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Gheorghiu MI, Seicean A, Pojoga C, Hagiu C, Seicean R, Sparchez Z. Contrast-enhanced guided endoscopic ultrasound procedures. World J Gastroenterol 2024; 30:2311-2320. [PMID: 38813054 PMCID: PMC11130571 DOI: 10.3748/wjg.v30.i17.2311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 03/10/2024] [Accepted: 04/15/2024] [Indexed: 04/30/2024] Open
Abstract
Contrast-enhanced endoscopic ultrasound (CH-EUS) can overcome the limitations of endoscopic ultrasound-guided acquisition by identifying microvessels inside inhomogeneous tumours and improving the characterization of these tumours. Despite the initial enthusiasm that oriented needle sampling under CH-EUS guidance could provide better diagnostic yield in pancreatic solid lesions, further studies did not confirm the supplementary values in cases of tissue acquisition guided by CH-EUS. This review details the knowledge based on the available data on contrast-guided procedures. The indications for CH-EUS tissue acquisition include isoechoic EUS lesions with poor visible delineation where CH-EUS can differentiate the lesion vascularisation from the surrounding parenchyma and also the mural nodules within biliopancreatic cystic lesions, which occur in select cases. Additionally, the roles of CH-EUS-guided therapy in patients whose pancreatic fluid collections or bile ducts that have an echogenic content have indications for drainage, and patients who have nonvisualized vessels that need to be highlighted via Doppler EUS are presented. Another indication is represented if there is a need for an immediate assessment of the post-radiofrequency ablation of pancreatic neuroendocrine tumours, in which case CH-EUS can be used to reveal the incomplete tumour destruction.
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Affiliation(s)
- Marcel Ioan Gheorghiu
- Department of Gastroenterology, “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca 400162, Cluj, Romania
| | - Andrada Seicean
- Department of Gastroenterology, “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca 400162, Cluj, Romania
| | - Cristina Pojoga
- Department of Gastroenterology, “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca 400162, Cluj, Romania
- Department of Clinical Psychology and Psychotherapy, International Institute for Advanced Study of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca 400375, Cluj, Romania
| | - Claudia Hagiu
- Department of Gastroenterology, “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca 400162, Cluj, Romania
| | - Radu Seicean
- The First Surgical Clinic, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj Napoca 400006, Cluj, Romania
| | - Zeno Sparchez
- Department of Gastroenterology, “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca 400162, Cluj, Romania
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Goessmann H, Schleder S, Stroszczynski C, Schreyer AG. Significance of Postprocedural Contrast Medium Injection after CT-Guided Abscess Drainage. Tomography 2023; 9:1434-1442. [PMID: 37624107 PMCID: PMC10458545 DOI: 10.3390/tomography9040114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/26/2023] Open
Abstract
The aim was to evaluate the additive clinical value of an additional post-procedural control-scan after CT-guided percutaneous abscess drainage (PAD) placement with contrast medium (CM) via the newly placed drain. All CT-guided PADs during a 33-month period were retrospectively analyzed. We analyzed two subgroups, containing patients with and without surgery before intervention. Additionally, radiological records were reevaluated, concerning severe inflammatory response syndrome (SIRS) during the intervention. A total of 499 drainages were placed under CT-guidance in 352 patients. A total of 197 drainages were flushed with CM directly after the intervention, and 51 (26%) showed an additional significant finding. An immediate change of therapy was found in 19 cases (9%). The subgroup that underwent surgery (120 CM-drainages; 32 (27%) additional findings; 13 (11%) immediate changes of therapy) showed no statistically significant difference compared to the subgroup without surgery (77 CM-drainages; 19 (25%) additional findings; 5 (6%) immediate changes of therapy). SIRS occurred in 2 of the 197 flushed drainages (1%) after CM application. An additional scan with CM injection via the newly placed drain revealed clinically significant additional information in almost 26% of the drainages reviewed in this study. In 9% of the cases this information led to an immediate change of therapy. Risks for SIRS are low.
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Affiliation(s)
- Holger Goessmann
- Department of Radiology, University Hospital Leipzig, 04103 Leipzig, Germany;
| | - Stephan Schleder
- Department of Diagnostic and Interventional Radiology, Merciful Brothers Hospital St. Elisabeth, 94315 Straubing, Germany;
| | | | - Andreas G. Schreyer
- Department of Diagnostic and Interventional Radiology, University Hospital Brandenburg, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg, Germany
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Efficacy and Prognosis of Ultrasound-Guided Percutaneous Catheter Drainage in Patients with Liver Abscess Complicated with Septic Shock. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:4688356. [PMID: 35844459 PMCID: PMC9279082 DOI: 10.1155/2022/4688356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 11/17/2022]
Abstract
Objective Currently, the therapeutic effect and outcomes of US-PCD in patients with liver abscess and septic shock remain unclear. This study is aimed at investigating the effects of ultrasound-guided percutaneous catheter drainage (US-PCD) on the prognosis of patients with liver abscess complicated with septic shock. Method We retrieved and assessed the data of 120 patients with liver abscess complicated with septic shock diagnosed at our hospital from January 2019 to March 2021. The patients underwent US-PCD in the observation group or conventional surgical incision and drainage in the control group. After treatment, we determined the levels of liver function indicators alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), direct bilirubin (DBIL), and alkaline phosphatase (ALP) as well as the levels of inflammatory cytokines IL-6, IL-8, and TNF-α in serum using ELISA on postoperative days 0, 2, 4, and 6. The postoperative body temperature recovery, peripheral white blood cell count recovery, extubation, postoperative length of stay, and complications were recorded, with a 12-month follow-up to calculate their survival rate. Results After treatment, the ALT, AST, TBIL, DBIL, and ALP levels and inflammatory factor levels in the two groups were gradually reduced over time and returned to the normal range with a better recovery trend in the observation group. US-PCD was associated with better postoperative body temperature recovery, peripheral white blood cell count recovery, shorter extubation time, hospital stay, lower postoperative rate, and a higher survival rate. Conclusion US-PCD may be effective in treating liver abscess and can significantly improve the prognosis of patients.
