Author + information
- Received July 12, 1993
- Revision received October 2, 1993
- Accepted October 28, 1993
- Published online March 15, 1994.
- Dirk Hausmann, MDa,1,
- Krishnankutty Sudhir, MD, PhDa,2,
- William L. Mullen, MDa,
- Peter J. Fitzgerald, MD, PhDa,
- Thomas A. Ports, MD, FACCa,
- Werner G. Daniel, MD, FACC∗ and
- Paul G. Yock, MD, FACCa,∗
- ↵∗Address for correspondence: Dr. Paul G. Yock, Division of Cardiology, M-1186, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143-0124.
Objectives. We evaluated a new technique for delineation of the vessel wall surface during intravascular ultrasound imaging using echogenic contrast agents.
Background. Intravascular ultrasound is used for detection of complex vessel wall structures after catheter-based interventions; however, differentiation between the lumen and these wall structures can be difficult.
Methods. In 12 anesthetized dogs, intracoronary ultrasound was performed during intracoronary bolus injection (3 and 6 ml) of different contrast agents (hand-agitated saline solution, standard iohexol, sonicated iohexol, hand-agitated iohexol, SHU 454, SHU 508). Contrast intensity was quantified by videodensitometry, and contrast homogeneity was assessed qualitatively (grade 0 to 3).
Results. Peak contrast intensities for SHU 454 and SHU 508 (mean [± SD] 48 ± 9 and 36 ± 6 U, respectively) were higher compared with standard, sonicated or agitated iohexol (16 ± 3, 28 ± 7 and 20 ± 3 U, respectively) or with agitated saline solution (17 ± 4 U); intensities were higher for 6 ml compared with that for 3 ml. Contrast homogeneity was higher for SHU 508 (mean [± SD] 3.0 ± 0) and SHU 454 (2.7 ± 0.5) compared with the other agents (standard iohexol 1.2 ± 0.4, sonicated iohexol 2.0 ± 0.5, agitated iohexol 1.8 ± 0.6, agitated saline solution 1.0 ± 0.4). Exact delineation of the vessel wall surface was possible in 100% of SHU 508 and in 88% of SHU 454 injections compared with 13% of agitated iohexol and 8% of sonicated iohexol injections. Accurate surface delineation was never achieved with standard iohexol or agitated saline solution. Shadowing of parts of the vessel wall by contrast material occurred at peak intensity of 75% of SHU 508 and 46% of SHU 454 injections but not with the other agents. No adverse physiologic reactions were noted, except for transient negative inotropic effects after 6 ml of SHU 508.
Conclusions. This preliminary study shows that delineation of the vessel wall boundary using echogenic contrast agents during intravascular ultrasound is safe and feasible. Because of higher contrast intensity and homogeneity, SHU 454 and SHU 508 are superior to other agents.
↵1 Dr. Hausmann was funded by the German Research Society (Deutsche Forschungsgemeinschaft).
↵2 Dr. Sudhir was funded as a C.J. Martin Overseas Fellow by the National Health and Medical Research Council of Australia and as a postdoctoral fellow by the American Heart Association. Schering AG, Berlin, Germany supplied the SHU 454 and SHU 508 used in this study.
☆ All editorial decisions for this article, including selection of referees, were made by a Guest Editor. This policy applies to all articles from the University of California San Francisco.
- Received July 12, 1993.
- Revision received October 2, 1993.
- Accepted October 28, 1993.