Hagen Ch. 18 Contrast Agents

Question 1

Contrast enhancement lasts longest when administering the ultrasound contrast agent by:
Select one:
a. Mouth
b. Bolus injection
c. Slow infusion 
d. Skin contact

Answer 1

c. Slow infusion

Question 2

Currently in the United States, which of the following contrast agents are available and approved by the U.S. Food and Drug Administration (FDA) for use in echocardiography?
Select one:
a. Definity, Optison, Imagent 
b. Levovist, Sonovue, Imagent
c. Imagent, Optison, Sonovue
d. Optison, Sonovue, Definity

Answer 2

a. Definity, Optison, Imagent

Question 3

Depending on the clinical application, vascular UCAs may be administered via:
Select one:
a. Intravenous bolus injection
b. Oral ingestion
c. Intravenous infusion 
d. Albumin

Answer 3

c. Intravenous infusion

Question 4

Evaluation of a patient with known cirrhosis often demonstrates a(n):
Select one:
a. Reduced portal venous flow with an increase in hepatic artery flow.
b. Increase in portal venous flow with an increase in hepatic artery flow.
c. Reduced portal venous flow with a reduction in hepatic artery flow.
d. Increase in portal venous flow with a reduction in hepatic artery flow.

Answer 4

a. Reduced portal venous flow with an increase in hepatic artery flow.

Question 5

For a vascular ultrasound contrast agent to be clinically useful, it should:
Select one:
a. Be nontoxic
b. Have microbubbles that are small enough to traverse the pulmonary capillary beds
c. Be stable enough to provide multiple recirculations
d. Have all of the above

Answer 5

d. Have all of the above

Question 6

Hepatic cavernous hemangioma demonstrate peripheral enhancement only during the:
Select one:
a. Arterial phase 
b. Portal venous phase
c. Late vascular phase
d. None of the above

Answer 6

a. Arterial phase

Question 7

In harmonic-imaging mode, the echoes from the oscillating microbubbles have a:
Select one:
a. Low signal-to-noise ratio
b. Low transducer frequency
c. Equal signal-to-noise ratio
d. High signal-to-noise ratio

Answer 7

d. High signal-to-noise ratio

Question 8

In the early arterial phase, using tissue-specific contrast agents, focal nodular hyperplasia can have a similar appearance to a:
Select one:
a. Hepatic cyst
b. Hemangioma
c. Hepatocellular carcinoma (HCC) 
d. Hepatic abscess

Answer 8

c. Hepatocellular carcinoma (HCC)

Question 9

Induced acoustic-emission effects are independent of:
Select one:
a. Doppler shifts
b. Microbubble size
c. Contrast motion 
d. All of the above

Answer 9

c. Contrast motion

Question 10

Most of the research and development of ultrasound contrast agents (UCAs) has centered on creating agents that can:
Select one:
a. Enhance the detection of stationary blood
b. Be administered by intra-arterial injection
c. Be administered intravenously
d. Enhance the detection of tumors in solid organs

Answer 10

c. Be administered intravenously

Question 11

Several reports have described the contrast-enhanced sonographic appearance of hepatocellular carcinoma as having intense enhancement in the \_\_\_\_\_\_\_\_\_\_\_\_\_ phase.
Select one:
a. Late vascular
b. Portal venous
c. Early arterial 
d. Late arterial

Answer 11

c. Early arterial

Question 12

The detection of flow in the hepatic capillaries is identified in the \_\_\_\_\_\_\_\_\_\_\_ phase.
Select one:
a. Arterial
b. Early vascular
c. Portal venous
d. Late vascular

Answer 12

d. Late vascular

Question 13

The first ultrasound contrast agent to receive FDA approval was used in:
Select one:
a. Biopsy procedures
b. Vascular sonography
c. Echocardiography 
d. General sonography

Answer 13

c. Echocardiography

Question 14

The mechanical index (MI) uses:
Select one:
a. Low acoustic output power 
b. Lower transducer frequency
c. Increase of dynamic range
d. High acoustic output power

Answer 14

a. Low acoustic output power

Question 15

The microbubble of a first-generation UCA contains which one of the following types of substance?
Select one:
a. Heavy gas such as a perfluorocarbon
b. Fluid that has low solubility in blood
c. Room air
d. Fluid that has acoustic properties that are drastically different than human blood

Answer 15

c. Room air

Question 16

The microbubbles of tissue-specific UCAs are:
Select one:
a. Significantly larger than red blood cells
b. Significantly larger than liver cells (hepatocytes)
c. Taken up by or have an affinity for specific tissues
d. Toxic to the targeted tissue

Answer 16

c. Taken up by or have an affinity for specific tissues

Question 17

The rupture of microbubbles results in random:
Select one:
a. Tissue enhancement
b. Doppler shifts 
c. Wall definition
d. Enhanced time

Answer 17

b. Doppler shifts

Question 18

Tissue-specific ultrasound contrast agents can be considered to be:
Select one:
a. Molecular-imaging agents 
b. First-generation contrast agents
c. Mechanical-imaging agents
d. Oral-contrast agents

Answer 18

a. Molecular-imaging agents

Question 19

To aid in contrast-enhanced imaging equipment, manufacturers have begun to incorporate into their systems:
Select one:
a. Harmonic imaging
b. MI
c. Intermittent imaging capabilities 
d. Frame one imaging

Answer 19

c. Intermittent imaging capabilities

Question 20

Ultrasound contrast agents have shown the potential to improve the accuracy of hepatic sonography including:
Select one:
a. Enhanced detection of hepatic masses
b. Enhanced characterization of hepatic masses
c. Improved detection of intrahepatic and extrahepatic blood flow
d. All of the above

Answer 20

d. All of the above

Question 21

Vascular ultrasound agents enhance Doppler flow signals by:
Select one:
a. Increasing the velocity of blood flow
b. Adding more and better acoustic scatterers to the bloodstream
c. Increasing the number of red blood cells in the vessel being evaluated
d. Decreasing the speed of sound through tissues

Answer 21

b. Adding more and better acoustic scatterers to the bloodstream

Question 22

When insonating microbubble-based UCAs, the energy present within the acoustic field:
Select one:
a. Has no effect on microbubbles.
b. Can have a detrimental effect on the contrast microbubbles.
c. Usually results in increasing the microbubble size.
d. Usually results in the creation of more microbubbles.

Answer 22

b. Can have a detrimental effect on the contrast microbubbles.

Question 23

When the microbubble is destroyed:
Select one:
a. Vessels are easier to detect with color Doppler.
b. Contrast enhancement is no longer provided.
c. Contrast enhancement is increased.
d. Vessels are easier to detect with gray-scale harmonic imaging.

Answer 23

b. Contrast enhancement is no longer provided.

Question 24

When using ultrasound contrast agents, a lesion that gets progressively echogenic over time is most likely:
Select one:
a. Focal nodular hyperplasia
b. Hemangioma 
c. Hepatocellular carcinoma
d. Adenoma

Answer 24

b. Hemangioma

Question 25

Which of the following vessels are the first to demonstrate contrast enhancement in the liver?
Select one:
a. Hepatic vein
b. Hepatic arteries 
c. Right portal veins
d. Left portal veins

Answer 25

b. Hepatic arteries