Contrast ultrasound perfusion imaging of lower extremities in peripheral arterial disease: a novel diagnostic method.
Daniel Duerschmied,Lisa Olson,Manfred Olschewski,Alexandra Rossknecht,Gabriele Freund,Christoph Bode,Christoph Hehrlein +6 more
TLDR
CUPI reflects the regional blood circulation of the calf muscle and shows a significantly longer TTP than control subjects, and is of clinical relevance for patients with peripheral arterial disease.Abstract:
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.read more
Citations
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Cholesterol reduction with atorvastatin improves walking distance in patients with peripheral arterial disease
TL;DR: In this paper, a randomized, double-blind, parallel-design study included 354 persons with claudication attributable to peripheral arterial disease, who were treated with placebo, atorvastatin (10 mg per day), or atorvisastatin(80mg per day) for 12 months, and the outcome measures included change in treadmill exercise time and patient-reported measures of physical activity and quality of life.
Journal ArticleDOI
Limb Stress-Rest Perfusion Imaging With Contrast Ultrasound For The Assessment Of Peripheral Arterial Disease Severity
Jonathan R. Lindner,Lisa Womack,Eugene J. Barrett,Judy Y. Weltman,Wendy Price,Nancy L. Harthun,Sanjiv Kaul,James T. Patrie +7 more
TL;DR: Perfusion imaging of limb skeletal during exercise and measurement of absolute flow reserve can provide valuable information on the severity PAD, and the best models for predicting severity of disease were the combination of diabetes and either exercise blood flow or flow reserve on CEU.
Journal ArticleDOI
Novel applications of contrast-enhanced ultrasound imaging in vascular medicine
Daniel Staub,Sasan Partovi,Stephan Imfeld,Heiko Uthoff,Thomas Baldi,Markus Aschwanden,Kurt A. Jaeger +6 more
TL;DR: The clinical value of contrast agents in vascular ultrasound by enhancing the vascular lumen is discussed, and more important, their role as a tool to deliver high resolution, real-time images of microvascular perfusion is discussed.
Journal ArticleDOI
Perfusion Assessment in Critical Limb Ischemia: Principles for Understanding and the Development of Evidence and Evaluation of Devices: A Scientific Statement From the American Heart Association
Sanjay Misra,Mehdi H. Shishehbor,Edwin A. Takahashi,Herbert D. Aronow,Luke P. Brewster,Matthew C. Bunte,Esther S.H. Kim,Jonathan R. Lindner,Kathleen Rich +8 more
TL;DR: The current tests and technologies for noninvasive assessment of limb perfusion, including the ankle-brachial index, toe- Brachial Index, and other perfusion technologies are discussed.
Journal ArticleDOI
Quantitative evaluation of muscle perfusion with CEUS and with MR.
TL;DR: Dedicated MR and CEUS methods are now available that visualize and quantify (patho-)physiologic information about microcirculation within skeletal muscles in vivo and hence establish a useful diagnostic tool for muscular diseases.
References
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