Quantitative evaluation of muscle perfusion with CEUS and with MR

Abstract

Functional imaging might increase the role of imaging in muscular diseases, since alterations of muscle morphology alone are not specific for a particular disease. Perfusion, i.e., the blood flow per tissue and time unit including capillary flow, is an important functional parameter. Pathological changes of skeletal muscle perfusion can be found in various clinical conditions, such as degenerative or inflammatory myopathies or peripheral arterial occlusive disease. This article reviews the theoretical basics of functional radiological techniques for assessing skeletal muscle perfusion and focuses on contrast-enhanced ultrasound (CEUS) and magnetic resonance imaging (MRI) techniques. Also, the applications of microvascular imaging, such as in detection of myositis and for discriminating myositis from other myopathies or evaluating peripheral arterial occlusive disease, are presented, and possible clinical indications are discussed. In conclusion, dedicated MR and CEUS methods are now available that visualize and quantify (patho-)physiologic information about microcirculation within skeletal muscles in vivo and hence establish a useful diagnostic tool for muscular diseases.

Liver Contrast Enhanced Ultrasound Perfusion Imaging in the Evaluation of Chronic Hepatitis C Fibrosis: Preliminary Results

“…CEUS perfusion, evaluating the blood flow per tissue and time unit including capillary flow, is an important functional tool for the evaluation of tissue pathological processes (Weber et al 2007). Kaneko et al (2005) showed a significant negative relationship between the gray-scale intensity of nontumorous areas of liver parenchyma in normal liver tissue versus cirrhosis and in chronic hepatitis versus cirrhosis.…”

Is contrast enhanced ultrasonography a useful tool for the evaluation of muscular microcirculation in patients with critical limb ischaemia?

“…Skin ischaemia may be assessed by TcPO2 but no simple clinical test can easily evaluate muscle ischaemia [12]. A few studies have used perfusion magnetic resonance to quantify perfusion and metabolic response of the muscle such as phosphocreatine recovery kinetics or tissue-level changes in oxygen delivery [2,3], but this technique is not readily available in clinical routine. Contrast enhanced ultrasonography is a new tool for measuring parenchyma perfusion [7,13] giving the possibility to evaluate microcirculation and the capillary bed.…”

The Evolution of Ultrasound Technologies; from Anatomic to Physiologic,Histologic, and Molecular Imaging

“…PAD patients have a significantly longer time to peak contrast concentration. CEUS can also be used in evaluation of myositis, and diabetic microvascular disease [14].…”