The diagnostic value of levovist in Doppler imaging of visceral arteries in patients with abdominal angina before and after angioplasty.
OBJECTIVE
To assess the diagnostic value of Levovist in the ultrasound imaging of visceral arteries in patients with clinical symptoms of abdominal angina, before and after percutaneous transluminal angioplasty (PTA).


METHODS
During a 12-month period (2000/2001) five patients with visceral arterial stenoses had ultrasound examinations and a subsequent PTA procedure. Indications for ultrasound examination were abdominal angina symptoms persisting for 3-5 years, (postprandial abdominal pain, diarrhea, and vomiting). In all patients ultrasound examinations were performed using color and spectral Doppler before and after Levovist injections. Color Doppler images and maximum blood flow velocity in stenosed visceral arteries were assessed. Patients underwent control Doppler examinations with Levovist injections to assess the effect of PTA.


RESULTS
In three patients conventional Doppler examination did not allow proper evaluation of visceral arteries, because of weak color and spectral Doppler signal and in two remaining patients visceral arteries were not visualized at all. In all five patients strong enhancement of color and spectral Doppler signal was observed after Levovist administration. In all these cases a hemodynamically significant stenosis was diagnosed: coeliac trunk-2 and superior mesenteric artery-3. PTA was performed successfully in these patients. In one of them ultrasound examination done before Levovist injection allowed good visualization of treated SMA and showed good PTA result. In the remaining four patients Doppler examination with the use of Levovist demonstrated visceral arteries well and confirmed successful PTA procedures.


CONCLUSIONS
The use of Levovist makes the diagnostic efficiency of Doppler examinations much higher. In most cases it allows an unequivocal diagnosis of visceral artery stenosis in patients with abdominal angina symptoms. The Doppler examination with the use of Levovist is the method of choice in follow-up after PTA.
Drelich-Zbroja
Anna
A
Department of Interventional Radiology and Neuroradiology, University School of Medicine in Lublin, 20-954 Jaczewskiego 8, Poland. zbroanna@interia.pl
Jargiello
Tomasz
T
Szymanska
Anna
A
Krzyzanowski
Wojciech
W
ElFurah
Mayda
M
Szczerbo-Trojanowska
Malgorzata
M
D000005:Abdomen / Q000098:blood supply; D015746:Abdominal Pain / Q000209:etiology; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000000981:diagnostic imaging* / Q000628:therapy*; D008875:Middle Aged; D011134:Polysaccharides; D018615:Ultrasonography, Doppler, Color
D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508