European Heart Journal Advance Access originally published online on November 24, 2005
European Heart Journal 2006 27(3):310-315; doi:10.1093/eurheartj/ehi636
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Contrast ultrasound perfusion imaging of lower extremities in peripheral arterial disease: a novel diagnostic method
1Department of Cardiology and Angiology, University Hospital of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
2Department of Medical Biometry and Statistics, University Hospital of Freiburg, Freiburg, Germany
3GE Healthcare Technologies, Ultrasound Europe, Solingen, Germany
Received 28 February 2005; revised 13 October 2005; accepted 20 October 2005; online publish-ahead-of-print 24 November 2005.
* Corresponding author. Tel: +49 761 270 3401; fax: +49 761 270 3699. E-mail address: duerschmied{at}medizin.ukl.uni-freiburg.de
Aims 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).
Methods and results Ultrasound contrast agent (SonoVueTM) 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.
Conclusion 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.
Key Words: Peripheral arterial disease • Contrast ultrasound • Microcirculation
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