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  • 1
    Keywords: AGENTS ; BLOOD ; Germany ; PERFUSION ; QUANTIFICATION ; VOLUME ; BLOOD-FLOW ; FLOW ; SIGNAL ; PARAMETERS ; RECRUITMENT ; KINETICS ; BODY ; SONOGRAPHY ; OXYGEN ; POWER DOPPLER SONOGRAPHY ; VASCULARIZATION ; ULTRASOUND-INDUCED DESTRUCTION ; exercise ; RE ; WEIGHT ; HEALTHY-VOLUNTEERS ; replenishment kinetics ; TUMOR PERFUSION ; muscle perfusion ; replenishment kinetics of microbubbles ; CAPILLARIES ; microvascular density ; contrast-enhanced sonography
    Abstract: Objective. The purpose of this study was to compare skeletal muscle perfusion measured by contrast-enhanced ultrasonography (CEUS) with microvascular density in muscle biopsies. Methods. Power Doppler sonography after intravenous bolus injection of Levovist (SH U 508A; Schering AG, Berlin, Germany) was used to examine perfusion of vastus lateralis muscle in 23 healthy volunteers. Local blood volume (B), blood flow velocity (v), and blood flow (f) were calculated by analyzing replenishment kinetics. CEUS perfusion was compared with vascularization of biopsy samples from vastus lateralis muscle. Subjects were selected such that their aerobic capacity (maximal oxygen uptake [VO(2)max]) per body weight ranged between 23 and 66 mL - min(-1) - kg(-1) to render a large variability of skeletal muscle capillarization. Moreover, subjects' venous blood hematocrit (Hkt) was determined to estimate the plasmatic intravascular volume fraction (1 - Hkt = PVF) in which the microbubbles can distribute. Results. Median capillary density was 331/mm(2) (range, 207-469/mm(2)), and median capillary fiber contacts (CFC) were 3.6 (range, 2.3-6.5). CFC was correlated with VO2max (r= 0.59; P 〈.01). Among CEUS parameters, B showed the closest correlation to CFC (r = 0.53; P 〈.01). When CFC was normalized for PVF, correlation of B to CFC was r = 0.64 (P 〈.01). CEUS could depict the physiologic large variability of vastus lateralis muscle perfusion at rest (median [range]: B, 2.5 [0.1-12.3] similar to mL; v, 0.3 [0.1-3.7] mm/s; f, 0.7 [0.1-5.3] similar to mL - min(-1) - 100 g tissue(-1)). Conclusions. B is significantly related to fiber-adjacent capillarization and may represent physiologic capillary recruitment (eg, through metabolic fiber-related signals). CEUS is feasible for skeletal muscle perfusion quantification
    Type of Publication: Journal article published
    PubMed ID: 16632781
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    Keywords: AGENTS ; BLOOD ; Germany ; PERFUSION ; DIAGNOSIS ; QUANTIFICATION ; VOLUME ; DISEASE ; TISSUE ; BLOOD-FLOW ; CONTRAST ; SKIN ; blood flow ; CONTRAST AGENT ; FLOW ; PARAMETERS ; SKELETAL-MUSCLE ; KINETICS ; HEALTHY ; SONOGRAPHY ; BOLUS ; POWER DOPPLER SONOGRAPHY ; VASCULARIZATION ; ULTRASOUND-INDUCED DESTRUCTION ; AGENT ; RE ; monitoring ; HEALTHY-VOLUNTEERS ; MICROBUBBLE CONTRAST ; replenishment kinetics ; TUMOR PERFUSION ; PRINCIPLES ; POWER ; contrast-enhanced ; contrast-enhanced ultrasonography ; muscle perfusion ; replenishment kinetics of microbubbles ; venous occlusion plethysmography
    Abstract: Objective. The purpose of this study was to develop a clinically applicable examination method to assess per-fusion of the skeletal muscle using contrast-enhanced ultrasonography (CEUS) analyzing replenishment kinetics of microbubbles. Methods. Power Doppler sonography (7 MHz) after intravenous bolus injection of 10 mL of a microbubble contrast agent was used to repeatedly examine the perfusion of the right biceps muscle at rest and after defined exercise in 10 healthy volunteers. Parameters of perfusion, such as local blood volume, blood flow velocity, and perfusion, were calculated by a modified analysis of replenishment kinetics. For validation, CEUS was correlated with venous occlusion plethysmography (VOP) examining the right forearm flexor muscles at rest and after defined exercise. Results. The CEUS examination was easily feasible and was able to depict the physiologic large variability of the right biceps muscle perfusion at rest (mean +/- SID, 3.0 +/- 2.3 [similar to mL/s (.) 100 mg]) compared with the results after exercise (22.9 +/- 11.0 [similar to mL/s (.) 100 mg]). The perfusion calculated with VOP significantly correlated with the CEUS parameters perfusion (r = 0.81; P 〈 .001) and blood volume (r = 0.82; P 〈 .001). The calculated mean blood flow velocity in the right forearm flexor muscles raised from 0.41 +/- 0.24 mm/s at rest to 0.64 +/- 0.39 mm/s after exercise, showing a significant correlation with the CEUS perfusion (r = 0.72; P 〈 .001). Conclusions. Muscle perfusion can be easily and quantitatively assessed with CEUS. Compared with VOP, CEUS allows for a separate analysis of different muscle groups, unaffected by skin perfusion. Its application may be of particular interest in the diagnosis and monitoring of pathologic microvascularization in myositis or diabetic obstructive disease
    Type of Publication: Journal article published
    PubMed ID: 15784761
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