Contrast-enhanced power Doppler sonography: Assessment of revascularization flow in Legg-Calve-Perthes' disease

A total of 26 children (26 affected, 25 control hips) with Legg-Calve-Perthes' disease (LCP) met the cooperation requirements for inclusion in the study using contrast-enhanced power Doppler sonography for assessment of changes in the revascularization flow. Sagittal sonograms were obtained before and at the peak effect of an intravenously injected microbubble-based contrast agent. Overall mean peak enhancement ratios were greater for children with later onset of disease (>5.8 years old) than for those with earlier onset (less than or equal to5.8) (p = 0.02). The use of ultrasound (US) contrast agents improved depiction of proximal femoral vascularity in all regions of the femoral head: epiphysis (n = 3, pre; n = 8, postcontrast), physis (n = 12, pre; it = 21, postcontrast) and metaphysis (n = 6, pre; n = 8, postcontrast) and resulted in a marked increase in the number of mean pixel intensity values within the physis (p = 0.02). In conclusion, contrast-enhanced power Doppler sonography is an effective method for demonstration of changes from the revascularization process in LCP, particularly within the physis. (C) 2002 World Federation for Ultrasound in Medicine Biology.