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B. Fuchs, K. Schlottmann, V.–P. Gabel; Contrast Harmonic Imaging With High Resolution Sonography – A New Method to Examine Choroidal Melanoma Perfusion Before and After Radiotherapy . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4314.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: Tumor vascularity is of diagnostic and prognostic importance. After sufficient radiotherapy, tumor vascularisation diminishes. On A–Scan, vascularity is indicated by the presence of a flickering motion. Large tumor vessels can be visualized and examined by color Doppler sonography. Due to physical restrictions the low flow in the microcirculation cannot be investigated by Doppler technique. The aim of our study was the visualization of such small tumor vessels and their behaviour after therapy by contrast harmonic imaging (CHI) with a contrast enhancer as a completely new approach in ophthalmology. Methods: After examination by standardized A– and B–mode sonography and color Doppler sonography, 20 patients with malignant melanomas of the choroids have been examined under CHI (Siemens Elegra, Germany) after injection of the contrast enhancer Sonovue (Bracco, Italy) using a 7,5 MHz probe (7.5L40) at time of diagnosis and three months after therapy. Results: At time of diagnosis, in all tumors small vessels which could not be shown on Doppler ultrasound were detected under CHI. Vascularity fairly correlated with standardized sonography. 4 patients underwent enucleation, 2 endoresection, so at least 7 patients showed enough prominence at control to repeat contrast enhanced sonography, which showed vascularisation reaching from none to unchanged high vascularisation. Conclusions:The detection of microvessels in tumors of the choroid by Sonovue is feasible. CHI allowed the detection of small tumor vessels, giving additional information about the amount of vessels and thus tumor vitality before and after radiotherapy. This has to be confirmed in larger series.
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