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Del Cura JL, Del Cura G, Zabala R, Korta I. Contrast-enhanced ultrasonography to guide diagnostic and therapeutic interventional procedures. RADIOLOGIA 2022; 64:277-288. [PMID: 35676061 DOI: 10.1016/j.rxeng.2021.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 02/08/2021] [Indexed: 11/18/2022]
Abstract
Although not necessary for the vast majority of ultrasound-guided procedures, intravenous contrast agents can be useful for procedures aimed at lesions that require contrast enhancement to be seen on ultrasonography. Using contrast-enhanced ultrasonography to guide procedures has two drawbacks: first, because enhancement from ultrasound contrast agents is short lived, it is often necessary to plan several injections; second, because the needle is poorly seen on contrast-enhanced ultrasonography, a dual image display format is necessary. Contrast-enhanced ultrasonography can be used for planning and monitoring diagnostic and therapeutic procedures, for guiding the procedures, and for follow-up. Using contrast-enhanced ultrasonography enables better results in both types of procedures; moreover, it can be used within cavities.
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Affiliation(s)
- J L Del Cura
- Servicio de Radiodiagnóstico, Hospital Universitario Donostia, Donostia-San Sebastián, Spain.
| | - G Del Cura
- Servicio de Radiodiagnóstico, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
| | - R Zabala
- Servicio de Radiodiagnóstico, Hospital Universitario Basurto, Bilbao, Bizkaia, Spain
| | - I Korta
- Servicio de Radiodiagnóstico, Hospital Universitario Basurto, Bilbao, Bizkaia, Spain
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Sparchez Z, Mocan T, Craciun R, Sparchez M, Nolsøe C. Contrast enhancement for ultrasound-guided interventions: when to use it and what to expect? Ultrasonography 2022; 41:263-278. [PMID: 35073625 PMCID: PMC8942733 DOI: 10.14366/usg.21207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 12/09/2021] [Indexed: 02/01/2023] Open
Abstract
The use of contrast-enhanced ultrasonography (CEUS) has recently become synonymous with high-standard ultrasonography (US). From expanding the reach of US diagnostics to improving the precision of various invasive procedures, CEUS is rapidly becoming a standard in numerous niches. However, proficiency in CEUS comes with a cost, both from a learning curve and material standpoint, and as every growing field, lacks firm evidence and standardization. Therefore, in the current paper, we aim to provide an evidence-based review of available methods and to discuss the advantages and pitfalls of CEUS in interventional procedures, trying to provide strong evidence whenever available, or at least an educated expert opinion if data are lacking.
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Affiliation(s)
- Zeno Sparchez
- 3rd Medical Department, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.,"Prof. Dr. O. Fodor" Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
| | - Tudor Mocan
- "Prof. Dr. O. Fodor" Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
| | - Rares Craciun
- 3rd Medical Department, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.,"Prof. Dr. O. Fodor" Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
| | - Mihaela Sparchez
- Department of Pediatrics, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Christian Nolsøe
- Center for Surgical Ultrasound, Department of Surgery, Zealand University Hospital, Køge, Denmark.,Copenhagen Academy for Medical Education and Simulation (CAMES), University of Copenhagen and the Capital Region of Denmark, Copenhagen E, Denmark
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Michels G, Horn R, Helfen A, Hagendorff A, Jung C, Hoffmann B, Jaspers N, Kinkel H, Greim CA, Knebel F, Bauersachs J, Busch HJ, Kiefl D, Spiel AO, Marx G, Dietrich CF. [Standardized contrast-enhanced ultrasound (CEUS) in clinical acute and emergency medicine and critical care (CEUS Acute) : Consensus statement of DGIIN, DIVI, DGINA, DGAI, DGK, ÖGUM, SGUM and DEGUM]. Med Klin Intensivmed Notfmed 2022; 117:1-23. [PMID: 35006320 DOI: 10.1007/s00063-021-00891-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The present document describes the possible applications of contrast-enhanced ultrasound (CEUS) in emergency examinations. Guidelines on contrast medium ultrasound in acute and emergency care and intensive care medicine have not yet been published. Evidence-based CEUS guidelines were first provided by the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) and the World Federation for Ultrasound in Medicine and Biology (WFUMB). The presented recommendations describe the possible applications and protocols of CEUS in acute care.
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Affiliation(s)
- Guido Michels
- Klinik für Akut- und Notfallmedizin, St.-Antonius-Hospital gGmbH, Eschweiler, Deutschland. .,Klinik für Akut- und Notfallmedizin, St.-Antonius-Hospital gGmbH, Akademisches Lehrkrankenhaus der RWTH Aachen, Dechant-Deckers-Str. 8, 52249, Eschweiler, Deutschland.
| | - Rudolf Horn
- Center da sandà Val Müstair, Notfallmedizin, Sta. Maria Val Müstair, Schweiz
| | - Andreas Helfen
- St.-Marien-Hospital Lünen, Medizinische Klinik I, Katholisches Klinikum Lünen Werne GmbH, Lünen, Deutschland
| | - Andreas Hagendorff
- Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Leipzig, Deutschland
| | - Christian Jung
- Klinik für Kardiologie, Pneumologie und Angiologie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
| | - Beatrice Hoffmann
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Natalie Jaspers
- Klinik für Gastroenterologie und Hepatologie, Universitätsklinikum Köln, Köln, Deutschland
| | - Horst Kinkel
- Praxis für Gastroenterologie, Düren, Deutschland
| | - Clemens-Alexander Greim
- Klinik für Anästhesiologie, Intensiv- und Notfallmedizin, Klinikum Fulda, Pacelliallee 4, 36043, Fulda, Deutschland
| | - Fabian Knebel
- Klinik für Innere Medizin, Sana Klinikum Lichtenberg, Berlin, Deutschland
| | - Johann Bauersachs
- Klinik für Kardiologie und Angiologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Hans-Jörg Busch
- Universitätsklinikum, Universitäts-Notfallzentrum, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
| | - Daniel Kiefl
- Klinik für Interdisziplinäre Notfallmedizin, Sana Klinikum Offenbach, Offenbach am Main, Deutschland
| | - Alexander O Spiel
- Klinik Ottakring, Zentrale Notaufnahme, Wiener Gesundheitsverbund, Wien, Österreich
| | - Gernot Marx
- Klinik für operative Intensivmedizin, Universitätsklinikum Aachen, Aachen, Deutschland
| | - Christoph F Dietrich
- Department für Allgemeine Innere Medizin Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Schweiz. .,Department Allgemeine Innere Medizin DAIM, Schänzlihalde 11, 3013, Bern, Schweiz.
