Objective To analyze the safety of abdominal contrast-enhanced ultrasound (CEUS) after intravenous injection of sulfur hexafluoride microbubbles. Methods All patients who underwent abdominal CEUS examination with intravenous injection of sulfur hexafluoride microbubbles in our center from January 2006 to September 2021 were retrospectively analyzed. The basic information

symptoms and signs of patients with adverse events(AEs) were collected

and the types

severity and risk factors of AEs were summarized. Results A total of 91312 intravenous injections of sulfur hexafluoride microbubbles were enrolled and 35 cases (0.038%) had AEs

including 25 males and 10 females. A total of 18 cases were mild

10 moderate and 7 severe in severity

and no death occurred. There were 7 allergy-like AEs and 28 physiologic AEs. For patients with allergy-like AEs

the most common sign and symptom was limited urticaria/pruritis. For patients with physiologic AEs

the most common signs and symptoms were nausea/vomiting and vasovagal reactions. The most common age of the AEs were 40~60 years old (65.7%

23/35).Thirty-one (88.6%) patients had abnormal liver function. Only one has a history of sulfa drug allergy. Almost all patients with AEs (97.1%

34/35) occurred within 10 minutes after contrast agent injection

and all patients were recovered on the same day. Among the patients with mild AEs

12 were relieved without any treatment and 6 were relieved after receiving corresponding treatment. All the patients with moderate and severe AEs were relieved after receiving corresponding treatment. Conclusion The incidence of adverse events after intravenous injection of sulfur hexafluoride microbubbles in abdominal CEUS is very low

which has a high safety in clinical application.