[Stimulated acoustic emissions with the ultrasound contrast medium levovist: a clinically useful contrast effect with liver-specific properties].
OBJECTIVE
The purpose of this study was systematically to investigate stimulated acoustic emission (SAE) with the microbubble contrast agent Levovist (Schering AG, Berlin) in vivo with regards to reproducibility, distribution in various organs over time, dependence on technical factors, and influence on the delineation of focal liver lesions.


METHODS
2 intravenous injections of 1 g of Levovist were given to 2 dogs and 1-6 injections of 2.5 g Levovist to 5 healthy volunteers and 37 patients. The liver, spleen, large abdominal vessels, and kidney were intermittently scanned for up to 30 min. Studies were evaluated for the presence of SAE signals by 2 observers. In 20 patients with focal liver lesions (15 with metastases, 4 haemangiomata, 1 hepatocellular carcinoma, and 1 cyst) the influence on lesion visualization was also assessed.


RESULTS
SAE effects, lasting up to 30 minutes, were seen in all subjects in the liver and spleen. Vascular and renal SAE signals were noted shortly after injection, lasting up to 6 minutes. SAE was absent or markedly reduced in focal liver lesions, which were seen as colour voids. This increased the conspicuity of focal lesions, and in 5 patients additional metastases were detected that could not be delineated on B-mode alone.


CONCLUSIONS
A liver- and spleen-specific late phase of Levovist can be consistently demonstrated using SAE and the effect increases the conspicuity of focal liver lesions.
Albrecht
T
T
Abteilung für Radiologie und Nuklearmedizin, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin. t.albrecht@medizin.fu-berlin.de
Blomley
M J
MJ
Heckemann
R A
RA
Cosgrove
D O
DO
Jayaram
V
V
Butler-Barnes
J
J
Eckersley
R J
RJ
Hoffmann
C W
CW
Bauer
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging; D003287:Contrast Media; D004285:Dogs; D004305:Dose-Response Relationship, Drug; D005260:Female; D020518:Focal Nodular Hyperplasia / Q000000981:diagnostic imaging; D006391:Hemangioma / Q000000981:diagnostic imaging; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides; D012016:Reference Values; D018615:Ultrasonography, Doppler, Color
D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508