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7
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Jung EM, Jung F, Stroszczynski C, Wiesinger I. Dynamic endoluminal contrast enhanced ultrasound (CEUS) for display of drainages in inflammatory abdominal fluid collections1. Clin Hemorheol Microcirc 2022; 80:49-59. [PMID: 35001884 DOI: 10.3233/ch-211370] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
AIM To evaluate the additive clinical value of endoluminal contrast enhanced ultrasound (CEUS) after interventional placement of drainages in abdominal fluid collections. MATERIAL/METHOD Examination of 30 patients using a 1-6 MHz convex probe (Resona 7, Mindray) to locate the fluid collection in B-Mode. Additionally, dynamic endoluminal CEUS with 1 ml sulphur-hexafluoride microbubbles was performed to measure the extent of the percutaneously drained abscesses. Independent assessment of dynamically stored images in PACS in DICOM format. Correlation to reference imaging using computed tomography (CT). RESULTS A total of 30 patients were examined (17 m, 19-78 years, mean 56.1 years). Drainages were positioned in the liver in 15 cases, in the pelvis after kidney transplantation in 4 cases, close to the spleen in 1 case and in the abdomen in 10 cases. In all cases abscesses showed marginal hyperaemia with reactive septations in CEUS. The drainage position was assessed by means of B-mode in all cases first and then by CEUS. In 4 cases CEUS showed a fistula to the pleura, in 5 cases to the peritoneum, in 2 cases to the intestine, in 5 cases to the biliary tract, corresponding to the CT. In 2 cases there was a hint of an anastomotic leakage after intestinal anastomosis, which was reliably detected by CT. The drainage was removed in 11 cases within a period of 2 to 5 days after CEUS control, in 9 cases within a period of 5 to 10 days. Another operation was necessary in 3 cases. A new drainage was placed in 2 cases. The required amount of contrast medium is 1 ml endoluminally diluted to 9 ml sodium chloride. CONCLUSION CEUS facilitates the exact localization and characterization of inflammatory abdominal fluid collections. Furthermore, possible fistulas can be detected that cannot be seen with conventional ultrasound.
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Affiliation(s)
- E M Jung
- Department of Radiology, University Medical Center Regensburg, Germany
| | - F Jung
- Institute of Biotechnology, Molecular Cell Biology, Brandenburg University of Technology, Senftenberg, Germany
| | - C Stroszczynski
- Department of Radiology, University Medical Center Regensburg, Germany
| | - I Wiesinger
- Department of Radiology, University Medical Center Regensburg, Germany
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Nielsen MB, Søgaard SB, Bech Andersen S, Skjoldbye B, Hansen KL, Rafaelsen S, Nørgaard N, Carlsen JF. Highlights of the development in ultrasound during the last 70 years: A historical review. Acta Radiol 2021; 62:1499-1514. [PMID: 34791887 DOI: 10.1177/02841851211050859] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This review looks at highlights of the development in ultrasound, ranging from interventional ultrasound and Doppler to the newest techniques like contrast-enhanced ultrasound and elastography, and gives reference to some of the valuable articles in Acta Radiologica. Ultrasound equipment is now available in any size and for any purpose, ranging from handheld devices to high-end devices, and the scientific societies include ultrasound professionals of all disciplines publishing guidelines and recommendations. Interventional ultrasound is expanding the field of use of ultrasound-guided interventions into nearly all specialties of medicine, from ultrasound guidance in minimally invasive robotic procedures to simple ultrasound-guided punctures performed by general practitioners. Each medical specialty is urged to define minimum requirements for equipment, education, training, and maintenance of skills, also for medical students. The clinical application of contrast-enhanced ultrasound and elastography is a topic often seen in current research settings.
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Affiliation(s)
- Michael Bachmann Nielsen
- Department of Radiology, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Stinne Byrholdt Søgaard
- Department of Radiology, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sofie Bech Andersen
- Department of Radiology, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bjørn Skjoldbye
- Department of Radiology, Aleris-Hamlet Hospitals, Copenhagen Denmark
| | - Kristoffer Lindskov Hansen
- Department of Radiology, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Søren Rafaelsen
- Department of Radiology, University Hospital of Southern Denmark, Vejle, Denmark
- Faculty of Health Sciences, Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Nis Nørgaard
- Department of Urology, Herlev Gentofte Hospital, Copenhagen, Denmark
| | - Jonathan F. Carlsen
- Department of Radiology, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Del Cura JL, Del Cura G, Zabala R, Korta I. Contrast-enhanced ultrasonography to guide diagnostic and therapeutic interventional procedures. RADIOLOGIA 2021; 64:S0033-8338(21)00067-9. [PMID: 33773773 DOI: 10.1016/j.rx.2021.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 01/23/2021] [Accepted: 02/08/2021] [Indexed: 10/21/2022]
Abstract
Although not necessary for the vast majority of ultrasound-guided procedures, intravenous contrast agents can be useful for procedures aimed at lesions that require contrast enhancement to be seen on ultrasonography. Using contrast-enhanced ultrasonography to guide procedures has two drawbacks: first, because enhancement from ultrasound contrast agents is short lived, it is often necessary to plan several injections; second, because the needle is poorly seen on contrast-enhanced ultrasonography, a dual image display format is necessary. Contrast-enhanced ultrasonography can be used for planning and monitoring diagnostic and therapeutic procedures, for guiding the procedures, and for follow-up. Using contrast-enhanced ultrasonography enables better results in both types of procedures; moreover, it can be used within cavities.
