Evaluation of a new ultrasound contrast agent (AI-700) using two-dimensional and three-dimensional imaging during acute ischemia

Imagify™ (perflubutane polymer microspheres) injectable suspension for the assessment of coronary artery disease

Myocardial contrast echocardiography is a rapidly evolving technique for the assessment of myocardial perfusion. Many studies have indicated their ability to detect flow-limiting coronary artery disease. Imagify (perflubutane polymer microspheres) injectable suspension, also known as AI-700, is a new ultrasound contrast agent that satisfies all the characteristics of an ideal agent for the assessment of myocardial perfusion. Preliminary studies with Imagify indicate that it is comparable with radionuclide perfusion techniques (presently the most widely used imaging technique to assess coronary artery disease) without the disadvantages of radiation and lack of availability at the bedside. This article provides an overview of Imagify, a new ultrasound contrast agent.

Gd-DTPA-loaded PLGA microbubbles as both ultrasound contrast agent and MRI contrast agent--a feasibility research

OBJECTIVE

To prepare the Gd-DTPA-loaded poly (lactic-co-glycolic acid) (PLGA) microbubbles for both ultrasound imaging and MRI imaging.

METHODS

Biodegradable high-molecular-weight poly (lactic-co-glycolic acid) (PLGA) was used as an encapsulating vehicle to fabricate a contrast agent composed of gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) and fluorocarbon-filled microbubbles by using double emulsion method. The morphology, size, and Gd loading capacity of PLGA microparticles were assessed. The efficacy of the contrast agent for ultrasound and magnetic resonance (MR) imaging was evaluated by in vivo imaging of hepatic vessels and the liver parenchyma of rabbit following injection of the contrast agent. Additionally, the liver and kidney functions were examined before and at 7, 14, 30 days after injection.

RESULTS

Electron microscopy showed Gd loaded PLGA microbubbles were spherical in shape. The mean diameter were 1.47 +/- 0.38 microm and the Gd loading was 25 +/- 2 microg/mg. Right after the injection of the PLGA microbubbles, the ultrasound echo intensity of hepatic vessels and the liver parenchyma was significantly enhanced. Moreover, enhanced signal intensity of the liver parenchyma on MR images was observed for approximately 30 min after injection of the contrast agent. Neither marked changes in the liver and kidney functions nor other severe complications were detected during the follow-up period.

CONCLUSION

Gd-DTPA-loaded PLGA microbubbles could enhance both ultrasound imaging and MRI imaging.

Myocardial Contrast Echocardiographic Estimates of Infarct Size Predict Likelihood of Left Ventricular Remodeling After Acute Anterior Wall Myocardial Infarction

OBJECTIVES

We sought to determine the utility of myocardial contrast echocardiography (MCE) in predicting left ventricular (LV) remodeling (LVR) in patients with a recent anterior wall myocardial infarction and residual regional LV akinesis.

BACKGROUND

Although recent studies have shown that MCE predicts recovery of regional and global LV systolic function after myocardial infarction, the relationship between myocardial perfusion patterns and likelihood of subsequent LVR has not been extensively studied.

METHODS

In all, 50 patients (mean age 62 years) underwent contrast-enhanced echocardiography for determination of LV volumes and ejection fraction, and MCE, 2 days after admission, with follow-up contrast-enhanced echocardiography 6 months later. LVR was defined as greater than 15% increase in LV end-diastolic volume index at follow-up.

RESULTS

LVR occurred in 19 patients (38%) (group 1), with stable LV volumes in 31 patients (62%) (group 2). Routine clinical and angiographic variables did not differ between groups 1 and 2. Both transmural extent of infarction and number of abnormally perfused myocardial segments (assessed by MCE) predicted LVR. LVR occurred in 55% of patients with transmural perfusion defects, and was less common in those with subendocardial perfusion defects or normal perfusion (31% and 21%, respectively). The mean percent increase in LV size was significantly greater for transmural infarcts (15 +/- 7%) versus subendocardial infarcts or normal perfusion (-1 +/- 8 and 8 +/- 8, respectively). When more than 5 myocardial segments were abnormally perfused, remodeling always occurred and was extensive.

CONCLUSIONS

MCE markers of infarct size are useful in predicting subsequent risk of LVR after myocardial infarction. Routine performance of MCE studies in select patients early after infarction may be helpful in further refining risk stratification.

Live Real-time Three-dimensional Echocardiography for the Visualization of Myocardial Perfusion–A Pilot Study in Open-chest Pigs

Visualization of myocardial perfusion is possible in both 2-dimensional and from reconstructive 3-dimensional echocardiography. We present the findings of our experimental pilot study of myocardial perfusion detection using live real-time 3-dimensional echocardiography in an animal model.

In Vitro Echogenicity Characterization of Poly[lactide-coglycolide] (PLGA) Microparticles and Preliminary In Vivo Ultrasound Enhancement Study for Ultrasound Contrast Agent Application

OBJECTIVES

This work includes (1) the characterization of a reproducible poly[lactide-coglycolide] (PLGA) microparticle preparation with an optimial mean diameter and size distribution and (2) the preliminary in vivo ultrasonographic investigation of PLGA microparticles.

METHODS

A first series of PLGA microparticle preparations (1 to 15 mum) was acoustically characterized on a hydrodynamic device to select the most appropriate for ultrasound contrast agent application. Preparations of 3-microm microparticles were selected, characterized at different doses, and then injected into 20 melanoma grafted mice for contrast-enhanced power Doppler ultrasonography evaluation.

RESULTS

The 3-microm microparticles (3.26-microm mean diameter with 0.41-microm standard deviation) led to in vitro enhancement of 18.3 dB at 0.62 mg/mL. In vivo experiments showed 47% enhancement of intratumoral vascularization detection after PLGA injection, significantly correlated (P < 0.0001) with preinjection intravascularization and tumoral volume. No toxicity was histologically observed.

CONCLUSION

The 3-microm PLGA microparticles provided significant enhancement in vitro and in vivo without any toxicity.