Ultrasound contrast media and their use in obstetrics and gynecology

Abramowicz, Jacques S.

doi:10.1016/s0301-5629(97)00201-9

Cited by 28 publications

(16 citation statements)

References 151 publications

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“…Mechanical phenomena may become very relevant if procedures arise by which the embryo or fetus is treated with echo contrast agents to enhance diagnostic capability. 75 It therefore seems more likely that a diagnostic ultrasound-induced thermal mechanism could be operating because the physics (sufficient acoustic output) and the biology (thermally sensitive stages) of obstetric settings are conjoined. Furthermore, this situation may worsen because acoustic outputs of instruments are rising 76 and will be exacerbated if the present regulated limitations on allowable SPTA acoustic emissions of diagnostic ultrasound devices are further relaxed or eliminated.…”

Section: Epidemiologic Datamentioning

confidence: 99%

Fetal Thermal Effects of Diagnostic Ultrasound

Abramowicz

Barnett

Duck

et al. 2008

Journal of Ultrasound in Medicine

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101

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rocesses that can produce a biological effect with some degree of heating (ie, about 1°C above the physiologic temperature) act via a thermal mechanism. Investigations with laboratory animals have documented that pulsed ultrasound can produce elevations of temperature and damage in biological tissues in vivo, particularly in the presence of bone (intracranial temperature elevation). Acoustic outputs used to induce these adverse bioeffects are within the diagnostic range, although exposure times are usually considerably longer than in clinical practice. Conditions present in early pregnancy, such as lack of perfusion, may favor bioeffects. Thermally induced teratogenesis has been shown in many animal studies, as well as several controlled human studies; however, human studies have not shown a causal relationship between diagnostic ultrasound exposure during pregnancy and adverse biological effects to the fetus. All human epidemiologic studies, however, were conducted with commercially available devices predating 1992, that is, with acoustic outputs not exceeding a spatial-peak temporal-average intensity of 94 mW/cm 2 . Current limits in the United States allow a spatial-peak temporal-average intensity of 720 mW/cm 2 for fetal applications. The synergistic effect of a raised body temperature (febrile status) and ultrasound insonation has not been examined in depth. Available evidence, experimental or epidemiologic, is insufficient to conclude that there is a causal relationship between obstetric diagnostic ultrasound exposure and obvious adverse thermal effects to the fetus. However, very subtle effects cannot be ruled out and indicate a need for further research, although research in humans may be extremely difficult to realize.

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Section: Epidemiologic Datamentioning

confidence: 99%

Fetal Thermal Effects of Diagnostic Ultrasound

Abramowicz

Barnett

Duck

et al. 2008

Journal of Ultrasound in Medicine

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101

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“…In human gynecology, hysterosalpingo-contrast sonography is a widely used first-line screening procedure to test for tubal patency [14][15][16]. An echo-contrast medium is given into the uterus and its flow through the upper genital tract monitored by transvaginal ultrasound.…”

Section: Discussionmentioning

confidence: 99%

“…Using the PSP test false positive results are however occurring [11], and testing of individual oviducts is impossible. In woman, where tubal dysfunction or obstruction accounts for approximately 35% of all the causes of infertility [13], hysterosalpingo-contrast sonography is a widely used first-line screening method to test for tubal patency [14][15][16]. An echo-contrast medium is instilled into the uterus through a balloon catheter and is imaged transvaginally as it exits the patent tube.…”

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confidence: 99%

Use of Contrast Sonography to Test for Tubal Patency in Dairy Cattle

Kauffold

Groeger

Bergmann

et al. 2009

Journal of Reproduction and Development

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Abstract. Hysterosalpingo-contrast sonography is an accurate first-line method used to test for tubal patency in human gynecology. Tubal pathology occurs in dairy cattle and is a reason for infertility, but easy and accurate methods to test for tubal patency are not available in the living cow. In this study it was thus investigated if contrast sonography (CS) using Echovist ® -200 as the echo-contrast medium is a feasible procedure to test for tubal patency in dairy cattle. In eight repeat breeder Holstein Frisian cows, all of them being in behavioral estrus, Echovist ® -200 was given into the uterus and its exit into the abdominal cavity then imaged by transrectal conventional B-mode ultrasound, and used as indicator for tubal patency. Animals were slaughtered one day later and the genital tracts subjected to gross morphology and histology in order to confirm the results of CS. In two cows, CS was prematurely terminated after examination of one oviduct because of rectal bleeding, while CS completely failed in another cow because of poor image quality. In five cows, both oviducts could be examined by CS, respectively. A total of five oviducts were found patent by CS and confirmed by post mortem examination. Two out of five oviducts diagnosed as occluded by CS were morphologically intact and thus misdiagnosed. Of the three non-patent oviducts, two were occluded because of a hydrosalpings, respectively, while the third was inflamed. In conclusion, CS has been shown a feasible procedure to test for tubal patency in dairy cattle. Further studies with more animals are however recommended to warrant this result. Repeat breeder cows are usually referred as to infertile animals that are bred several times but do not conceive and return to estrus in a regular interval, in the absence of signs that can be associated with not conceiving [4]. Repeat breeding is a multifactorial problem involving a multitude of extrinsic as well as intrinsic factors including subtle genital disorders [5][6][7]. Tubal pathology has been associated with infertility in dairy cattle [8][9][10], but its contribution to the repeat breeder syndrome has yet not been determined. This is due, at least in part, to the difficulty in the assessment of the oviducts in the living cow. Rectal palpation, laparotomy and laparoscopy have been advocated as viable methods for this purpose [11], however these are either inappropriate to test for tubal patency and/or unreliable, laborious and expensive. In contrast, tubal patency in cattle can be tested using the red dye phenolsulfonphtalein (PSP). When it is given into the uterus as a solution, it flows into the abdominal cavity in case of tubal patency, where it is resorbed and then excreted in urine [11,12]. Using the PSP test false positive results are however occurring [11], and testing of individual oviducts is impossible. In woman, where tubal dysfunction or obstruction accounts for approximately 35% of all the causes of infertility [13], hysterosalpingo-contrast sonography is a widely used first-line scre...

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“…Diagnostic ultrasound's safety has been extensively studied, as reviewed numerous times (Abramowicz, 1997;ISUOGEC, 2007). A recent paper raises interesting questions about large doses of diagnostic ultrasound, such as one might encounter during pregnancies that result from in vitro fertilization, where monthly monitoring, or more, is the norm.…”

Section: Contrast Agentsmentioning

confidence: 99%

Therapeutic ultrasound with an emphasis on applications to the brain

Mourad

2012

Ultrasonic Transducers

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Ultrasound contrast media and their use in obstetrics and gynecology

Cited by 28 publications

References 151 publications

Fetal Thermal Effects of Diagnostic Ultrasound

Fetal Thermal Effects of Diagnostic Ultrasound

Use of Contrast Sonography to Test for Tubal Patency in Dairy Cattle

Therapeutic ultrasound with an emphasis on applications to the brain

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