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Affiliation(s)
- J L Del Cura
- Servicio de Radiodiagnóstico, Hospital Universitario Donostia, Donostia-San Sebastián, España.
| | - G Del Cura
- Servicio de Radiodiagnóstico, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, España
| | - R Zabala
- Servicio de Radiodiagnóstico, Hospital Universitario Basurto, Bilbao, Bizkaia, España
| | - I Korta
- Servicio de Radiodiagnóstico, Hospital Universitario Basurto, Bilbao, Bizkaia, España
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10
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Beckmann S, Simanowski JH. Update in Contrast-Enhanced Ultrasound. Visc Med 2020; 36:476-486. [PMID: 33447604 PMCID: PMC7768106 DOI: 10.1159/000511352] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 09/03/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The aim of modern medicine is to safely classify diseases for successful therapy without invasive measures. Sonography, computed tomography (CT), and magnetic resonance imaging (MRI) are potent imaging techniques. However, without contrast medium, the informative value of the 3 native methods is limited. The advantages of sonography are: no radiation exposure or previously known physically harmful interactions with tissue, proportionate disappearance of a contrast agent risk, no (probably irreversible) contrast agent deposits, and no risk of renal insufficiency. But, is that enough to compete with of even exceed CT and MRI? SUMMARY In this review, the state of the art of contrast-enhanced ultrasound (CEUS) in the abdominal cavity is presented. The remarkable diagnostic possibilities can unfortunately only be demonstrated here in a small number of impressive, typical case studies underpinned by the literature, so that, from one's own perspective, the full spectrum of CEUS can be used by oneself or initiated. Within the limits of physics, the real-time dynamics of CEUS enable conclusions to be drawn, so that with the current technology, sonography, including expansion by contrast, can be considered superior to other imaging methods. It is not uncommon for CEUS to have the value of a control and reference method. KEY MESSAGES Sonography very often enables reliable diagnostics. The introduction of a contrast agent in sonography has led to a quantum leap similar to that of other imaging techniques. Already natively, the real-time representation of dynamic events leads to a certain superiority, i.e., complete observation of the inflow and outflow phases of the contrast medium and the resulting diagnostic; tissue-specific differentiation options provide a unique selling point. Further advantages of the first-choice imaging diagnostic method are: a lack of radiation exposure, repeatability of the examination at any time, local independence, a negligible allergy rate compared to the contrast agents of other methods, and a lack of kidney and thyroid exposure or excluded deposits.
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Affiliation(s)
| | - Jörg H. Simanowski
- Clinic for General, Visceral, Vascular and Obesity Surgery and Interdisciplinary Emergency Center of the Nordstadt Clinic of the Hannover Region Clinic, Hannover, Germany
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11
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Dietrich CF, Nolsøe CP, Barr RG, Berzigotti A, Burns PN, Cantisani V, Chammas MC, Chaubal N, Choi BI, Clevert DA, Cui X, Dong Y, D'Onofrio M, Fowlkes JB, Gilja OH, Huang P, Ignee A, Jenssen C, Kono Y, Kudo M, Lassau N, Lee WJ, Lee JY, Liang P, Lim A, Lyshchik A, Meloni MF, Correas JM, Minami Y, Moriyasu F, Nicolau C, Piscaglia F, Saftoiu A, Sidhu PS, Sporea I, Torzilli G, Xie X, Zheng R. Guidelines and Good Clinical Practice Recommendations for Contrast Enhanced Ultrasound (CEUS) in the Liver - Update 2020 - WFUMB in Cooperation with EFSUMB, AFSUMB, AIUM, and FLAUS. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2020; 41:562-585. [PMID: 32707595 DOI: 10.1055/a-1177-0530] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The present, updated document describes the fourth iteration of recommendations for the hepatic use of contrast enhanced ultrasound (CEUS), first initiated in 2004 by the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB). The previous updated editions of the guidelines reflected changes in the available contrast agents and updated the guidelines not only for hepatic but also for non-hepatic applications.The 2012 guideline requires updating as previously the differences of the contrast agents were not precisely described and the differences in contrast phases as well as handling were not clearly indicated. In addition, more evidence has been published for all contrast agents. The update also reflects the most recent developments in contrast agents, including the United States Food and Drug Administration (FDA) approval as well as the extensive Asian experience, to produce a truly international perspective.These guidelines and recommendations provide general advice on the use of ultrasound contrast agents (UCA) and are intended to create standard protocols for the use and administration of UCA in liver applications on an international basis to improve the management of patients.
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Affiliation(s)
- Christoph F Dietrich
- Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
- Johann Wolfgang Goethe Universitätsklinik Frankfurt, Germany
| | - Christian Pállson Nolsøe
- Center for Surgical Ultrasound, Dep of Surgery, Zealand University Hospital, Køge. Copenhagen Academy for Medical Education and Simulation (CAMES). University of Copenhagen, Denmark
| | - Richard G Barr
- Department of Radiology, Northeastern Ohio Medical University, Rootstown, Ohio, USA and Southwoods Imaging, Youngstown, Ohio, USA
| | - Annalisa Berzigotti
- Hepatology, University Clinic for Visceral Surgery and Medicine, DBMR, Inselspital, University of Bern, Switzerland
| | - Peter N Burns
- Dept Medical Biophysics, University of Toronto, Imaging Research, Sunnybrook Research Institute, Toronto
| | - Vito Cantisani
- Uos Ecografia Internistico-chirurgica, Dipartimento di Scienze Radiologiche, Oncologiche, Anatomo-Patologiche, Policlinico Umberto I, Univ. Sapienza, Rome, Italy
| | - Maria Cristina Chammas
- Institute of Radiology, Hospital das Clínicas, School of Medicine, University of São Paulo, Brazil
| | - Nitin Chaubal
- Thane Ultrasound Centre, Jaslok Hospital and Research Centre, Mumbai, India
| | - Byung Ihn Choi
- Department of Radiology, Chung-Ang University Hospital, Seoul, Korea
| | - Dirk-André Clevert
- Interdisciplinary Ultrasound-Center, Department of Radiology, University of Munich-Grosshadern Campus, Munich, Germany
| | - Xinwu Cui
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan China
| | - Yi Dong
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Mirko D'Onofrio
- Department of Radiology, G.B. Rossi University Hospital, University of Verona, Verona, Italy
| | - J Brian Fowlkes
- Basic Radiological Sciences Division, Department of Radiology, University of Michigan Health System, Ann Arbor, MI, United States
| | - Odd Helge Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, and Department of Clinical Medicine, University of Bergen, Norway
| | - Pintong Huang
