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Thank you Michael for your response.  I am sure the cardiologists will
appreciate this valuable information, as do I.
-Elaine
----- Original Message -----
From: "Michael, Dwight" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Monday, November 18, 2002 4:40 PM
Subject: Re: Renal Artery Duplex with Ultrasound Contrast


> Elain, I have used Definity for renal arteries.  It provides excellent
color
> enhancement and makes extremely difficult to impossible to do patients,
> doable.  I've used it several ways and the most effective for me seems to
be
> mixing the Definity in 200-250 ml IV solution, (normal saline, D5W, etc).
I
> usually do not turn on the contrast until I'm ready to look at flow in the
> kidney and arteries.  At that point I titrate the drip rate to provide
> adequate enhancement (but not so fast as to use up all my contrast on one
> side.)  If you've never used contrast, beware.  You can get overpowered
with
> color.  Use the lowest Mechanical Index possible.  You should use a MI of
> less than 0.6 in order not to destroy the "bubbles".  I've not tried
Optison
> for renals.  We no longer use it at all.  Optison settles out in solution
> and would be very difficult to maintain in suspension for continuous drip.
> I've used the Definity with small bolus injections, as well as less
dilution
> (100 cc),  The 200-250 cc solution seems to work best for me.  Good Luck!
I
> hope this has been of some benefit.
>
> -----Original Message-----
> From: Elaine Erickson [mailto:[log in to unmask]]
> Sent: Sunday, November 17, 2002 8:58 PM
> To: [log in to unmask]
> Subject: Renal Artery Duplex with Ultrasound Contrast
>
>
> Hi,
> Has anyone out there had experience with bubble contrast to enhance renal
> artery studies.  If so, I would be interested in your opinion as to
whether
> or not sufficient optimization resulted from the use of contrast, and what
> protocol was followed to achieve the maximum benefits.  I currently work
> for cardiologists, but my previous experience has been limited to
abdominal
> and peripheral exams.  The cardiologists do rely on Optison for cardiac
> imaging on some technically difficult patients, and was curious if anyone
> has had experience in other applications of bubble contrast.
> Thank you,
> Elaine Erickson
>
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