Imaging with ultrasound contrast agents: current status and future
Imaging with ultrasound contrast agents: current status and future
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DOI：
10.1007/s00261-018-1516-1
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发表时间：
2018-04-01
影响因子：
2.4
通讯作者：
Dayton, Paul A.
中科院分区：
文献类型：
--
作者：
Chong, Wui K.;Papadopoulou, Virginie;Dayton, Paul A.
微泡超声造影剂（UCA）最近被食品和药物管理局批准用于非心脏成像。UCA的物理原理，管理方法，剂量，不良反应，以及成像技术的当前和未来的描述。UCA由悬浮液中的微泡组成，其与超声波束强烈相互作用，并且容易被超声成像系统检测到。与碘化造影剂和钆造影剂不同，它们在静脉内给药时仅限于血池。基于二十多年的使用，UCA具有经证实的安全记录，在此期间，它们已在美国用于超声心动图，并在世界其他地区用于非心脏成像。与CT/MR造影剂相比，UCA的不良反应较少见。与CT和MR相比，超声造影具有实时成像、便携、对金属和运动伪影敏感性低等优点。UCA无肾毒性，可用于肾衰竭。高声幅可导致微泡以可导致毛细血管渗透性短期增加或毛细血管破裂的方式破碎。这些生物效应可能是有益的，并已用于在适当条件下增强药物递送。机械指数< 0.4的成像保留了微泡，通常与实质性生物效应无关。分子靶向超声造影剂是通过将微泡壳与肽、抗体或其他配体缀合而产生的，所述肽、抗体或其他配体被设计成靶向与肿瘤血管生成或炎症相关的内皮生物标志物。然后这些微泡在微脉管系统中积聚在它们可以成像的靶部位。超声造影剂是诊断成像工具包的一个有价值的补充。它们将有助于在造影增强CT和MR禁忌或不切实际的情况下进行腹部横断面成像。
Microbubble ultrasound contrast agents (UCAs) were recently approved by the Food and Drug administration for non-cardiac imaging. The physical principles of UCAs, methods of administration, dosage, adverse effects, and imaging techniques both current and future are described. UCAs consist of microbubbles in suspension which strongly interact with the ultrasound beam and are readily detectable by ultrasound imaging systems. They are confined to the blood pool when administered intravenously, unlike iodinated and gadolinium contrast agents. UCAs have a proven safety record based on over two decades of use, during which they have been used in echocardiography in the U.S. and for non-cardiac imaging in the rest of the world. Adverse effects are less common with UCAs than CT/MR contrast agents. Compared to CT and MR, contrast-enhanced ultrasound has the advantages of real-time imaging, portability, and reduced susceptibility to metal and motion artifact. UCAs are not nephrotoxic and can be used in renal failure. High acoustic amplitudes can cause microbubbles to fragment in a manner that can result in short-term increases in capillary permeability or capillary rupture. These bioeffects can be beneficial and have been used to enhance drug delivery under appropriate conditions. Imaging with a mechanical index of < 0.4 preserves the microbubbles and is not typically associated with substantial bioeffects. Molecularly targeted ultrasound contrast agents are created by conjugating the microbubble shell with a peptide, antibody, or other ligand designed to target an endothelial biomarker associated with tumor angiogenesis or inflammation. These microbubbles then accumulate in the microvasculature at target sites where they can be imaged. Ultrasound contrast agents are a valuable addition to the diagnostic imaging toolkit. They will facilitate cross-sectional abdominal imaging in situations where contrast-enhanced CT and MR are contraindicated or impractical.