ArticleJournal of the American Society of Echocardiography : official publication of the American Society of Echocardiography2017
Rest-Stress Limb Perfusion Imaging in Humans with Contrast Ultrasound Using Intermediate-Power Imaging and Microbubbles Resistant to Inertial Cavitation.
Article in Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 7 citations in OpenAlex.
- Ultrasound Cavitation of Microbubbles Augments Limb Perfusion and Promotes Ulcer Healing in Chronic Limb-Threatening Ischemia.JACC. Cardiovascular imaging · 2026Trial
- Influence of Microbubble Properties and Carrier Frequency on Ultrasound Cavitation-Induced Flow Augmentation.Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography · 2026Article
- Acoustic Bubble Sensing Techniques and Bioapplications.Biosensors · 2026Review
- Photoacoustic imaging: a unique imaging examination for the assessment of diabetic vascular disease.Frontiers in clinical diabetes and healthcare · 2025Review
- Article
- Limb Perfusion During Exercise Assessed by Contrast Ultrasound Varies According to Symptom Severity in Patients with Peripheral Artery Disease.Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography · 2019Article
- Contrast Enhanced Ultrasound Perfusion Imaging in Skeletal Muscle.Journal of cardiovascular imaging · 2019Review
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundContrast-enhanced ultrasound (CEU) limb perfusion imaging is a promising approach for evaluating peripheral artery disease (PAD). However, low signal enhancement in skeletal muscle has necessitated high-power intermittent imaging algorithms, which are not clinically feasible. We hypothesized that CEU using a combination of intermediate power and a contrast agent resistant to inertial cavitation would allow real-time limb stress perfusion imaging.
methodsIn normal volunteers, CEU of the calf skeletal muscle was performed on separate days with Sonazoid, Optison, or Definity. Progressive reduction in the ultrasound pulsing interval was used to assess the balance between signal enhancement and agent destruction at escalating mechanical indices (MI, 0.1-0.4). Real-time perfusion imaging at MI 0.1-0.4 using postdestructive replenishment kinetics was performed at rest and during 25 W plantar flexion contractile exercise.
resultsFor Optison, limb perfusion imaging was unreliable at rest due to very low signal enhancement generated at all MIs and was possible during exercise-induced hyperemia only at MI 0.1 due to agent destruction at higher MIs. For Definity, signal intensity progressively increased with MI but was offset by microbubble destruction, which resulted in modest signal enhancement during CEU perfusion imaging and distortion of replenishment curves at MI ≥ 0.2. For Sonazoid, there strong signal enhancement at MI ≥ 0.2, with little destruction detected only at MI 0.4. Accordingly, high signal intensity and nondistorted perfusion imaging was possible at MI 0.2-0.3 and detected an 8.0- ± 5.7-fold flow reserve.
conclusionsRest-stress limb perfusion imaging in humans with real-time CEU, which requires only seconds to perform, is possible using microbubbles with viscoelastic properties that produce strong nonlinear signal generation without destruction at intermediate acoustic pressures.
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