title: [Clinical significance of echocontrast enchancement in neurovascular diagnosis. Review of experience following a year of use].
abstract: OBJECTIVE
  To evaluate the potential and limitations of echocontrast enhancement using Levovist in a non selected consecutive cohort of neurological patients with insufficient native ultrasound investigations.
  
  
  METHODS
  In 91 patients an indication for echocontrast application was seen after an insufficient extracranial (n = 17), transtemporal (n = 54), and transforaminal (n = 20) Doppler- und color-coded Duplex sonography. Levovist was injected at a concentration of 400 mg/ml and 200-400 mg/ml for the transcranial and extracranial approach, respectively. The effect of the echocontrast enhancement was assessed semiquantitatively with respect to signal enhancement, imaging quality, and diagnostic confidence.
  
  
  RESULTS
  In a total of 83 patients (91%) the signal enhancement led to a moderate to high imaging quality allowing to reach 67 definite neurovascular diagnoses (74%). In subgroup analysis, the amount of sufficiently confident examinations was significantly higher for the transtemporal and transforaminal (both 80%) than for the extracranial approach (47%). The latter was mostly due to artificial signals derived from adjacent neck vessels.
  
  
  CONCLUSIONS
  Levovist constitutes a safe and highly effective diagnostic tool especially for the transtemporal and transforaminal neurosonographical imaging. By means of a differentiated application of echocontrast agents, its cost-effectiveness can be increased and the need for other potential invasive and expansive neuroimaging methods can be further reduced.
authors.affiliation: Klinik und Poliklinik für Neurologie, Westfälische Wilhelms-Universität, Münster.
authors.forename: D G
authors.initials: DG
authors.lastname: Nabavi
authors.forename: D W
authors.initials: DW
authors.lastname: Droste
authors.forename: G
authors.initials: G
authors.lastname: Schulte-Altedorneburg
authors.forename: V
authors.initials: V
authors.lastname: Kemény
authors.forename: M
authors.initials: M
authors.lastname: Panzica
authors.forename: S
authors.initials: S
authors.lastname: Weber
authors.forename: E B
authors.initials: EB
authors.lastname: Ringelstein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000000981:diagnostic imaging*; D003287:Contrast Media / Q000009:adverse effects; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides / Q000009:adverse effects; D018608:Ultrasonography, Doppler / Q000379:methods
chemical_list: D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508
vernacular_title: Klinische Bedeutung der Echokontrastverstärkung in der neurovaskulären Diagnostik. Erfahrungsbericht nach einjähriger offener Anwendungsstudie.