Contrast-Enhanced Ultrasound in Clinical Practice

The value of ultrasound contrast agents (USCA) in clinical practice depends on the pharmacokinetics the signal processing and the contrast-specific imaging modalities. USCA are exogenous non-toxic substances smaller than red blood cellswhich after intravenous administration must be stable enough to pass through the pulmonary capillary bed and enter the blood pool producing the necessary contrast enhancement for the duration of the examination. Recently second-generation agents such as SonoVue (Bracco Imaging SpAMilanItaly)have been introduced into the market. These agentstaking advantage of the stability of their microbubbleswithstand the acoustic pressure of insonation much better than previous USCAresulting in an increased half-life of the agent and thus in a prolonged diagnostic window. These agents are blood pool agents that remain in the intravascular compartment and do not leak into the organ tissue. Thereforethey are used to - crease the Doppler signal amplitude during their dynamic vascular phase. Concomitant with the improvement of contrast agentsd- ferent contrast-specific imaging modalities have been developed whichused in combination with USCA and a low mechanical - dex (MI)allow continuous real-time grey-scale imaging. These - cent technical improvements have opened new possibilities in the use of USCA in a variety of indicationsas shown in the contributions contained in this book. In the following chapterssome of the most distinguished users of second-generation USCA will share their knowledge and experience. The first contributor is Dr. Thomas AlbrechtDepartment of - diology University Hospital of Berlin Germany.