective passive targeting of these areas. Other contrast media concepts include targeted drug delivery via contrast microbubbles. Tissue-specific ultrasound contrast agents are injected intravenously and taken up by specific tissues or they adhere to specific targets such as venous thrombosis. These effects may require minutes to several hours to reach maximum effectiveness. By enhancing the acoustic differences between normal and diseased tissues, these tissue-specific agents improve the detectability of abnormalities. Some microbubbles accumulate in normal hepatic tissue; some are phagocytosed by Kupffer cells in the reticuloendothelial system and others may stay in the sinusoids. Liver tumors without normal Kupffer cells can be identified by the lack of the typical mosaic color pattern of the induced acoustic emission. The hepatic parenchymal phase, which may last from less than an hour to several days, depending on the specific contrast medium used, may be imaged by bubble-specific modes such as stimulated acoustic emission (color Doppler using high MI) or pulse inversion imaging. Further Reading: News & More:
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