Safety Proﬁle of Musculoskeletal Contrast-Enhanced Ultrasound with Sulfur Hexaﬂuoride Contrast Agent

Therapeutics and Clinical Risk Management, 2020 · DOI: http://doi.org/10.2147/TCRM.S235235 · Published: January 1, 2020

Healthcare Medical Imaging Musculoskeletal Medicine

Simple Explanation

This study examines the safety of using contrast-enhanced ultrasound (CEUS) with a sulfur hexafluoride contrast agent to assess muscle, bone, and tendon health. The study found that adverse events were rare, suggesting that CEUS with sulfur hexafluoride is a safe method for musculoskeletal imaging, even in older patients. CEUS is easily accessible, quick to use, well tolerated by patients and allows a real-time diagnostic workup.

Study Duration

2012 to 2019

Participants

764 patients

Evidence Level

Not specified

Key Findings

1
The total rate of all adverse events was 0.13%, and the rate of severe adverse events was 0.04%.
2
No fatal events occurred during the 2268 CEUS examinations performed.
3
Adverse events occurred promptly and at the first application of the contrast agent.

Research Summary

This study confirms the safety of musculoskeletal CEUS using sulfur hexafluoride contrast agent, with a lower rate of adverse events compared to other contrast agents. The study analyzed 2268 CEUS examinations in 764 patients, finding a total adverse event rate of 0.13% and a severe adverse event rate of 0.04%. Musculoskeletal CEUS offers advantages over other imaging techniques like MRI and CT, including no ionizing radiation, no risk of contrast agent deposition, and applicability in patients with renal impairment.

Practical Implications

Safe Diagnostic Tool

Musculoskeletal CEUS with sulfur hexafluoride is a safe diagnostic tool for assessing microperfusion in musculoskeletal tissues.

Alternative Imaging Modality

CEUS can be used as an alternative imaging modality for patients with contraindications to MRI or CT.

Real-Time Assessment

CEUS allows for real-time assessment of tissue microcirculation, aiding in the diagnosis and management of musculoskeletal conditions.

Study Limitations

1
Specific risks, such as symptoms or changes in electrocardiogram as well as changes in blood pressure or oxygen saturation were not routinely investigated during the examination.
2
Possible reactions with delayed occurrence (30–60 minutes after the examination and application of sulfur hexaﬂuoride contrast agent) or after the patient’s discharge might have been missed
3
A prospective analysis with a previously well-deﬁned establishment of all individual risk factors of every patient would have been more accurate

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