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We do a pretty fair number of RA duplexes (3-5 per day) and are an
accredited visceral lab. We used Optison initially during our learning curve
but have not used contrast for a renal duplex in over three years. It does
not help in pt's that are poorly prepped (gassy!) and does not substitute
for a concisely performed, complete study. We have not found that the
addition of contrast has improved significantly in our ability to see the
renals in their entirety in properly prepped pt's. I would suggest that if
you think you need contrast in a fair number of studies that you might need
to spend more time either making sure the patients are prepped and properly
positioned during the exam. Sometimes moving the patient just a little to
either side will make a big difference. Of course patient's breath holding
is crucial also. We do all our studies with an ATL 5000 with SonoCT. I have
found SonoCT to be more helpful than contrast.
    With respect to Optison "layering out" we do use a fair amount of it for
Perfusion Echo studies. If you jostle the IV back every few minutes I think
you will find that it can be given by infusion as easily as Definity.
Ed Bernaski, M.D., F.A.C.C.
Gramercy Park Cardiology
----- Original Message -----
From: "Elaine Erickson" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Sunday, November 17, 2002 9:57 PM
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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