Saracco A, Aspelin P, Leifland K, Themudo R, Wilczek B, Axelsson R
Division of Radiology, Department of Clinical Science, Intervention, and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden.
Acta Radiol. 2009 Oct;50(8):854-9. doi: 10.1080/02841850903085576.
Contrast-enhanced ultrasound (CEUS) has gained interest because of its ability to gather vascular information in various organs. There is still a matter of debate concerning its value in breast lesions. The method of choice on how to administer the contrast agent varies depending on the organ to be studied. Infusion of microbubbles is used in echocardiography, while bolus administration is the preferred technique for abdominal organs.
To compare-in equal doses-bolus versus continuous infusion of microbubbles, using real-time contrast harmonic imaging in breast tumors.
A total of 29 female patients (mean age 54 years) with either clear malignant or benign findings in the breast or axilla were included. Contrast harmonic imaging (CHI US) was performed with a Philips iU22 using an L9-3 MHz linear probe, especially designed for this purpose. A low mechanical index (0.06-0.07) was used to avoid massive destruction of the microbubbles. A dose of 2.4 ml of Sono Vue was first infused intravenously over 1 min with an infusion pump. After 10 min, the same dose was injected as a bolus over 2 s, followed by a flush of 10 ml of saline solution. Contrast uptakes by the tumors were recorded 2 min from the moment of injection, with both methods for each patient.
Bolus administration of contrast agent provided a sharply demarcated enhancement and wash-out pattern for all lesions. The continuous infusion of the same contrast agent failed to show any wash-in/wash-out or time-to-peak/peak intensity phenomena in all cases.
CEUS using real-time harmonic imaging in order to evaluate breast tumors should be performed with bolus administration of contrast agent in order to achieve better intensity/time curve outcomes.
超声造影（CEUS）因其能够收集各器官的血管信息而受到关注。其在乳腺病变中的价值仍存在争议。造影剂给药方法的选择因所研究的器官而异。超声心动图中使用微泡输注，而团注给药是腹部器官的首选技术。
在乳腺肿瘤中使用实时造影谐波成像，以相等剂量比较微泡团注与持续输注。
纳入29例女性患者（平均年龄54岁），其乳腺或腋窝有明确的恶性或良性病变。使用飞利浦iU22超声仪，配备专门为此设计的L9 - 3MHz线性探头，进行造影谐波成像（CHI US）。采用低机械指数（0.06 - 0.07）以避免微泡大量破坏。首先使用输液泵在1分钟内静脉输注2.4ml声诺维。10分钟后，以团注方式在2秒内注射相同剂量，随后用10ml生理盐水冲洗。从注射时刻起2分钟记录每位患者两种方法下肿瘤的造影剂摄取情况。
团注造影剂时，所有病变均呈现出边界清晰的增强和消退模式。持续输注相同造影剂在所有病例中均未显示出任何增强/消退或达峰时间/峰值强度现象。
为了获得更好的强度/时间曲线结果，使用实时谐波成像评估乳腺肿瘤的CEUS应采用造影剂团注给药。
