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Basic Properties of Ultrasound Contrast Agents

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Medical Imaging Contrast Agents: A Clinical Manual

Abstract

The acronym CEUS refers to contrast-enhanced ultrasound techniques. In this chapter, we describe the composition, basic properties and physics behind currently available ultrasound contrast agents (UCAs). Today CEUS easily allows real-time recording and evaluation of the wash-in and wash-out phases of the UCA over several minutes. The main diagnostic features are vascular architecture (evaluated in the early wash-in phase) and contrast enhancement of the lesion compared to the adjacent tissue. Special care was taken to discuss artefacts, their appearance and how to avoid them. UCA application, specific imaging techniques (e.g. CEUS-guided interventions, paediatric patients and newborns, extravascular-intracavitary use and quantification) and safety issues are also discussed in depth.

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References

  1. Albrecht T, Blomley M, Bolondi L, Claudon M, Correas JM, Cosgrove D, Greiner L, et al. Guidelines for the use of contrast agents in ultrasound. January 2004. Ultraschall Med. 2004;25:249–56.

    Article  CAS  PubMed  Google Scholar 

  2. Claudon M, Cosgrove D, Albrecht T, Bolondi L, Bosio M, Calliada F, Correas JM, et al. Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS)—update 2008. Ultraschall Med. 2008;29:28–44.

    Article  CAS  PubMed  Google Scholar 

  3. Piscaglia F, Nolsoe C, Dietrich CF, Cosgrove DO, Gilja OH, Bachmann NM, Albrecht T, et al. The EFSUMB Guidelines and Recommendations on the Clinical Practice of Contrast Enhanced Ultrasound (CEUS): update 2011 on non-hepatic applications. Ultraschall Med. 2012;33:33–59.

    Article  CAS  PubMed  Google Scholar 

  4. Claudon M, Dietrich CF, Choi BI, Cosgrove DO, Kudo M, Nolsoe CP, Piscaglia F, et al. Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS) in the liver—update 2012: a WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS. Ultraschall Med. 2013;34:11–29.

    CAS  PubMed  Google Scholar 

  5. Claudon M, Dietrich CF, Choi BI, Cosgrove DO, Kudo M, Nolsoe CP, Piscaglia F, et al. Guidelines and good clinical practice recommendations for Contrast Enhanced Ultrasound (CEUS) in the liver—update 2012: a WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS. Ultrasound Med Biol. 2013;39:187–210.

    Article  PubMed  Google Scholar 

  6. Dietrich CF, Ignee A, Trojan J, Fellbaum C, Schuessler G. Improved characterisation of histologically proven liver tumours by contrast enhanced ultrasonography during the portal venous and specific late phase of SHU 508A. Gut. 2004;53:401–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Dietrich CF, Schuessler G, Trojan J, Fellbaum C, Ignee A. Differentiation of focal nodular hyperplasia and hepatocellular adenoma by contrast-enhanced ultrasound. Br J Radiol. 2005;78:704–7.

    Article  CAS  PubMed  Google Scholar 

  8. Dietrich CF, Becker D. Signalverstärkte Lebersonographie zur verbesserten Detektion und Charakterisierung von Leberraumforderungen. Dt Aerzteblatt. 2002;24:7.

    Google Scholar 

  9. Dietrich CF. [3D real time contrast enhanced ultrasonography,a new technique]. Rofo. 2002;174:160–3.

    Google Scholar 

  10. Dietrich CFWD, Brunner V, Braden B, Zeuzem S, Caspary WF. Erste Erfahrungen mit einem neuen Signalverstärker bei der Untersuchung der Leber. Ultraschall Med. 1998;19.

    Google Scholar 

  11. Dietrich CF, Averkiou MA, Correas JM, Lassau N, Leen E, Piscaglia F. An EFSUMB introduction into Dynamic Contrast-Enhanced Ultrasound (DCE-US) for quantification of tumour perfusion. Ultraschall Med. 2012;33:344–51.

    Article  CAS  PubMed  Google Scholar 

  12. Ignee A, Jedrejczyk M, Schuessler G, Jakubowski W, Dietrich CF. Quantitative contrast enhanced ultrasound of the liver for time intensity curves-reliability and potential sources of errors. Eur J Radiol. 2010;73:153–8.

