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Internevtional > Conrtast enhanced u/s (CEUS) > Flashcards

Conrtast enhanced u/s (CEUS) Flashcards

1
Q

what is ultrasound contrast agents?

A
  • gas liquid sispensions of biocompatible gas-filled microshpheres
  • wjem injected they flow inimpedid through the patients circulatory system, mimicking the flow patterns of RBC’s while producing enhanced u/s reflectivity
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2
Q

what are contrast agents composed of?

A
  • gassfilled microbubbles surrounded by an outter shell composed of phospholipids or sunthetic polymers
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3
Q

microbubbles are smaller than RBC’s T or F?

A

true

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4
Q

where are contranst agents injected?

A
  • into patients arm

- remain in the blood vessels, not excreted

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5
Q

function of contrast agent- mircrobubbles?

A
  • mircobubbles oscillate within the circulation in response to the changes within the u/s beam, compressing and expanding
  • as bubbles oscillate they produce non-linear frequencies and a strong signal
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6
Q

the microbubbles oscillate at the same frequency and produce scattering at the same frequency at what MI?

A
  • very low MI (<0.1)
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7
Q

what occurs at an MI 0.1-0.3?

A

the oscillations are no loner synchronized with the applied U/S beam and scattering with harmonic frequencies ensues (non-linear response)

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8
Q

what occurs at a high MI (0.3-0.6)?

A
  • causes microbubbles to burst and the released gas rapidly diffuses into the surrounfing liquid
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9
Q

how long does an agent dose typically last?

A

4-6 mins

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10
Q

dose of contrast agent?

A

typically 0.1-0.3ml

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11
Q

contrast agents 1st generation?

A
  • air-based- provide unstable during lung passage
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12
Q

1st generation contrast agent brand names? (2)

A
  • echovist (no longer used)

- levovist (no longer used)

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13
Q

contranst agents 2nd generation brand names (4)?

A
  • sonovue
  • definity
  • optison
  • lumason
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14
Q

CEUS- equipment?

A
  • all u/s machines have contrast specific software used to display the harmonic bubble signals
  • contrast preset is set to enhance the image with the use of contrast agents not the organ itself
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15
Q

CEUS image optimization?

A
  • Low MI
  • dual screen utilized (1 2-d, one image black)
  • focus zone placed at posterior part of image (bubbles tend to burst here)
  • use of timer
  • shallow breathing
  • store cine clips during procedure
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16
Q

CEUS is used to enhance imaging of what organs and vessels?

A
  • abdominal
  • small parts
  • vascular
  • cardiac
17
Q

CEUS wash in phase?

A
  • early phase of injection, entry of agent into the plane of imaging
18
Q

CEUS wash out phase?

A
  • late phase of injection, exit of agent from the plane of imaging
19
Q

CEUS 3 liver phases?

A
  1. arterial phase- earliest phase
  2. portal venous phase- early phase
  3. sinusoidal phase- late phase
20
Q

timing of phases (start and end)?

  • liver arterial
  • liver portal venous
  • liver late
  • kidney cortical
  • kidney medullary
  • soft tissue arterial
  • soft tissue venous
A
21
Q

CEUS benign characteristics?

A
  • lesions will remain enhanced in late phase

- stays echogenic from early phase to late phase

22
Q

CEUS maliganant characteristics?

A
  • fast wash in and fast wash out of contrast
  • lesions will wash out in late phase, going from echogenic lesion in early phase to hypoechouc in late phase
  • irregular vessel pattern
23
Q

CEUS on vessles?

A
  • delineates liminal perfusion
  • reveals irregularities
  • accurtate measurement of degree of stenosis
  • length of stenosis
  • neo-vascultariry visualization
  • stent graft
24
Q

CEUS steps of procedure?

A
  • obtain consent
  • start IV (canulla 20G or larger)
  • preprocedural images
  • mark skin
  • switch to contrast preset
  • activate contrast agent
  • inject and saline flush
  • start timer
  • store cine clips
  • end study
  • store representitive still images and measurements from cine clips after exam
  • iv removal, dressing
  • patient post procedural instructions
25
Q

when do you start the timer in a CEUS procedure?

A

at the beginning of the saline flush

26
Q

CEUS- possible side effects?

A
  • minimal side effects
Transient altered taste sensation
Headache
Backache
Dizziness
Palpitations
Urticaria - hives
27
Q

CEUS advantages?

A

Accurate and reliable diagnoses
Strong safety profile – ok for pediatric use
No ionizing radiation (as in Nuc Med, CT, and X-Ray)
No iodinated dye (as in CT, MRI or X-Ray)
No risk of nephrotoxicity – safe in patients with renal insufficiency
No anesthesia or sedation
Helps characterize type of lesion
Can be used during and post interventional procedures
cheaper
convenient and easy to use
portable
May be used to image growing number of severely obese patients
Potential for screening, prevention and ongoing monitoring of care

Internevtional (12 decks)

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