Riccabona M, Uggowitzer M, Klein E, Lindbichler F, Ebner F, Fotter R
Department of Radiology, University Hospital LKH Graz, Austria.
J Ultrasound Med. 2000 Nov;19(11):789-96. doi: 10.7863/jum.2000.19.11.789.
Fifty-one patients, with a range of underlying pathologic conditions, were studied prospectively to assess the diagnostic value of echo-enhanced color Doppler sonography in the pediatric and adolescent population Their diagnoses included various tumors, vascular disorders, cerebral bleeding, pathologic conditions of small parts, and focal lesions of parenchymal organs. All patients underwent color Doppler sonography before proceeding to echo-enhanced color Doppler sonography. Diagnoses were confirmed by additional imaging (computed tomography, magnetic resonance imaging, angiography, and scintigraphy) performed as appropriate, with or without histologic study. An additional 20 children did not proceed to echoenhanced color Doppler sonography as color Doppler sonography alone was found to be sufficiently diagnostic. Levovist (SHU 508A), a contrast agent based on galactose-encapsulated air microbubbles, is approved for pediatric applications in Austria and was used as the echo-enhancing agent. Echo-enhanced color Doppler sonography was performed a total of 63 times in 51 patients (mean age, 9.8 years). Compared to color Doppler sonography, echo-enhanced color Doppler sonography either detected or enhanced visualization of pathologic conditions in 55 investigations (87.3%), yielding an overall accuracy of 95.2% (sensitivity, 95%), versus 65.7% with color Doppler sonography. One spinal arteriovenous malformation, one cerebral cavernoma, and one liver lesion were missed. The contrast material was easy to administer; no adverse reactions were observed. We conclude that echoenhanced color Doppler sonography is beneficial in pediatric sonography. It enhances visualization of vessels and perfusion, thus offering a nonionizing imaging tool for detection and follow-up evaluation of pathologic conditions with disturbed vasculature in specific cases. In infants and in persons with superficial lesions it did not offer significant advantages over color Doppler sonography.
对51例患有一系列基础病理状况的患者进行了前瞻性研究，以评估超声增强彩色多普勒超声在儿童和青少年人群中的诊断价值。他们的诊断包括各种肿瘤、血管疾病、脑出血、小部位病理状况以及实质器官的局灶性病变。所有患者在进行超声增强彩色多普勒超声检查之前均接受了彩色多普勒超声检查。诊断通过适当进行的其他影像学检查（计算机断层扫描、磁共振成像、血管造影和闪烁扫描）予以证实，有或没有组织学研究。另外20名儿童未进行超声增强彩色多普勒超声检查，因为发现仅彩色多普勒超声检查就具有足够的诊断性。Levovist（SHU 508A）是一种基于半乳糖包裹空气微泡的造影剂，在奥地利被批准用于儿科应用，并用作超声增强剂。51例患者（平均年龄9.8岁）共进行了63次超声增强彩色多普勒超声检查。与彩色多普勒超声相比，超声增强彩色多普勒超声在55次检查（87.3%）中检测到或增强了病理状况的可视化，总体准确率为95.2%（敏感性为95%），而彩色多普勒超声的准确率为65.7%。漏诊了1例脊髓动静脉畸形、1例脑海绵状血管瘤和1例肝脏病变。造影剂易于给药；未观察到不良反应。我们得出结论，超声增强彩色多普勒超声在儿科超声检查中是有益的。它增强了血管和灌注的可视化，从而为特定病例中血管系统紊乱的病理状况的检测和随访评估提供了一种非电离成像工具。在婴儿和浅表病变患者中，它与彩色多普勒超声相比没有显著优势。
