Evaluation of myocardial, hepatic, and renal perfusion in a variety of clinical conditions using an intravenous ultrasound contrast agent (Optison) and second harmonic imaging

Objective-To assess the potential of intravenous Optison, a second generati on ultrasound contrast agent, and various ultrasound imaging modes to deter mine myocardial, kidney, and liver perfusion in normal subjects and patient s with left ventricular dysfunction or chronic pulmonary disease together w ith renal or hepatic dysfunction. Methods-Five normal subjects and 20 patients underwent grey scale echocardi ographic imaging of myocardium, kidney, and liver during 505 intravenous in jections of Optison. Images were assessed qualitatively by two independent observers and quantitatively using video densitometry to determine the peak contrast enhancement effect. Results-Qualitative analysis showed that intermittent harmonic imaging was superior to either conventional fundamental or continuous harmonic imaging for all organs. Quantitative analysis showed that the peak change in echoca rdiographic intensity v baseline during continuous harmonic imaging was 11 units for myocardium (p < 0.03), 7 units for kidney (NS), and 14 units for Liver (p < 0.05). During intermittent harmonic imaging the peak change was significantly greater, being 33 units for myocardium (p < 0.0001), 24 units for kidney (p < 0.0002), and 16 units for liver (p < 0.001). Conclusions-Organ tissue perfusion can be demonstrated following intravenou s injection of Optison, particularly when used in combination with intermit tent harmonic imaging techniques. This contrast agent is effective in a var iety of clinical conditions.