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Ultraschallkontrastmittel

Arzneimittelsicherheit und Bioeffekte

Ultrasound contrast agents

Pharmaceutical drug safety and bioeffects

  • Leitthema: Kontrastmittelsicherheit
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Zusammenfassung

In dieser Arbeit werden die Sicherheitsaspekte von Ultraschallkontrastmitteln (USKM) aufgezeigt und diskutiert.

USKM sind generell sehr sichere Arzneimittel. Insbesondere aufgrund der kolloidalen Struktur muss jedoch auch hier mit allergoiden Reaktionen gerechnet werden. Daneben wird durch die Applikation von USKM die Schwelle für das Auftreten akustisch induzierter Bioeffekte herabgesetzt und diese möglicherweise verstärkt. In vitro und im Rahmen von Tierversuchen konnten durch USKM und Ultraschall petechiale Blutungen, vaskuläre Schäden und die Bildung freier Radikale bis hin zu Schädigungen von DNA-Einzelsträngen nachgewiesen werden. Klinisch stehen diesen Untersuchungen jedoch keine entsprechenden Resultate gegenüber. Selten wurde bei kardiologischen Untersuchungen eine erhöhte Rate an ventrikulären Kontraktionen bei kontrastverstärkter Sonographie mit Triggerung auf die Endsystole beobachtet. Nephrotoxische Effekte, wie bei anderen Kontrastmitteln, wurden keine gefunden, sodass der kontrastmittelverstärkte Ultraschall als wichtige Untersuchungsalternative bei Patienten mit eingeschränkter Niereninsuffizienz anzusehen ist.

Abstract

In this overview safety aspects of ultrasound contrast agents (USCA) are described and discussed. In general USCA are very safe drugs. However, allergic adverse reactions can rarely occur, particularly due to the colloidal structure of USCA. In addition, the use of USCA could reduce the threshold for acoustically induced bioeffects and has the potential to increase these effects. In in vitro studies and animal trials USCA caused petechial hemorrhages, vascular damage, and the formation of free radicals. Even DNA damage with single strand breaks could be demonstrated. In human studies and clinical practice none of these bioeffects could be observed. In contrast-enhanced echocardiography a higher rate of premature ventricular contractions has been reported when imaging was triggered at the end systole. Compared with other contrast agents contrast-enhanced ultrasound showed no nephrotoxic effects and could prove to be an alternative diagnostic method for patients with renal failure.

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Interessenkonflikt

M. Krix ist in der klinischen Forschung der Firma Bracco ALTANA beschäftigt, welche das USKM SonoVue in Deutschland vertreibt. Die Präsentation des Themas ist jedoch davon unabhängig und die Darstellung der Inhalte produktneutral.

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Authors and Affiliations

  1. Forschungsschwerpunkt Innovative Krebsdiagnostik und –therapie, Abteilung Radiologie, Deutsches Krebsforschungszentrum, Heidelberg, Deutschland

    M. Krix

  2. Alten Graben 15, 78462, Konstanz, Deutschland

    M. Krix

  3. Klinische Kooperationseinheit Strahlentherapie, Deutsches Krebsforschungszentrum, Heidelberg, Deutschland

    J.W. Jenne

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  1. M. Krix
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  2. J.W. Jenne
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Correspondence to M. Krix.

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Krix, M., Jenne, J. Ultraschallkontrastmittel. Radiologe 47, 800–807 (2007). https://doi.org/10.1007/s00117-007-1544-2

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  • DOI: https://doi.org/10.1007/s00117-007-1544-2

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