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SonoVue (BR1), a new long-acting echocontrast agent, improves transcranial colour-coded duplex ultrasonic imaging
Dirk Wolfgang Droste1, Jean Bernard Llull, Carla Pezzoli
1Department of Neurology, University of Münster, Germany. droste2@uni-muenster.de
Background And Purpose:
Visualization of normal or pathological flow in the intracranial arteries using transcranial colour-coded duplex sonography (TCCS) is occasionally obstructed by insufficient temporal bone windows, unfavourable insonation angles, or low flow velocities or volumes. SonoVue (BR1) is a new, long-acting echocontrast agent, which could be helpful in these instances.
Methods:
SonoVue was studied in two separate multicentre investigations of patients with insufficient bone windows (BR1-014 with 73 patients and BR1-017 with 40 patients) using an identical protocol. The agent was given intravenously as a bolus in four different doses (0.3, 0.6, 1.2 and 2.4 ml). Evaluation was performed on-site and off-site with video clips.
Results:
The contrast agent was well tolerated. As compared to the precontrast scans, SonoVue facilitated the visualization of vessel patency, stenosis, occlusion, and collateral flow, decreased the need for additional tests, and had an impact on the patient's treatment. In 66-74%, a non-diagnostic investigation was converted into a diagnostic investigation. The highest dose (2.4 ml) allowed for a clinically useful signal enhancement of a median 1.9-6.3 min.
Conclusions:
SonoVue at a single dose of 1.2 or 2.4 ml is effective in increasing the detection of normal or pathological flow in the intracerebral arteries in patients who do not have a fully diagnostic unenhanced TCCS examination.