- Department of Ultrasound in Medicine, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Andre Ignee
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - Christian Jenssen
- Krankenhaus Märkisch Oderland, Department of Internal Medicine, Strausberg/Wriezen, Germany
| | - Yuko Kono
- Departments of Medicine and Radiology, University of California, San Diego, USA
| | - Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Nathalie Lassau
- Imaging Department. Gustave Roussy and BIOMAPS. Université Paris-Saclay, Villejuif, France
| | - Won Jae Lee
- Department of Radiology and Center For Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Departments of Health and Science and Technology and Medical Device Management and Research, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Korea
| | - Jae Young Lee
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Adrian Lim
- Department of Imaging, Imperial College London and Healthcare NHS Trust, Charing Cross Hospital Campus, London United Kingdom
| | - Andrej Lyshchik
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA, United States
| | | | - Jean Michel Correas
- Service de Radiologie Adultes, Hôpital Necker, Université Paris Descartes, Paris, France
| | - Yasunori Minami
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Fuminori Moriyasu
- Center for Cancer Ablation Therapy, Sanno Hospital, International University of Health and Welfare, Tokyo, Japan
| | - Carlos Nicolau
- Radiology Department, Hospital Clinic. University of Barcelona, Barcelona, Spain
| | - Fabio Piscaglia
- Unit of Internal Medicine, Dept of Medical and Surgical Sciences, University of Bologna S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Adrian Saftoiu
- Research Center of Gastroenterology and Hepatology Craiova, University of Medicine and Pharmacy Craiova, Romania
| | - Paul S Sidhu
- Department of Radiology, King's College Hospital, King's College London, London
| | - Ioan Sporea
- Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania
| | - Guido Torzilli
- Department of Surgery, Division of Hepatobiliary & General Surgery, Humanitas University & Research Hospital, Rozzano, Milano, Italy
| | - Xiaoyan Xie
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Rongqin Zheng
- Department of Ultrasound, The 3rd Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Dietrich CF, Nolsøe CP, Barr RG, Berzigotti A, Burns PN, Cantisani V, Chammas MC, Chaubal N, Choi BI, Clevert DA, Cui X, Dong Y, D'Onofrio M, Fowlkes JB, Gilja OH, Huang P, Ignee A, Jenssen C, Kono Y, Kudo M, Lassau N, Lee WJ, Lee JY, Liang P, Lim A, Lyshchik A, Meloni MF, Correas JM, Minami Y, Moriyasu F, Nicolau C, Piscaglia F, Saftoiu A, Sidhu PS, Sporea I, Torzilli G, Xie X, Zheng R. Guidelines and Good Clinical Practice Recommendations for Contrast-Enhanced Ultrasound (CEUS) in the Liver-Update 2020 WFUMB in Cooperation with EFSUMB, AFSUMB, AIUM, and FLAUS. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:2579-2604. [PMID: 32713788 DOI: 10.1016/j.ultrasmedbio.2020.04.030] [Citation(s) in RCA: 201] [Impact Index Per Article: 50.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 04/16/2020] [Accepted: 04/24/2020] [Indexed: 05/14/2023]
Abstract
The present, updated document describes the fourth iteration of recommendations for the hepatic use of contrast-enhanced ultrasound, first initiated in 2004 by the European Federation of Societies for Ultrasound in Medicine and Biology. The previous updated editions of the guidelines reflected changes in the available contrast agents and updated the guidelines not only for hepatic but also for non-hepatic applications. The 2012 guideline requires updating as, previously, the differences in the contrast agents were not precisely described and the differences in contrast phases as well as handling were not clearly indicated. In addition, more evidence has been published for all contrast agents. The update also reflects the most recent developments in contrast agents, including U.S. Food and Drug Administration approval and the extensive Asian experience, to produce a truly international perspective. These guidelines and recommendations provide general advice on the use of ultrasound contrast agents (UCAs) and are intended to create standard protocols for the use and administration of UCAs in liver applications on an international basis to improve the management of patients.
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Affiliation(s)
- Christoph F Dietrich
- Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland; Johann Wolfgang Goethe Universitätsklinik, Frankfurt, Germany.
| | - Christian Pállson Nolsøe
- Center for Surgical Ultrasound, Dep of Surgery, Zealand University Hospital, Køge. Copenhagen Academy for Medical Education and Simulation (CAMES). University of Copenhagen, Denmark
| | - Richard G Barr
- Department of Radiology, Northeastern Ohio Medical University, Rootstown, Ohio, USA; Southwoods Imaging, Youngstown, Ohio, USA
| | - Annalisa Berzigotti
- Hepatology, University Clinic for Visceral Surgery and Medicine, DBMR, Inselspital, University of Bern, Switzerland
| | - Peter N Burns
- Department of Medical Biophysics, University of Toronto, Imaging Research, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Vito Cantisani
- Uos Ecografia Internistico-chirurgica, Dipartimento di Scienze Radiologiche, Oncologiche, Anatomo-Patologiche, Policlinico Umberto I, Univ. Sapienza, Rome, Italy
| | - Maria Cristina Chammas
- Institute of Radiology, Hospital das Clínicas, School of Medicine, University of São Paulo, Brazil
| | - Nitin Chaubal
- Thane Ultrasound Centre, Jaslok Hospital and Research Centre, Mumbai, India
| | - Byung Ihn Choi
- Department of Radiology, Chung-Ang University Hospital, Seoul, Korea
| | - Dirk-André Clevert
- Interdisciplinary Ultrasound-Center, Department of Radiology, University of Munich-Grosshadern Campus, Munich, Germany
| | - Xinwu Cui
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Dong
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Mirko D'Onofrio
- Department of Radiology, G. B. Rossi University Hospital, University of Verona, Verona, Italy
| | - J Brian Fowlkes
- Basic Radiological Sciences Division, Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Odd Helge Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, and Department of Clinical Medicine, University of Bergen, Norway
| | - Pintong Huang
- Department of Ultrasound in Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Andre Ignee
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - Christian Jenssen
- Krankenhaus Märkisch Oderland, Department of Internal Medicine, Strausberg/Wriezen, Germany
| | - Yuko Kono
- Departments of Medicine and Radiology, University of California, San Diego, California, USA
| | - Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Nathalie Lassau
- Imaging Department, Gustave Roussy and BIOMAPS, Université Paris-Saclay, Villejuif, France
| | - Won Jae Lee
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Departments of Health and Science and Technology and Medical Device Management and Research, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Korea
| | - Jae Young Lee
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Adrian Lim
- Department of Imaging, Imperial College London and Healthcare NHS Trust, Charing Cross Hospital Campus, London, United Kingdom