    Article  PubMed  Google Scholar 

  13. Lassau N, Cosgrove D, Armand JP. Early evaluation of targeted drugs using dynamic contrast-enhanced ultrasonography for personalized medicine. Future Oncol. 2012;8:1215–8.

    Article  CAS  PubMed  Google Scholar 

  14. Lassau N, Koscielny S, Chami L, Chebil M, Benatsou B, Roche A, Ducreux M, et al. Advanced hepatocellular carcinoma: early evaluation of response to bevacizumab therapy at dynamic contrast-enhanced US with quantification—preliminary results. Radiology. 2011;258:291–300.

    Article  PubMed  Google Scholar 

  15. Lassau N, Koscielny S, Albiges L, Chami L, Benatsou B, Chebil M, Roche A, et al. Metastatic renal cell carcinoma treated with sunitinib: early evaluation of treatment response using dynamic contrast-enhanced ultrasonography. Clin Cancer Res. 2010;16:1216–25.

    Article  CAS  PubMed  Google Scholar 

  16. Frampas E, Lassau N, Zappa M, Vullierme MP, Koscielny S, Vilgrain V. Advanced Hepatocellular Carcinoma: early evaluation of response to targeted therapy and prognostic value of Perfusion CT and Dynamic Contrast Enhanced-Ultrasound. Preliminary results. Eur J Radiol. 2013;82:e205–11.

    Article  PubMed  Google Scholar 

  17. Williams R, Hudson JM, Lloyd BA, Sureshkumar AR, Lueck G, Milot L, Atri M, et al. Dynamic microbubble contrast-enhanced US to measure tumor response to targeted therapy: a proposed clinical protocol with results from renal cell carcinoma patients receiving antiangiogenic therapy. Radiology. 2011;260:581–90.

    Article  PubMed  Google Scholar 

  18. Dietrich CF, Averkiou M, Nielsen MB, Barr RG, Burns PN, Calliada F, Cantisani V, et al. How to perform Contrast-Enhanced Ultrasound (CEUS). Ultrasound Int Open. 2018;4:E2–E15.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Gramiak R, Shah PM. Echocardiography of the aortic root. Invest Radiol. 1968;3:356–66.

    Article  CAS  PubMed  Google Scholar 

  20. Kremkau FW, Gramiak R, Carstensen EL, Shah PM, Kramer DH. Ultrasonic detection of cavitation at catheter tips. Am J Roentgenol Radium Ther Nucl Med. 1970;110:177–83.

    Article  CAS  PubMed  Google Scholar 

  21. Feinstein SB, Shah PM, Bing RJ, Meerbaum S, Corday E, Chang BL, Santillan G, et al. Microbubble dynamics visualized in the intact capillary circulation. J Am Coll Cardiol. 1984;4:595–600.

    Article  CAS  PubMed  Google Scholar 

  22. D’Arrigo JS, Mano Y. Bubble production in agarose gels subjected to different decompression schedules. Undersea Biomed Res. 1979;6:93–8.

    PubMed  Google Scholar 

  23. Cui W, Bei J, Wang S, Zhi G, Zhao Y, Zhou X, Zhang H, et al. Preparation and evaluation of poly(L-lactide-co-glycolide) (PLGA) microbubbles as a contrast agent for myocardial contrast echocardiography. J Biomed Mater Res B Appl Biomater. 2005;73:171–8.

    Article  PubMed  CAS  Google Scholar 

  24. Eisenbrey JR, Hsu J, Wheatley MA. Plasma sterilization of poly lactic acid ultrasound contrast agents: surface modification and implications for drug delivery. Ultrasound Med Biol. 2009;35:1854–62.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Cavalieri F, El Hamassi A, Chiessi E, Paradossi G. Stable polymeric microballoons as multifunctional device for biomedical uses: synthesis and characterization. Langmuir. 2005;21:8758–64.

    Article  CAS  PubMed  Google Scholar 

  26. Forsberg F, Basude R, Liu JB, Alessandro J, Shi WT, Rawool NM, Goldberg BB, et al. Effect of filling gases on the backscatter from contrast microbubbles: theory and in vivo measurements. Ultrasound Med Biol. 1999;25:1203–11.

