Contrast ultrasound (CEUS) contrast-enhanced ultrasound -CEUS) is a non-invasive radiological method that does not emit radiation and is performed with the use of a contrast medium.
Compared to the usual ultrasound, it enables a better presentation of diseases of the liver and other organs (most often the aorta, kidneys and spleen), both in adults and in children.
CEUS is an important part of the diagnostic and therapeutic procedure in the monitoring of complications after the placement of metal supports as part of the endovascular treatment of aortic disease -endovascular aortic repair,EVAR).
It is necessary to fast for 4 to 8 hours before the actual examination. Upon arrival in the vein, a needle is placed through which the contrast medium will be administered later. During the examination, a convex probe that emits ultrasound waves of lower frequencies is used to visualize the aorta, and the examination itself does not emit radiation. A few mL of contrast agent is administered in a vein, usually on two occasions. SonoVue® (sulfur hexafluoride) is the name of the only approved contrast agent for CEUS examinations after EVAR.
The rate of side effects (headache, skin redness, palpitations, dizziness, low blood pressure, nausea, vomiting, abdominal pain) is very low (0.125%), and the rate of life-threatening side effects, such as anaphylactic reaction, is even lower (0 .0086%).
Who is CEUS intended for?
CEUS is safe for patients with poor kidney function because the contrast agent is removed from the body through the respiratory tract.
CEUS is not recommended in patients with increased sensitivity to sulfur hexafluoride, right-left blood flow, high pulmonary and blood pressure, and acute respiratory distress syndrome. Special caution is required in patients with cardiovascular diseases (unstable ischemic heart disease, a recent episode of acute coronary events, heart failure and arrhythmias) or new inflammatory events in the body.
Patient recovery and follow-up
The gold standard for follow-up of patients after EVAR is radiation computed tomography angiography (CTA), which should be performed 30 days after the procedure.
In the case of a normal finding, the CTA is repeated in 12 months, and in the case of a bad finding, the search must be repeated in 6 months, that is, if necessary, the procedure can be repeated (reintervention).
If the condition of the aorta is stable during the first year of the control period, further follow-up with CEUS is recommended, and CTA should be performed once every 5 years. The goal is to reduce the use of contrast agents with potentially bad effects on the kidneys and to reduce radiation exposure.