title: Contrast ultrasound perfusion imaging of lower extremities in peripheral arterial disease: a novel diagnostic method.
abstract: OBJECTIVE
  The purpose of this study was to establish contrast-enhanced ultrasound perfusion imaging (CUPI) of the lower extremities as a novel non-invasive diagnostic tool for patients with peripheral arterial disease (PAD).
  
  
  RESULTS
  Ultrasound contrast agent (SonoVue) was injected into a peripheral vein of 16 control subjects and 16 PAD patients and its appearance in the calf muscle was detected by low-energy harmonic ultrasound. Analysis of the wash-in curves revealed that PAD patients had a significantly longer time to peak intensity (TTP), i.e. duration of maximum contrast perfusion [37 s (19-79 s) in control subjects vs. 56 s (32-104 s) in PAD patients at rest, age-adjusted P=0.002]. Exercise stress test of the calf muscle resulted in a decrease of the TTP, maintaining the significant difference in TTP between the groups [19 s (8-37 s) in control subjects vs. 32 s (18-48 s) in PAD patients after exercise, age-adjusted P=0.004]. Neither ankle-brachial index and TTP nor age and TTP showed a significant correlation.
  
  
  CONCLUSIONS
  CUPI reflects the regional blood circulation of the calf muscle. In this pilot study, PAD patients show a significantly longer TTP than control subjects. The clinical relevance of CUPI is topic of ongoing studies.
authors.affiliation: Department of Cardiology and Angiology, University Hospital of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany. duerschmied@medizin.ukl.uni-freiburg.de
authors.forename: Daniel
authors.initials: D
authors.lastname: Duerschmied
authors.forename: Lisa
authors.initials: L
authors.lastname: Olson
authors.forename: Manfred
authors.initials: M
authors.lastname: Olschewski
authors.forename: Alexandra
authors.initials: A
authors.lastname: Rossknecht
authors.forename: Gabriele
authors.initials: G
authors.lastname: Freund
authors.forename: Christoph
authors.initials: C
authors.lastname: Bode
authors.forename: Christoph
authors.initials: C
authors.lastname: Hehrlein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003287:Contrast Media; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000000981:diagnostic imaging* / Q000503:physiopathology; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D010743:Phospholipids; D010865:Pilot Projects; D013459:Sulfur Hexafluoride; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride