title: Diagnostic efficacy of SonoVue, a second generation contrast agent, in the assessment of extracranial carotid or peripheral arteries using colour and spectral Doppler ultrasound: a multicentre study.
abstract: The purpose of this study was to demonstrate the improvement in diagnostic quality and diagnostic accuracy of SonoVue microbubble contrast-enhanced ultrasound (CE-US) versus unenhanced ultrasound imaging during the investigation of extracranial carotid or peripheral arteries. 82 patients with suspected extracranial carotid or peripheral arterial disease received four SonoVue doses (0.3 ml, 0.6 ml, 1.2 ml and 2.4 ml) with Doppler ultrasound performed before and following each dose. Diagnostic quality of the CE-US examinations was evaluated off-site for duration of clinically useful contrast enhancement, artefact effects and percentage of examinations converted from non-diagnostic to diagnostic. Accuracy, sensitivity and specificity were assessed as agreement of CE-US diagnosis evaluated by an independent panel of experts with reference standard modality. The median duration of clinically useful signal enhancement significantly increased with increasing SonoVue doses (p< or =0.002). At the dose of 2.4 ml of SonoVue, diagnostic quality evaluated as number of inconclusive examinations significantly improved, falling from 40.7% at baseline down to 5.1%. Furthermore, SonoVue significantly (p<0.01) increased the accuracy, sensitivity and specificity of assessment of disease compared with baseline ultrasound. SonoVue increases the diagnostic quality of Doppler images and improves the accuracy of both spectral and colour Doppler examinations of extracranial carotid or peripheral arterial disease.
authors.affiliation: Department of Radiology, King's College Hospital, Denmark Hill, London SE5 9RS, UK.
authors.forename: P S
authors.initials: PS
authors.lastname: Sidhu
authors.forename: P L
authors.initials: PL
authors.lastname: Allan
authors.forename: F
authors.initials: F
authors.lastname: Cattin
authors.forename: D O
authors.initials: DO
authors.lastname: Cosgrove
authors.forename: A H
authors.initials: AH
authors.lastname: Davies
authors.forename: D D
authors.initials: DD
authors.lastname: Do
authors.forename: S
authors.initials: S
authors.lastname: Karakagil
authors.forename: J
authors.initials: J
authors.lastname: Langholz
authors.forename: D A
authors.initials: DA
authors.lastname: Legemate
authors.forename: A
authors.initials: A
authors.lastname: Martegani
authors.forename: J-B
authors.initials: JB
authors.lastname: Llull
authors.forename: C
authors.initials: C
authors.lastname: Pezzoli
authors.forename: A
authors.initials: A
authors.lastname: Spinazzi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016477:Artifacts; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging*; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging*; D010743:Phospholipids / Q000008:administration & dosage; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D018615:Ultrasonography, Doppler, Color / Q000592:standards; D017585:Ultrasonography, Doppler, Transcranial / Q000592:standards
chemical_list: D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride