Abstract
Second-generation ultrasound contrast agents are gas microbubbles that are injected into a peripheral vein and enhance the backscattered ultrasound from the blood vessel lumen. The non-linear signal produced by the bubbles can be differentiated from the tissue signal. No severe adverse events have been reported, and these agents can be used in patients who are at high risk due to heart failure, renal failure, or pulmonary hypertension. In patients with liver disease, contrast-enhanced ultrasonography provides an evaluation of the microvessels within focal nodular lesions and a characterization of benign and malignant lesions similar in terms of semiology and reliability to that obtained with computed tomography. Second-generation contrast agents substantially improve the results of ultrasonography for detecting and quantifying liver metastases. Adaptations to the ultrasound equipment must be made to allow use of these agents.
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