Contrast-enhanced US-guided Interventions: Improving Success Rate and Avoiding Complications Using US Contrast Agents

Area of Science:

• Radiology
• Medical Imaging
• Interventional Procedures

Background:

• Ultrasound (US) is a key imaging modality for interventions.
• Microbubble ultrasound contrast agents (UCAs) offer potential improvements in US imaging for interventions.
• UCAs are safe, with no renal toxicity risk, unlike iodinated or gadolinium agents.

Purpose of the Study:

• To describe indications, contraindications, and techniques for using UCAs in US-guided interventions.
• To highlight UCAs as an adjunctive tool to enhance interventional procedures.
• To facilitate effective treatment, improve complication management, and increase procedural success.

Main Methods:

• Contrast-enhanced ultrasound (CEUS) for microvascular applications improves targeting of vascularized areas.
• CEUS enables real-time angiographic imaging in macrovascular applications without nephrotoxicity or radiation.
• Endocavitary CEUS provides fluoroscopy-like imaging for bedside follow-up interventions.

Main Results:

• CEUS enhances delineation of necrotic and vascularized areas for improved real-time targeting.
• CEUS allows true assessment of vascularity for follow-up of devascularizing interventions.
• CEUS in endocavitary applications offers bedside imaging comparable to fluoroscopy.

Conclusions:

• UCAs represent a natural progression in US-guided intervention.
• Proper utilization of UCAs can optimize interventional procedures.
• This review aims to guide clinicians in the safe and effective use of UCAs.