    Article  CAS  PubMed  Google Scholar 

  27. Fritzsch T, Schlief R. Future prospects for echo-enhancing agents. Clin Radiol. 1996;51(Suppl 1):56–8.

    PubMed  Google Scholar 

  28. Paefgen V, Doleschel D, Kiessling F. Evolution of contrast agents for ultrasound imaging and ultrasound-mediated drug delivery. Front Pharmacol. 2015;6:197.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  29. Chen CC, Borden MA. The role of poly(ethylene glycol) brush architecture in complement activation on targeted microbubble surfaces. Biomaterials. 2011;32:6579–87.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Yanagisawa K, Moriyasu F, Miyahara T, Yuki M, Iijima H. Phagocytosis of ultrasound contrast agent microbubbles by Kupffer cells. Ultrasound Med Biol. 2007;33:318–25.

    Article  PubMed  Google Scholar 

  31. Appis AW, Tracy MJ, Feinstein SB. Update on the safety and efficacy of commercial ultrasound contrast agents in cardiac applications. Echo Res Pract. 2015;2:R55–62.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Leong-Poi H, Song J, Rim SJ, Christiansen J, Kaul S, Lindner JR. Influence of microbubble shell properties on ultrasound signal: implications for low-power perfusion imaging. J Am Soc Echocardiogr. 2002;15:1269–76.

    Article  PubMed  Google Scholar 

  33. Yin T, Wang P, Zheng R, Zheng B, Cheng D, Zhang X, Shuai X. Nanobubbles for enhanced ultrasound imaging of tumors. Int J Nanomedicine. 2012;7:895–904.

    CAS  PubMed  PubMed Central  Google Scholar 

  34. Ignee A, Atkinson NS, Schuessler G, Dietrich CF. Ultrasound contrast agents. Endosc Ultrasound. 2016;5:355–62.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Uzuner N, Horner S, Pichler G, Svetina D, Niederkorn K. Right-to-left shunt assessed by contrast transcranial Doppler sonography: new insights. J Ultrasound Med. 2004;23:1475–82.

    Article  PubMed  Google Scholar 

  36. Cosgrove D. Echo enhancers and ultrasound imaging. Eur J Radiol. 1997;26:64–76.

    Article  CAS  PubMed  Google Scholar 

  37. Feinstein SB, Cheirif J, Ten Cate FJ, Silverman PR, Heidenreich PA, Dick C, Desir RM, et al. Safety and efficacy of a new transpulmonary ultrasound contrast agent: initial multicenter clinical results. J Am Coll Cardiol. 1990;16:316–24.

    Article  CAS  PubMed  Google Scholar 

  38. Calliada F, Campani R, Bottinelli O, Bozzini A, Sommaruga MG. Ultrasound contrast agents: basic principles. Eur J Radiol. 1998;27(Suppl 2):S157–60.

    Article  PubMed  Google Scholar 

  39. Piscaglia F, Nolsoe C, Dietrich CF, Cosgrove DO, Gilja OH, Bachmann Nielsen M, Albrecht T, et al. The EFSUMB Guidelines and Recommendations on the Clinical Practice of Contrast Enhanced Ultrasound (CEUS): update 2011 on non-hepatic applications. Ultraschall Med. 2012;33:33–59.

    Article  CAS  PubMed  Google Scholar 

  40. Cantisani V, Wilson SR. CEUS: where are we in 2015? Eur J Radiol. 2015;84(9):1621–2. https://doi.org/10.1016/j.ejrad.2015.05.028. Epub 2015 Jun 17.

    Article  PubMed  Google Scholar 

  41. Hagiwara Y, Saijo Y, Ando A, et al. Comparison of articular cartilage images assessed by high-frequency ultrasound microscope and scanning acoustic microscope. Int Orthop. 2012;36(1):185–90. https://doi.org/10.1007/s00264-011-1263-1.

  42. Averkiou MA, Bruce MF, Powers JE, et al. Imaging methods for ultrasound contrast agents. Ultrasound Med Biol. 46(3):498–517. https://doi.org/10.1016/j.ultrasmedbio.2019.11.004.

