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Journal of Ultrasound in Medicine, Vol 17, Issue 12 751-756, Copyright © 1998 by American Institute of Ultrasound in Medicine

JOURNAL ARTICLE

Comparison of power Doppler and B-scan sonography for renal imaging using a sonographic contrast agent

C. M. Sehgal, P. H. Arger, C. R. Pugh, J. I. Kirchofer, E. Y. Kotlar and K. C. Bovee
Department of Radiology, University of Pennsylvania, Philadelphia, USA.

The goal of this study was to evaluate the relative performance of power Doppler and B-scan imaging modes in detecting vascular perfusion changes resulting from injection of a contrast agent. To allow this comparison the imaging plane and the contrast agent injection must be the same for both modes. We achieved this by using a rigid transducer holder and simultaneously recording power Doppler and B-scan images on separate videotapes. The kidneys of five adult beagles were scanned to allow a comparison of how power Doppler and B-scan imaging methods monitor changes during the injection of 0.1 ml/kg of a contrast agent, EchoGen emulsion (Sonus Pharmaceuticals, Bothell, WA). The changes in the images were assessed qualitatively by three radiologists and quantitatively using a custom-designed image analysis software. All of the radiologists agreed that no visually detectable changes occurred in B-scan images but that significant changes could be observed in power Doppler images. Image analysis also indicated a difference between power Doppler and B-scan images. The change in mean color level of power Doppler images could be displayed as an indicator dilution curve with a peak enhancement of 46 +/- 16 above the preinjection value. The time at which mean color level peaked was 18 +/- 13 s. The mean color level returned to half of the peak value by 69 +/- 42 s and returned to the preinjection baseline value by 148 +/- 73 s. Conversely, B-scan images showed statistically insignificant changes, and time measurements could not be made. By all measures used to evaluate images, power Doppler imaging had a greater sensitivity in detecting changes resulting from contrast agent injection than B-scan imaging. This finding indicates that power Doppler imaging of contrast agent injections can be used to map regional differences in flow as well as quantitative measurements of a contrast agent's transit time and has the potential to assess kidney abnormalities associated with renal blood flow.


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Copyright © 1998 by the American Institute of Ultrasound in Medicine.