Type:
Educational Exhibit
Keywords:
Interventional non-vascular, Interventional vascular, Ultrasound physics, Ultrasound, Percutaneous, Catheter arteriography, Contrast agent-other, Ablation procedures, Abscess delineation, Tissue characterisation, Abscess, Aneurysms
Authors:
K. Patel1, M. Daneshi1, A. Obaro2, I. Khan1, P. Sidhu1, D. Y. Huang1; 1London/UK, 2London, Lo/UK
DOI:
10.1594/ecr2013/C-2529
Background
‘Interventional Ultrasonography’ – Why?
One of the proven technology in imaging-guided,
minimally invasive procedures is with ultrasound.
Ultrasound-guided intervention:
- Eliminates the need for iodinated contrast agents. This is especially important for patients with renal insufficiency not yet on dialysis in whom iodinated contrast or gadolinium-based MRI contrast exposure could be detrimental,
or those with severe allergy to iodinated contrast medium,
- It avoids the problems associated with radiation exposure for both patients and treating clinicians and Significantly,
- Portable.
in unstable patients where ‘bedside’ procedures can be advantageous.
- Imaging with ultrasound is often more cost effective.
Contrast Enhanced Ultrasound (CEUS) – The Rising Star in Interventional Radiology
Sulphur hexafluoride is a microbubble contrast agent with a phospholipid shell (SonoVue®,
Bracco,
Milan) which was introduced in 2001.
Microbubble ultrasound contrast agents are very safe with a low incidence of side effects.
They are not nephrotoxic and it is therefore not necessary to perform laboratory tests before their administration.
The incidence of severe hypersensitivity or anaphylactoid reactions is much lower than with current X-ray agents.
SonoVue® is CE marked for liver,
breast and vascular applications.
This is the main agent in general use.
There has been exponentially increasing interest in the clinical applications of CEUS and new fields have been investigated,
so that nearly all organ systems have now been subjected to some kind of CEUS study.
Potential Benefit of Utilising CEUS in Interventional Radiology
CEUS could provide:
- Real-time enhancement information,
- Improved ability to differentiate between normal and abnormal tissue,
and
- simplifies the precise navigation of needles during an intervention.
- Portable,
can be performed bedside,
- Opportunity to repeat the examination without harming the patient
CEUS therefore could play an important role in the practice of interventional radiology,
particularly when iodinated contrast or ionising radiation is undesirable,
or in unstable patients where ‘bedside’ procedures are advantageous.