Contrast ultrasound perfusion imaging of lower extremities in peripheral arterial disease: a novel diagnostic method

• Published in: European heart journal Vol. 27; no. 3; pp. 310 - 315
• Main Authors: Duerschmied, Daniel, Olson, Lisa, Olschewski, Manfred, Rossknecht, Alexandra, Freund, Gabriele, Bode, Christoph, Hehrlein, Christoph
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.02.2006; Oxford Publishing Limited (England)
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Case-Control Studies; Contrast Media; Contrast ultrasound; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Humans; Intermittent Claudication - diagnostic imaging; Intermittent Claudication - physiopathology; Leg - blood supply; Male; Medical sciences; Microcirculation; Middle Aged; Peripheral arterial disease; Peripheral Vascular Diseases - diagnostic imaging; Peripheral Vascular Diseases - physiopathology; Phospholipids; Pilot Projects; Sulfur Hexafluoride; Ultrasonography; Sonography; Ultrasound imaging; Peripheral arterial disease; Cardiovascular disease; Contrast ultrasound; Method; Contrast; Phlebology; Arterial disease; Vascular disease; Microcirculation; Perfusion; Occlusive arterial disease; Circulatory system; Diagnosis; Technique; Cardiology; Ultrasound
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/eurheartj/ehi636

Aims The purpose of this study was to establish contrast-enhanced ultrasound perfusion imaging (CUPI) of the lower extremities as a novel non-invasive diagnostic tool for patients with peripheral arterial disease (PAD). Methods and results Ultrasound contrast agent (SonoVue™) was injected into a peripheral vein of 16 control subjects and 16 PAD patients and its appearance in the calf muscle was detected by low-energy harmonic ultrasound. Analysis of the wash-in curves revealed that PAD patients had a significantly longer time to peak intensity (TTP), i.e. duration of maximum contrast perfusion [37 s (19–79 s) in control subjects vs. 56 s (32–104 s) in PAD patients at rest, age-adjusted P=0.002]. Exercise stress test of the calf muscle resulted in a decrease of the TTP, maintaining the significant difference in TTP between the groups [19 s (8–37 s) in control subjects vs. 32 s (18–48 s) in PAD patients after exercise, age-adjusted P=0.004]. Neither ankle-brachial index and TTP nor age and TTP showed a significant correlation. Conclusion CUPI reflects the regional blood circulation of the calf muscle. In this pilot study, PAD patients show a significantly longer TTP than control subjects. The clinical relevance of CUPI is topic of ongoing studies.