| | - Andrej Lyshchik
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | | | - Jean Michel Correas
- Service de Radiologie Adultes, Hôpital Necker, Université Paris Descartes, Paris, France
| | - Yasunori Minami
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Fuminori Moriyasu
- Center for Cancer Ablation Therapy, Sanno Hospital, International University of Health and Welfare, Tokyo, Japan
| | - Carlos Nicolau
- Radiology Department, Hospital Clinic. University of Barcelona, Barcelona, Spain
| | - Fabio Piscaglia
- Unit of Internal Medicine, Department of Medical and Surgical Sciences, University of Bologna S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Adrian Saftoiu
- Research Center of Gastroenterology and Hepatology Craiova, University of Medicine and Pharmacy Craiova, Romania
| | - Paul S Sidhu
- Department of Radiology, King's College Hospital, King's College London, London, United Kingdom
| | - Ioan Sporea
- Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania
| | - Guido Torzilli
- Department of Surgery, Division of Hepatobiliary & General Surgery, Humanitas University & Research Hospital, Rozzano, Milan, Italy
| | - Xiaoyan Xie
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Rongqin Zheng
- Department of Ultrasound, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
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Intracavitary contrast-enhanced ultrasound in ultrasound-guided percutaneous management of abdominal fluid collections/abscesses by a single clinician: an example of point-of-care ultrasound. J Ultrasound 2020; 23:175-181. [PMID: 32361920 DOI: 10.1007/s40477-020-00467-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 04/20/2020] [Indexed: 12/21/2022] Open
Abstract
PURPOSE To assess the role of intracavitary contrast-enhanced ultrasound (IC-CEUS) as a focused ultrasound (US) examination aimed at supporting a single physician in the management of interventional procedures for abdominal fluid collections/abscesses. METHODS In 43 patients (27 M/16 F, median age 68 years, range 35-91), a single physician performed catheter drainage (42) or needle aspiration (3) for the following: 14 infected abdominal fluid collections, 11 non-infected abdominal fluid collections, 9 pyogenic liver abscesses, 8 gallbladder empyema, and 3 infected pancreatic fluid collections. IC-CEUS (0.1-0.2 mL of SonoVue in 20 mL of saline) was carried out during catheter/needle placement and during the follow-up for catheters left in place. RESULTS Immediate IC-CEUS allowed to verify the (1) correct positioning of the needle/catheter inside the target in all cases and (2) communication with adjacent structures so as to choose a proper treatment in 21% of the cases. Follow-up IC-CEUS aided in the management of 40 catheters left in place. Appropriate treatment was implemented in 19.3% of the cases because of the presence of biliary fistulas and gallbladder perforation. IC-CEUS helped the physician with the appropriate timing of catheter removal by providing information on catheter malfunction (due to obstruction/dislodgement) and the size of residual undrained cavities. No side effects were registered following IC-CEUS. CONCLUSION Even if not strictly performed at bedside, IC-CEUS may represent an example of point-of-care ultrasound since it allows an interventional clinician to assess needle/catheter placement success, make treatment decisions, and choose the optimal timing for catheter removal with low costs and without side effects.
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14
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Kessner R, Nakamoto DA, Kondray V, Partovi S, Ahmed Y, Azar N. Contrast-Enhanced Ultrasound Guidance for Interventional Procedures. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:2541-2557. [PMID: 30714653 DOI: 10.1002/jum.14955] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 01/03/2019] [Indexed: 06/09/2023]
Abstract
Since its introduction, contrast-enhanced ultrasound (CEUS) has gained an important role in the diagnosis and management of abdominal and pelvic diseases. Contrast-enhanced ultrasound can improve lesion detection rates as well as success rates of interventional procedures when compared to conventional ultrasound alone. Additionally, CEUS enables the interventionalist to assess the dynamic enhancement of different tissues and lesions, without the adverse effects of contrast-enhanced computed tomography, such as exposure to ionizing radiation and nephrotoxicity from iodinated contrast material. This review article describes the various applications and advantages of the use of CEUS to enhance performance of ultrasound-guided interventions in the abdomen and pelvis.
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Affiliation(s)
- Rivka Kessner
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Dean A Nakamoto
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Victor Kondray
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Sasan Partovi
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Yasmine Ahmed
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Nami Azar
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
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Marenga G, Traficante S, Ragonici S, Vincenzi C, Rocchetti M, De Rito G, Fonsi GB, Messineo D. Successful Diagnosis of a Longstanding Giant Amoebic Liver Abscess Using Contrast-Enhanced Ultrasonography (CEUS): A Case Report in a Western Country. AMERICAN JOURNAL OF CASE REPORTS 2019; 20:493-498. [PMID: 30969949 PMCID: PMC6474154 DOI: 10.12659/ajcr.914378] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND E. histolytica liver abscess results from extra-intestinal diffusion of amebiasis, which is responsible for up 100 000 deaths per annum, placing it second only to malaria in mortality. Currently, the criterion standard for the diagnosis of liver abscesses is ultrasound, but CEUS (contrast-enhanced ultrasound) is emerging as a more accurate method for liver study, and it could be more accurate than ultrasound and non-invasive compared to CT. CASE REPORT A white man (59 years old) with a 2-day history of dyspnea, acute abdominal pain in right upper quadrant, and raised inflammatory markers was admitted to a second-level Emergency Department in Rome (Italy). He reported several trips to tropical areas many years before, during which he ingested non-potable water and became infected with Entamoeba histolytica. This was treated medically with success. After administration of antibiotics (meropenem and metronidazole), a liver CEUS (contrast-enhanced ultrasonography) with administration of SonoVue (sulphur hexafluoride microbubbles) confirmed a giant liver abscess (15×16 cm). One day later, CT-guided drainage was performed without complications and the patient was discharged on the 25th post-procedure day, with improved blood results. CONCLUSIONS Acute abdominal pain can be caused by a variety of diseases, but a diagnosis of parasitic abscess should not be overlooked in non-endemic Western countries. CEUS is a new, promising, and more accurate technique that can be utilized to recognize liver abnormalities, including abscesses; however, retrospective population-wide studies are necessary to define the differential diagnoses.
