title: Reliability of contrast-enhanced ultrasound for the assessment of muscle perfusion in health and peripheral arterial disease.
abstract: We investigated the reliability of contrast-enhanced ultrasound (CEUS) in assessing calf muscle microvascular perfusion in health and disease. Response to a post-occlusive reactive hyperaemia test was repeated on two occasions >48 h apart in healthy young (28 ± 7 y) and elderly controls (70 ± 5 y), and in peripheral arterial disease patients (PAD, 69 ± 7 y; n = 10, 9 and 8 respectively). Overall, within-individual reliability was poor (coefficient of variation [CV] range: 15-87%); the most reliable parameter was time to peak (TTP, 15-48% CV). Nevertheless, TTP was twice as long in elderly controls and PAD compared to young (19.3 ± 10.4 and 22.0 ± 8.6 vs. 8.9 ± 6.2 s respectively; p < 0.01), and area under the curve for contrast intensity post-occlusion (a reflection of blood volume) was ∼50% lower in elderly controls (p < 0.01 versus PAD and young). Thus, CEUS assessment of muscle perfusion during reactive hyperaemia demonstrated poor reliability, yet still distinguished differences between PAD patients, elderly and young controls.
authors.affiliation: Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand; School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand.
authors.forename: Kate N
authors.initials: KN
authors.lastname: Thomas
authors.affiliation: School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand.
authors.forename: James D
authors.initials: JD
authors.lastname: Cotter
authors.affiliation: Department of Physiology, University of Otago, Dunedin, New Zealand; School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom.
authors.forename: Samuel J E
authors.initials: SJ
authors.lastname: Lucas
authors.affiliation: Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Brigid G
authors.initials: BG
authors.lastname: Hill
authors.affiliation: Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. Electronic address: andre.vanrij@otago.ac.nz.
authors.forename: André M
authors.initials: AM
authors.lastname: van Rij
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D003287:Contrast Media; D005260:Female; D005466:Fluorocarbons; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology*; D009135:Muscular Diseases / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*; D055420:Perfusion Imaging / Q000379:methods*; D058729:Peripheral Arterial Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media; D005466:Fluorocarbons; C042852:perflutren
keywords: Contrast-enhanced ultrasound; Muscle perfusion; Peripheral arterial disease