  43. Dietrich CF, Averkiou MA, Correas J-M, et al. An EFSUMB introduction into Dynamic Contrast-Enhanced Ultrasound (DCE-US) for quantification of tumour perfusion. Ultraschall Med. 2012;33:344–51.

    Article  CAS  PubMed  Google Scholar 

  44. Dietrich CF, Ignee A, Greis C, Cui XW, Schreiber-Dietrich DG, Hocke M. Artifacts and pitfalls in contrast-enhanced ultrasound of the liver. Ultraschall Med. 2014;35:108–25; quiz 126–7.

    Article  CAS  PubMed  Google Scholar 

  45. Dietrich CF, Ignee A, Hocke M, Schreiber-Dietrich D, Greis C. Pitfalls and artefacts using contrast enhanced ultrasound. Z Gastroenterol. 2011;49:350–6.

    Article  CAS  PubMed  Google Scholar 

  46. Cui XW, Ignee A, Hocke M, Seitz K, Schrade G, Dietrich CF. Prolonged heterogeneous liver enhancement on contrast-enhanced ultrasound. Ultraschall Med. 2014;35:246–52.

    CAS  PubMed  Google Scholar 

  47. Solbiati L, Tonolini M, Cova L, Goldberg SN. The role of contrast-enhanced ultrasound in the detection of focal liver leasions. Eur Radiol. 2001;11(Suppl 3):E15–26.

    Article  PubMed  Google Scholar 

  48. D’Onofrio M, Martone E, Faccioli N, Zamboni G, Malago R, Mucelli RP. Focal liver lesions: sinusoidal phase of CEUS. Abdom Imaging. 2006;31:529–36.

    Article  PubMed  Google Scholar 

  49. Dietrich CF, Lorentzen T, Appelbaum L, Buscarini E, Cantisani V, Correas JM, Cui XW, et al. EFSUMB Guidelines on Interventional Ultrasound (INVUS), part III—abdominal treatment procedures (long version). Ultraschall Med. 2016;37:E1–E32.

    CAS  PubMed  Google Scholar 

  50. Strobel D, Seitz K, Blank W, Schuler A, Dietrich C, von Herbay A, Friedrich-Rust M, et al. Contrast-enhanced ultrasound for the characterization of focal liver lesions—diagnostic accuracy in clinical practice (DEGUM multicenter trial). Ultraschall Med. 2008;29:499–505.

    Article  CAS  PubMed  Google Scholar 

  51. Bernatik T, Seitz K, Blank W, Schuler A, Dietrich CF, Strobel D. Unclear focal liver lesions in contrast-enhanced ultrasonography—lessons to be learned from the DEGUM multicenter study for the characterization of liver tumors. Ultraschall Med. 2010;31:577–81.

    Article  CAS  PubMed  Google Scholar 

  52. Seitz K, Greis C, Schuler A, Bernatik T, Blank W, Dietrich CF, Strobel D. Frequency of tumor entities among liver tumors of unclear etiology initially detected by sonography in the noncirrhotic or cirrhotic livers of 1349 patients. Results of the DEGUM multicenter study. Ultraschall Med. 2011;32:598–603.

    Article  CAS  PubMed  Google Scholar 

  53. Strobel D, Bernatik T, Blank W, Schuler A, Greis C, Dietrich CF, Seitz K. Diagnostic accuracy of CEUS in the differential diagnosis of small (</= 20 mm) and subcentimetric (</= 10 mm) focal liver lesions in comparison with histology. Results of the DEGUM multicenter trial. Ultraschall Med. 2011;32:593–7.

    Article  CAS  PubMed  Google Scholar 

  54. Sidhu PS, Cantisani V, Dietrich CF, Gilja OH, Saftoiu A, Bartels E, Bertolotto M, et al. The EFSUMB guidelines and recommendations for the clinical practice of Contrast-Enhanced Ultrasound (CEUS) in non-hepatic applications: update 2017 (long version). Ultraschall Med. 2018;39:e2–e44.

    Article  PubMed  Google Scholar 

  55. Sidhu PS, Cantisani V, Dietrich CF, Gilja OH, Saftoiu A, Bartels E, Bertolotto M, et al. The EFSUMB guidelines and recommendations for the clinical practice of Contrast-Enhanced Ultrasound (CEUS) in non-hepatic applications: update 2017 (short version). Ultraschall Med. 2018;39:154–80.

    Article  PubMed  Google Scholar 

  56. Kudo M. Defect reperfusion imaging with Sonazoid(R): a breakthrough in hepatocellular carcinoma. Liver Cancer. 2016;5:1–7.

    Article  CAS  PubMed  Google Scholar 

  57. Dietrich CF, Greis C. [How to perform contrast enhanced ultrasound]. Dtsch Med Wochenschr. 2016;141:1019–24.

    Google Scholar 

  58. Lassau N, Bonastre J, Kind M, Vilgrain V, Lacroix J, Cuinet M, Taieb S, et al. Validation of dynamic contrast-enhanced ultrasound in predicting outcomes of antiangiogenic therapy for solid tumors: the French multicenter support for innovative and expensive techniques study. Invest Radiol. 2014;49:794–800.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. O’Connor JP, Aboagye EO, Adams JE, Aerts HJ, Barrington SF, Beer AJ, Boellaard R, et al. Imaging biomarker roadmap for cancer studies. Nat Rev Clin Oncol. 2017;14:169–86.

    Article  PubMed  CAS  Google Scholar 

  60. Jenssen C, Gilja OH, Serra AL, Piscaglia F, Dietrich CF, Rudd L, Sidhu PS. European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) policy document development strategy—clinical practice guidelines, position statements and technological reviews. Ultrasound Int Open. 2019;5:E2–E10.

    Article  PubMed  Google Scholar 

  61. Sidhu PS, Cantisani V, Deganello A, Dietrich CF, Duran C, Franke D, Harkanyi Z, et al. Role of Contrast-Enhanced Ultrasound (CEUS) in paediatric practice: an EFSUMB position statement. Ultraschall Med. 2017;38:33–43.

    PubMed  Google Scholar 

  62. Wu W, Chen MH, Yin SS, Yan K, Fan ZH, Yang W, Dai Y, et al. The role of contrast-enhanced sonography of focal liver lesions before percutaneous biopsy. AJR Am J Roentgenol. 2006;187:752–61.

    Article  PubMed  Google Scholar 

  63. Bang N, Bachmann Nielsen M, Vejborg I, Mellon Mogensen A. Clinical report: contrast enhancement of tumor perfusion as a guidance for biopsy. Eur J Ultrasound. 2000;12:159–61.

    Article  CAS  PubMed  Google Scholar 

  64. Sparchez Z, Radu P, Zaharia T, Kacso G, Grigorescu I, Botis G, Badea R. Usefulness of contrast enhanced ultrasound guidance in percutaneous biopsies of liver tumors. J Gastrointestin Liver Dis. 2011;20:191–6.

    PubMed  Google Scholar 

  65. Yoon SH, Lee KH, Kim SY, Kim YH, Kim JH, Lee SH, Kim TK. Real-time contrast-enhanced ultrasound-guided biopsy of focal hepatic lesions not localised on B-mode ultrasound. Eur Radiol. 2010;20:2047–56.

    Article  PubMed  Google Scholar 

  66. Lackey L 2nd, Peterson C, Barr RG. Contrast-enhanced ultrasound-guided radiofrequency ablation of renal tumors. Ultrasound Q. 2012;28:269–74.

    Article  PubMed  Google Scholar 

  67. Ignee A, Boerner N, Bruening A, Dirks K, von Herbay A, Jenssen C, Kubale R, et al. Duplex sonography of the mesenteric vessels—a critical evaluation of inter-observer variability. Z Gastroenterol. 2016;54:304–11.

    Article  CAS  PubMed  Google Scholar 

  68. Sanz E, Hevia V, Arias F, Fabuel JJ, Alvarez S, Rodriguez-Patron R, Gomez V, et al. Contrast-enhanced ultrasound (CEUS): an excellent tool in the follow-up of small renal masses treated with cryoablation. Curr Urol Rep. 2015;16:469.

    Article  PubMed  Google Scholar 

  69. Meloni MF, Bertolotto M, Alberzoni C, Lazzaroni S, Filice C, Livraghi T, Ferraioli G. Follow-up after percutaneous radiofrequency ablation of renal cell carcinoma: contrast-enhanced sonography versus contrast-enhanced CT or MRI. AJR Am J Roentgenol. 2008;191:1233–8.

