ICUS Weekly News Monitor 8-7-2015

1.  Pharmabiz.com,  Aug 5, 2015,  Bracco, Amerinet expand group purchasing pact to include Lumason for injectable suspension for contrast echocardiography
 
2.  7th Space Interactive,  Aug 4, 2015,  Contrast-enhanced ultrasonography diagnosis of fundal localized type of gallbladder adenomyomatosis
Authors:  ShaoShan Tang, et aL
 
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Pharmabiz.com
Aug 5, 2015
 
Bracco, Amerinet expand group purchasing pact to include Lumason for injectable suspension for contrast echocardiography
 
Bracco Diagnostics Inc., the US affiliate of Bracco Imaging, one of the world’s leading companies in the diagnostic imaging business, and Amerinet, a leading national healthcare solutions organisation, announced the expansion of its group purchasing agreement to include Lumason.
 
Under the terms of the agreement, Amerinet’s membership base of more than 82,000 provider organisations across the US, will have access to Bracco’s Lumason for their contrast enhanced echocardiography needs.
 
Lumason, internationally known as SonoVue which has been marketed for over 14 years in currently more than 30 countries worldwide, is an ultrasound contrast agent made up of gas-filled microbubbles or microspheres that reflect the sound waves to enhance the image.
 
Lumason has been approved by the US Food and Drug Administration for use in adults with suboptimal echocardiograms to opacify the left ventricular chamber and to improve the delineation of the left ventricular endocardial border.
 
“We are proud to be a long-term Amerinet partner, and to offer Amerinet’s members and their healthcare professionals, the benefits of our contrast enhanced ultrasound agent,” said Vittorio Puppo, chief executive officer and president, Bracco Diagnostics Inc. “This offering further demonstrates our commitment to improve patient care in the United States.”
 
Lumason is supplied as a three-part kit. Each kit contains a Lumason vial containing 25 mg of lipid-type A lyophilized powder and 60.7 mg sulfur hexafluoride headspace, a prefilled syringe containing 5 ml of Sodium Chloride 0.9 per cent injection, USP (Diluent), and a Mini-Spike.
 
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7th Space Interactive
Credits/Source: BMC Gastroenterology 2015, 15:99
Aug 4, 2015
 
Contrast-enhanced ultrasonography diagnosis of fundal localized type of gallbladder adenomyomatosis
Author: ShaoShan Tang*, LiPing Huang, Yao Wang and YiJiao Wang
* Corresponding author: ShaoShan Tang This email address is being protected from spambots. You need JavaScript enabled to view it.
Author Affiliations
Department of ultrasound, Shengjing hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang 110004, China
 
Adenomyomatosis of gallbladder is an acquired hyperplastic lesion, characterized by focal or diffuse thickening of the gallbladder with intramural cysts or echogenic areas with comet tail on ultrasonography. But in some cases, especially in the localized fundal type of adenomyomatosis, the intramural anechoic cystic spaces are uncertainty which causes difficult to differential adenomyomatosis from GB cancer.
 
The purpose of this study was to determine the accuracy of real-time contrast-enhanced ultrasonography(CEUS) in the diagnosis of the fundal localized type of gallbladder adenomyomatosis.
 
Methods: We performed a retrospective study of 21 patients with pathologically proven fundal localized type of gallbladder (GB) adenomyomatosis. All patients underwent preoperative grayscale ultrasound (US) and real-time CEUS examination.
 
The study's reviewers made the diagnosis of adenomyomatosis according to the presence of the focal thickening of the fundal gallbladder wall with intramural cyst or intramural echogenic foci on grayscale US or CEUS. The diagnostic accuracy of US and CEUS was compared.
 
The enhanced pattern and degree of intactness of the GB wall were also recorded.
 
Results: The fundal portion of the GB wall showed localized thickness in all 21 patients. Small anechoic spaces or intramural echogenic foci were detected in 14 (66.7Â %) and 21 (100Â %) of cases respectively, and the intactness of the GB wall's outer hyper-echoic layer was demonstrated in 17 (81Â %) and 20 (95Â %) on grayscale US and CEUS, respectively.
 
The accuracy rate of the above two examination modalities was significantly different (p < 0.05). In the arterial phase of the CEUS, areas of focal thickened GB wall were iso-enhanced in 18 cases and hyper-enhanced in 3 cases.
 
All 21 cases appeared to show heterogeneous enhancement with small non-enhancement spaces. The mucosal and serosal layers of the GB wall surrounding the lesions were enhanced, which presented as two 'hyper-echoic lines'in the arterial phase of CEUS.
 
In the venous phase of the CEUS, 19 lesions were iso-enhanced and 2 lesions were hypo-enhanced. The small non-enhancement spaces were more clearly during the venous phase.
 
Conclusion: The small non-enhancement space is a characteristic finding of the fundal localized type of gallbladder adenomyomatosis on CEUS.
 
CEUS could increase the degree of visualization of Rokitansky-Aschoff sinuses (RAS) and intactness of the GB wall, which play an important role in differential diagnosis.

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