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Ultrasonographic Contrast Media

Has the Time Come in Obstetrics and Gynecology?

Department of Obstetrics and Gynecology, Rush University Medical School, Chicago, Illinois USA.

Address correspondence and reprint requests to Jacques S. Abramowicz, MD, Rush University Medical Center, 1653 W Congress Pkwy, Chicago, IL 60612 USA. E-mail: jacques_abramowicz{at}rush.edu

Objective. The aim of this work was to review the technical aspects and clinical applications of contrast media (microbubbles and nanomolecular agents) in obstetric and gynecologic ultrasonographic imaging. Methods. With the use of a computerized database (MEDLINE) and several Web-based search engines (Google Scholar and Copernic), relevant articles on ultrasonographic contrast media were reviewed. References cited in these articles and not obtained via the search engines were also reviewed. Results. Ultrasonographic contrast media constitute a new and expanding technology. They are frequently used, for example, in adult cardiology. Extensive research in laboratory setups, animals, and human subjects has shown their safety and huge potential as an adjunctive tool in clinical practice. They increase signals returning from insonated tissues and are particularly effective as intravascular agents, enhancing color and Doppler signals, for instance. Preliminary results in tumor imaging are encouraging. The ultrasonographic contrast media permit pharmacokinetic perfusion studies, which may be of enormous clinical importance in the study of early cancer development. Targeted imaging and therapies are becoming a reality. Microbubbles have already brought a new dimension to diagnostic ultrasonographic imaging. Many authors have described the clinical value of these agents in liver, prostate, and breast imaging, among others. Newer types of media, the nanomolecules, are now emerging as the latest in imaging enhancers as well as therapeutic agent carriers. Conclusions. Although showing potential in imaging of the uterus and fallopian tubes as well as some obstetric applications, the contrast media, in particular the nanomolecules, seem to be most promising in ovarian cancer.

Key Words: gynecology • nanomolecular imaging • obstetrics • ovarian cancer • ultrasonographic contrast medium

Abbreviations: SHG, sonohysterography • UCM, ultrasonographic contrast media

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