Contrast-enhanced endoscopic ultrasonography with galactose microparticles: SHU508 A (Levovist).
OBJECTIVE
To evaluate the utility of a suspension of galactose microparticles available as SHU508 A (Levovist) as a contrast agent during endoscopic ultrasonography (EUS).


METHODS
Three sets of experiments were performed on three 20-25 kg swine (Sus scrofa) under general anesthesia. Upper EUS was performed with an echo endoscope with color Doppler capability (Pentax FG-32 UA). The celiac artery, superior mesenteric artery, aorta, portal vein, pancreas, and gastrointestinal wall were imaged by EUS. Multiple intravenous bolus injections of 400 mg/ml of SHU508 A were made, and their effect on color Doppler and gray-scale imaging during EUS was studied.


RESULTS
After contrast injection there was a significant, visually noticeable enhancement of the color Doppler signals from the celiac artery, superior mesenteric artery, and portal vein. Vessels with weak to no color Doppler signals before injection of SHU508 A--for example, the celiac artery and superior mesenteric artery--were observed to have strong color signals after injection. The effect of SHU508 A on color Doppler imaging was easily appreciated subjectively without the need for complex quantitative measurements. No visually noticeable color Doppler enhancement was seen in vessels such as the aorta that had a very pronounced color Doppler signal even prior to the injection of contrast. Movement of particulate matter was seen in the portal vein on the gray scale.


CONCLUSIONS
Intravenous SHU508 A as a contrast agent significantly enhances color Doppler signals during EUS. Vascualar contrast of this sort could potentially have a significant role in improving the accuracy of EUS in diagnosing malignant vascular invasion, the detection of occult pancreatic neoplasms, and the diagnosis of vascular thrombosis.
Bhutani
M S
MS
Dept. of Veterans' Affairs Medical Center, Dayton, Ohio, USA.
Hoffman
B J
BJ
van Velse
A
A
Hawes
R H
RH
D000818:Animals; D002445:Celiac Artery / Q000000981:diagnostic imaging; D003287:Contrast Media; D019160:Endosonography / Q000379:methods*; D007089:Image Enhancement; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging; D011134:Polysaccharides; D011169:Portal Vein / Q000000981:diagnostic imaging; D013552:Swine; D018615:Ultrasonography, Doppler, Color
D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508