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Affiliation(s)
- Giuseppe Marenga
- Department of Emergency, Sapienza University of Rome, Rome, Italy
| | | | - Serena Ragonici
- Department of Emergency, Sapienza University of Rome, Rome, Italy
| | - Claudia Vincenzi
- Department of Emergency, Sapienza University of Rome, Rome, Italy
| | - Maura Rocchetti
- Department of Emergency, Sapienza University of Rome, Rome, Italy
| | - Giuseppe De Rito
- Department of Emergency, Sapienza University of Rome, Rome, Italy
| | | | - Daniela Messineo
- Department of Radiological Sciences, Oncology and Anatomo-Pathological Science, Sapienza University of Rome, Rome, Italy
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16
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Nolsøe CP, Nolsøe AB, Klubien J, Pommergaard HC, Rosenberg J, Meloni MF, Lorentzen T. Use of Ultrasound Contrast Agents in Relation to Percutaneous Interventional Procedures: A Systematic Review and Pictorial Essay. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:1305-1324. [PMID: 29230842 DOI: 10.1002/jum.14498] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 08/28/2017] [Accepted: 09/08/2017] [Indexed: 06/07/2023]
Abstract
The aim of this article is to provide an inventory of the use of contrast-enhanced ultrasound (CEUS) in relation to percutaneous interventional procedures. The article is structured into a systematic literature review followed by a clinical part relating to percutaneous CEUS-guided procedures. A literature search identified 3109 records. After abstract screening, 55 articles were analyzed and supplemented with pictorial material to explain the techniques. In conclusion, the best-evidenced indications for CEUS-guided interventions are biopsy and ablation of inconspicuous or B-mode-invisible tumors, intraprocedural ablation control and follow-up, as well as percutaneous transhepatic cholangiography and drainage procedures.
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Affiliation(s)
- Christian Pállson Nolsøe
- Ultrasound Section, Division of Surgery, Department of Gastroenterology, Herlev Hospital, and Copenhagen Academy for Medical Education and Simulation, University of Copenhagen, Herlev, Denmark
| | - Alexander Bjørneboe Nolsøe
- Center for Perioperative Optimization, Department of Surgery, Herlev Hospital, and Copenhagen Academy for Medical Education and Simulation, University of Copenhagen, Herlev, Denmark
| | - Jeanett Klubien
- Center for Perioperative Optimization, Department of Surgery, Herlev Hospital, and Copenhagen Academy for Medical Education and Simulation, University of Copenhagen, Herlev, Denmark
| | - Hans-Christian Pommergaard
- Department of Surgical Gastroenterology and Transplantation, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jacob Rosenberg
- Center for Perioperative Optimization, Department of Surgery, Herlev Hospital, and Copenhagen Academy for Medical Education and Simulation, University of Copenhagen, Herlev, Denmark
| | - Maria Franca Meloni
- Interventional Ultrasound Section, Department of Radiology, Institute of Care Igea, Milan, Italy
- University of Wisconsin Hospital and Clinics, Madison, Wisconsin, USA
| | - Torben Lorentzen
- Ultrasound Section, Division of Surgery, Department of Gastroenterology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
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17
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Dietrich CF, Averkiou M, Nielsen MB, Barr RG, Burns PN, Calliada F, Cantisani V, Choi B, Chammas MC, Clevert DA, Claudon M, Correas JM, Cui XW, Cosgrove D, D'Onofrio M, Dong Y, Eisenbrey J, Fontanilla T, Gilja OH, Ignee A, Jenssen C, Kono Y, Kudo M, Lassau N, Lyshchik A, Franca Meloni M, Moriyasu F, Nolsøe C, Piscaglia F, Radzina M, Saftoiu A, Sidhu PS, Sporea I, Schreiber-Dietrich D, Sirlin CB, Stanczak M, Weskott HP, Wilson SR, Willmann JK, Kim TK, Jang HJ, Vezeridis A, Westerway S. How to perform Contrast-Enhanced Ultrasound (CEUS). Ultrasound Int Open 2018; 4:E2-E15. [PMID: 29423461 PMCID: PMC5802984 DOI: 10.1055/s-0043-123931] [Citation(s) in RCA: 183] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 11/27/2017] [Accepted: 11/29/2017] [Indexed: 02/06/2023] Open
Abstract
"How to perform contrast-enhanced ultrasound (CEUS)" provides general advice on the use of ultrasound contrast agents (UCAs) for clinical decision-making and reviews technical parameters for optimal CEUS performance. CEUS techniques vary between centers, therefore, experts from EFSUMB, WFUMB and from the CEUS LI-RADS working group created a discussion forum to standardize the CEUS examination technique according to published evidence and best personal experience. The goal is to standardise the use and administration of UCAs to facilitate correct diagnoses and ultimately to improve the management and outcomes of patients.
