Far-Wall Pseudoenhancement During Contrast-Enhanced Ultrasound of the Carotid Arteries: Clinical Description and In Vitro Reproduction

Gerrit L. ten Kate, Guillaume G.J. Renaud, Zeynettin Akkus, Stijn C.H. van den Oord, Folkert J. ten Cate, Vijay Shamdasani, Rob R. Entrekin, Eric J.G. Sijbrands, Nico de Jong, Johan G. Bosch, Arend F.L. Schinkel, Antonius F.W. van der Steen

Research output: Contribution to journalArticlepeer-review

61 Scopus citations

Abstract

The present study describes the presence of pseudoenhancement during contrast-enhanced ultrasound (CEUS) imaging of human carotid arteries and the reproduction of this pseudoenhancement in vitro. Seventy patients underwent bilateral CEUS examination of the carotid arteries using a Philips iU22 ultrasound system equipped with a L9-3 ultrasound probe and SonoVue microbubble contrast. During CEUS of the carotid arteries, we identified enhancement in close proximity to the far wall, parallel to the main lumen. The location of this enhancement does not correlate to the anatomical location of a parallel vessel. To corroborate the hypothesis that this is a pseudoenhancement artifact, the enhancement was recreated in a tissue-mimicking material phantom, using the same ultrasound system, settings and contrast agent as the patient study. The phantom study showed that pseudoenhancement may be present during vascular CEUS and that the degree of pseudoenhancement is influenced by the size and concentration of the microbubbles. During vascular CEUS, identification of the artifact is important to prevent misinterpretation of enhancement in and near the far wall.

Original languageEnglish (US)
Pages (from-to)593-600
Number of pages8
JournalUltrasound in Medicine and Biology
Volume38
Issue number4
DOIs
StatePublished - Apr 2012

Keywords

  • Attenuation
  • Carotid artery
  • Contrast-enhanced ultrasound
  • Imaging artifact
  • Microbubbles
  • Nonlinear propagation
  • Pseudoenhancement
  • Vascular ultrasound

ASJC Scopus subject areas

  • Biophysics
  • Radiological and Ultrasound Technology
  • Acoustics and Ultrasonics

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