Ultraschall Med 2016; 37 - SL20_4
DOI: 10.1055/s-0036-1587813

CEUS and color-coded perfusion analysis in venous malformations before and after sclerotherapy with ethanolgel

V Teusch 1, WA Wohlgemuth 1, EM Jung 1
  • 1University Hospital Regensburg, Radiology, Regensburg, Germany

Purpose: Therapy monitoring of sclerotherapy with ethanolgel (ScleroGel, ab medica, Duesseldorf, Germany) in patients with venous malformations with CEUS and color-coded perfusions analysis.

Material and methods: In this prospective study, approved by the local institutional review board, 22 patients with peripheral venous malformations gave their written consent (in case of children their caregivers) and were included (mean age: 25.3 years (6.6 – 46.5 years), female: n = 19). At the beginning of the study and after 1 – 2 treatment sessions with ethanolgel ultrasound was executed by an experienced examiner with a high resolution multifrequency linear transducer of an Acuson S 2000 ultrasound machine (Siemens, Erlangen, Germany). Flow in the malformation was detected with CCDS and Power Mode. CEUS and color-coded perfusion analysis were executed after injection of 1 – 2.4 ml of SonoVue (Bracco, Milan), a cine sequence was stored for 60 s. Quantitative perfusion-analysis was executed, percentage peak enhancement (peak,%), time to peak (TTP, s), area under the curve (AUC, %s), and mean transit time (MTT, s) were measured in the centre of the malformation as well as the surrounding tissue before and after treatment. Statistic analysis was calculated with Wilcoxon signed rank test.

Results: Comparison of TTP and MTT in the centre of the lesion before and after treatment revealed statistic significant differences (TTP: 32 vs. 26 s, p < 0.05; MTT: 43 vs. 35 s, p < 0.05). Comparison of AUC and peak enhancement before and after treatment in the centre of the lesion showed no statistic significant difference (AUC: 984 vs. 668%s; peak: 20 vs. 17%). The comparison of all four parameters in the surrounding tissue before and after treatment was not statistically significant.

Conclusion: In patients with venous malformations TTP and MTT seem to be important parameters for therapy monitoring after sclerotherapy with ethanolgel.