    Article  PubMed  Google Scholar 

  70. Schreiber-Dietrich DG, Cui XW, Piscaglia F, Gilja OH, Dietrich CF. Contrast enhanced ultrasound in pediatric patients: a real challenge. Z Gastroenterol. 2014;52:1178–84.

    Article  CAS  PubMed  Google Scholar 

  71. Dietrich CF, Maurer M, Riemer-Hommel P. Challenges for the German health care system—pharmaceuticals. Endheu. 2014;27:45–53.

    Google Scholar 

  72. Esposito F, Di Serafino M, Sgambati P, Mercogliano F, Tarantino L, Vallone G, Oresta P. Ultrasound contrast media in paediatric patients: is it an off-label use? Regulatory requirements and radiologist’s liability. Radiol Med. 2012;117:148–59.

    Article  CAS  PubMed  Google Scholar 

  73. Chiorean L, Cui XW, Tannapfel A, Franke D, Stenzel M, Kosiak W, Schreiber-Dietrich D, et al. Benign liver tumors in pediatric patients—review with emphasis on imaging features. World J Gastroenterol. 2015;21:8541–61.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Ignee A, Schuessler G, Cui XW. Endocavernous contrast-enhanced ultrasound—different applications, literature review and future perspectives. Ultraschall Med. 2013;34:2–26.

    Google Scholar 

  75. Nylund K, Maconi G, Hollerweger A, Ripolles T, Pallotta N, Higginson A, Serra C, Dietrich CF, Sporea I, Saftoiu A, Dirks K, Hausken T, Calabrese E, Romanini L, Maaser C, Nuernberg D, Gilja OH. EFSUMB Recommendations and Guidelines for Gastrointestinal Ultrasound. Ultraschall Med. 2017;38(3):e1–15. English. https://doi.org/10.1055/s-0042-115853. Epub 2016 Sep 7. PMID: 27604052.

  76. Nylund K, Maconi G, Hollerweger A, Ripolles T, Pallotta N, Higginson A, Serra C, Dietrich CF, Sporea I, Saftoiu A, Dirks K, Hausken T, Calabrese E, Romanini L, Maaser C, Nuernberg D, Gilja OH. EFSUMB Recommendations and Guidelines for Gastrointestinal Ultrasound. Ultraschall Med. 2017;38(3):273–84. English. https://doi.org/10.1055/s-0042-115410. Epub 2016 Sep 7. PMID: 27604051.

  77. Cui XW, Ignee A, Maros T, Straub B, Wen JG, Dietrich CF. Feasibility and usefulness of intra-cavitary contrast-enhanced ultrasound in percutaneous nephrostomy. Ultrasound Med Biol. 2016;42:2180–8.

    Article  PubMed  Google Scholar 

  78. Ignee A, Cui X, Schuessler G, Dietrich CF. Percutaneous transhepatic cholangiography and drainage using extravascular contrast enhanced ultrasound. Z Gastroenterol. 2015;53:385–90.

    Article  CAS  PubMed  Google Scholar 

  79. Ignee A, Jenssen C, Cui XW, Schuessler G, Dietrich CF. Intracavitary contrast-enhanced ultrasound in abscess drainage—feasibility and clinical value. Scand J Gastroenterol. 2016;51:41–7.

    Article  PubMed  Google Scholar 

  80. Darge K. Voiding urosonography with US contrast agents for the diagnosis of vesicoureteric reflux in children. II. Comparison with radiological examinations. Pediatr Radiol. 2008;38:54–63; quiz 126–7.

    Article  PubMed  Google Scholar 

  81. Darge K. Voiding urosonography with ultrasound contrast agents for the diagnosis of vesicoureteric reflux in children. I. Procedure. Pediatr Radiol. 2008;38:40–53.

    Article  PubMed  Google Scholar 

  82. Zengel P, Siedek V, Berghaus A, Clevert DA. Intraductally applied contrast-enhanced ultrasound (IA-CEUS) for improved visualization of obstructive diseases of the salivary glands, primary results. Clin Hemorheol Microcirc. 2010;45:193–205.

