The purpose of this study way to assess the value of contrast enhanced gray-scale ultrasound (CEUS) in detection of vascularity in joints of patients with rheumatoid arthritis (RA) in a multicenter study of the International Arthritis Contrast Ultrasound (IACUS) study group. We assessed 113 joints in 113 patients (44 men, 69 women; mean age 51+/-14 years) with clinical diagnosis of RA. Gray-scale ultrasound (US), power Doppler US (PDUS) and CEUS, using a low mechanical index US technique, was performed. CEUS was done by bolus administration of the contrast agent SonoVue (Bracco, Milan, Italy) with a dosage of 4.8-ml SonoVue flushed with 10 ml saline. Detection of joint vascularity was performed for differentiation of active synovitis from inactive intra-articular thickening (synovitis/effusion). With the use of US and PDUS, active synovitis could be differentiated from inactive intra-articular thickening in 68/113 joints (60.1%), whereas CEUS enabled differentiation in 110/113 (97.3%) joints (p<0.0001). Thickness measurement of active synovitis was significantly improved after contrast administration (p=0.008). In conclusion, CEUS improves the differentiation of active synovitis from inactive intra-articular thickening. Since CEUS has shown an ability to improve assessment of vascularized synovial proliferation in RA affected joints, this technique may have further potential in monitoring therapy.

Volume and mass indexes are superior to the traditional score, density, and number of lesions for comparing the results of electron beam and multirow detector CT and for determining significant coronary artery disease.

Contrast-enhanced low-MI sonography is superior to non-enhanced B-Mode sonography in differentiating synovitis and joint effusion.

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Background Ultrasound is one of the most important imaging methods in the daily routine. Contrast-enhanced ultrasound (CEUS) has put ultrasound on equal footing with computed tomography and magnetic resonance imaging in many areas. Although ultrasound contrast agents are commonly administered intravenously, endocavitary application as performed in the case of iodine-containing contrast agents is also possible. Method Based on the current literature, this overview provides information regarding possible endocavitary applications of ultrasound contrast agents as they are used and could be used in the daily routine in radiology. Examples are provided to illustrate the advantages and disadvantages of clinical use. Results and Conclusion Endocavitary CEUS broadens the spectrum of possible ultrasound applications and can be safely used for patient diagnosis and treatment. The method can be safely used for diagnosis and patient management, particularly in patients in whom examinations including exposure to radiation with iodine-containing contrast agents may be contraindicated and who have limited mobility due to disease severity. Key points:  Citation Format