    Article  CAS  PubMed  Google Scholar 

  83. Lanzani C, Savasi V, Leone FP, Ratti M, Ferrazzi E. Two-dimensional HyCoSy with contrast tuned imaging technology and a second-generation contrast media for the assessment of tubal patency in an infertility program. Fertil Steril. 2009;92:1158–61.

    Article  CAS  PubMed  Google Scholar 

  84. Zuber-Jerger I, Endlicher E, Scholmerich J, Klebl F. Endoscopic retrograde cholangiography with contrast ultrasonography. Endoscopy. 2008;40(Suppl 2):E202.

    Article  PubMed  Google Scholar 

  85. Chew SS, Yang JL, Newstead GL, Douglas PR. Anal fistula: Levovist-enhanced endoanal ultrasound: a pilot study. Dis Colon Rectum. 2003;46:377–84.

    Article  PubMed  Google Scholar 

  86. Rosch T, Meining A, Fruhmorgen S, Zillinger C, Schusdziarra V, Hellerhoff K, Classen M, et al. A prospective comparison of the diagnostic accuracy of ERCP, MRCP, CT, and EUS in biliary strictures. Gastrointest Endosc. 2002;55:870–6.

    Article  PubMed  Google Scholar 

  87. Tranquart F, Mercier L, Frinking P, et al. Perfusion quantification in Contrast-Enhanced Ultra-sound (CEUS)—ready for research projects and routine clinical use. Ultraschall Med. 2012;33:S31–8.

    Article  PubMed  Google Scholar 

  88. Piscaglia F, Bolondi L, Italian Society for Ultrasound in Medicine and Biology (SIUMB) Study Group on Ultrasound Contrast Agents. The safety of Sonovue in abdominal applications: retrospective analysis of 23188 investigations. Ultrasound Med Biol. 2006;32:1369–75.

    Article  PubMed  Google Scholar 

  89. Kusnetzky LL, Khalid A, Khumri TM, Moe TG, Jones PG, Main ML. Acute mortality in hospitalized patients undergoing echocardiography with and without an ultrasound contrast agent: results in 18,671 consecutive studies. J Am Coll Cardiol. 2008;51:1704–6.

    Article  PubMed  Google Scholar 

  90. Main ML, Ryan AC, Davis TE, Albano MP, Kusnetzky LL, Hibberd M. Acute mortality in hospitalized patients undergoing echocardiography with and without an ultrasound contrast agent (multicenter registry results in 4,300,966 consecutive patients). Am J Cardiol. 2008;102:1742–6.

    Article  PubMed  Google Scholar 

  91. Dolan MS, Gala SS, Dodla S, Abdelmoneim SS, Xie F, Cloutier D, Bierig M, et al. Safety and efficacy of commercially available ultrasound contrast agents for rest and stress echocardiography a multicenter experience. J Am Coll Cardiol. 2009;53:32–8.

    Article  CAS  PubMed  Google Scholar 

  92. Aggeli C, Giannopoulos G, Roussakis G, Christoforatou E, Marinos G, Toli C, Pitsavos C, et al. Safety of myocardial flash-contrast echocardiography in combination with dobutamine stress testing for the detection of ischaemia in 5250 studies. Heart. 2008;94:1571–7.

    Article  CAS  PubMed  Google Scholar 

  93. Szebeni J. Complement activation-related pseudoallergy: a new class of drug-induced acute immune toxicity. Toxicology. 2005;216:106–21.

    Article  CAS  PubMed  Google Scholar 

  94. Bokor D, Chambers JB, Rees PJ, Mant TG, Luzzani F, Spinazzi A. Clinical safety of SonoVue, a new contrast agent for ultrasound imaging, in healthy volunteers and in patients with chronic obstructive pulmonary disease. Invest Radiol. 2001;36:104–9.

    Article  CAS  PubMed  Google Scholar 

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Cantisani, V. et al. (2021). Basic Properties of Ultrasound Contrast Agents. In: Erturk, S.M., Ros, P.R., Ichikawa, T., Saylisoy, S. (eds) Medical Imaging Contrast Agents: A Clinical Manual. Springer, Cham. https://doi.org/10.1007/978-3-030-79256-5_10

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