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Affiliation(s)
- Christoph F. Dietrich
- Caritas-Krankenhaus, Medizinische Klinik 2, Bad Mergentheim, Germany and Ultrasound Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | | | | | - Richard G. Barr
- Radiology, Northeastern Ohio Medical University, Rootstown, United States
| | - Peter N. Burns
- Dept Medical Biophysics, University of Toronto. Sunnybrook Research Institute, Toronto, Canada
| | - Fabrizio Calliada
- Policlinico San Matteo, University of Pavia, Department of Radiology, Pavia, Italy
| | - Vito Cantisani
- Department of Radiology, "Sapienza" University of Rome, ROME, Italy
| | - Byung Choi
- Department of Radiology, Chung-Ang University Hosptial, Seoul, Korea (the Republic of)
| | - Maria C. Chammas
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Instituto de Radiologia, São Paulo, Brazil
| | - Dirk-André Clevert
- Department of Clinical Radiology, University of Munich-Grosshadern Campus, Munich, Germany
| | - Michel Claudon
- Department of Pediatric Radiology, Centre Hospitalier Universitaire de Nancy and Université de Lorraine, Vandoeuvre, France
| | - Jean-Michel Correas
- Hopital universitaire Necker-Enfants malades, Service de Radiologie Adultes, Paris, France
| | - Xin-Wu Cui
- Department of Medical Ultrasound, Tongji Hospital of Tongji Medical college, Huahzong University of Science and technology, Wuhan, China
| | - David Cosgrove
- Imperial College London, Imaging, London, United Kingdom of Great Britain and Northern Ireland
| | | | - Yi Dong
- Department of Ultrasound, Zhongshan Hospital, Fudan University, 200032 Shanghai, China
| | - JohnR. Eisenbrey
- Department of Radiology, Thomas Jefferson University, Philadelphia, United States
| | - Teresa Fontanilla
- Radiology, Hospital Universitario Puerta del Hierro Majadahonda, Majadahonda, Spain
| | - Odd Helge Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen and Department of Clinical Medicine, University of Bergen, Norway
| | - Andre Ignee
- Department of Medical Ultrasound, Tongji Hospital of Tongji Medical college, Huahzong University of Science and technology, Wuhan, China
| | - Christian Jenssen
- Krankenhaus Märkisch Oderland Strausberg/ Wriezen, Klinik für Innere Medizin, Wriezen, Germany
| | - Yuko Kono
- Department of Medicine and Radiology, University of California, San Diego, United States
| | - Masatoshi Kudo
- Kinki Daigaku Igakubu, Department Gastroenterology and Hepatology, Osakasayama, Osaka, Japan
| | - Nathalie Lassau
- Gustave Roussy and IR4MUMR8081. Université Paris-Sud, Université Paris-Saclay, Radiology, Paris, France
| | - Andrej Lyshchik
- Department of Radiology, Thomas Jefferson University, Philadelphia, United States
| | - Maria Franca Meloni
- Radiology Department of Interventional Ultrasound - Casa di cura Igea- Milano, Italy
| | - Fuminori Moriyasu
- Sanno Hospital,International University of Helth and Welfare, Center for Cancer Ablation Therapy, Tokyo, Japan
| | - Christian Nolsøe
- Ultrasound Section, Division of Surgery, Dep. of Gastroenterology, Herlev Hospital Copenhagen Academy for Medical Education and Simulation (CAMES), University of Copenhagen, Denmark
| | - Fabio Piscaglia
- Div. Internal Medicine, Dept of Medical and Surgical Sciences, Bologna, Italy
| | - Maija Radzina
- P.Stradina Clinical University Hospital, Diagnosic Radiology Institute, Riga, Latvia
| | - Adrian Saftoiu
- Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Paul S. Sidhu
- King's College London, Radiology, London, United Kingdom of Great Britain and Northern Ireland
| | - Ioan Sporea
- Gastroenterology, University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | | | - Claude B. Sirlin
- Liver Imaging Grup, University of California, Department of Radiology, San Diego, United States
| | - Maria Stanczak
- Department of Radiology, Thomas Jefferson University, Philadelphia, United States
| | | | - Stephanie R. Wilson
- Department of Radiology, Foothills Medical Centre University of Calgary, Division of Ultrasound, Calgary, Canada
| | | | - Tae Kyoung Kim
- Department of Medical Imaging, University of Toronto, Toronto, Canada
| | - Hyun-Jung Jang
- Department of Medical Imaging, University of Toronto, Toronto, Canada
| | | | - Sue Westerway
- Ultrasound, Charles Sturt University NSW Australia, NSW, Australia
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18
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Atkinson NSS, Bryant RV, Dong Y, Maaser C, Kucharzik T, Maconi G, Asthana AK, Blaivas M, Goudie A, Gilja OH, Nuernberg D, Schreiber-Dietrich D, Dietrich CF. How to perform gastrointestinal ultrasound: Anatomy and normal findings. World J Gastroenterol 2017; 23:6931-6941. [PMID: 29097866 PMCID: PMC5658311 DOI: 10.3748/wjg.v23.i38.6931] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 05/30/2017] [Accepted: 06/19/2017] [Indexed: 02/06/2023] Open
Abstract
Gastrointestinal ultrasound is a practical, safe, cheap and reproducible diagnostic tool in inflammatory bowel disease gaining global prominence amongst clinicians. Understanding the embryological processes of the intestinal tract assists in the interpretation of abnormal sonographic findings. In general terms, the examination principally comprises interrogation of the colon, mesentery and small intestine using both low-frequency and high-frequency probes. Interpretation of findings on GIUS includes assessment of bowel wall thickness, symmetry of this thickness, evidence of transmural changes, assessment of vascularity using Doppler imaging and assessment of other specific features including lymph nodes, mesentery and luminal motility. In addition to B-mode imaging, transperineal ultrasonography, elastography and contrast-enhanced ultrasonography are useful adjuncts. This supplement expands upon these features in more depth.
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Affiliation(s)
- Nathan S S Atkinson
- Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, United Kingdom
| | - Robert V Bryant
- School of Medicine, University of Adelaide, Adelaide, South Australia, 5005, Australia
- Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide 5000, Australia
| | - Yi Dong
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Christian Maaser
- Ambulanzzentrum Gastroenterologie, Klinikum Lüneburg, 21339 Lüneburg, Germany
| | - Torsten Kucharzik
- Department of Gastroenterology, Städtisches Klinikum Luneburg gGmbH, 21339 Lüneburg, Germany
| | - Giovanni Maconi
- Gastrointestinal Unit, Department of Biomedical and Clinical Sciences, “L.Sacco” University Hospital, 20157 Milan, Italy
| | - Anil K Asthana
- Department of Gastroenterology and Hepatology, The Alfred Hospital, Melbourne, Vic, Australia; Monash University, Melbourne 3004 Vic, Australia
| | - Michael Blaivas
- Piedmont Hospital, Department of Emergency Medicine, Atlanta, GA 30076, United States
| | - Adrian Goudie
- Fremantle Hospital and Health Service, Emergency Department, Fremantle, WA 6160, United States
| | - Odd Helge Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen N-5021, Norway
- Department of Clinical Medicine, University of Bergen, 5021 Bergen, Norway
| | - Dieter Nuernberg
- Department of Gastroenterology, Brandenburg Medical School, 16816 Neuruppin, Germany
| | | | - Christoph F Dietrich
- Med. Klinik 2, Caritas-Krankenhaus Bad Mergentheim, D-97980 Bad Mergentheim, Germany
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Dietrich CF, Dong Y, Jenssen C, Ciaravino V, Hocke M, Wang WP, Burmester E, Moeller K, Atkinson NSS, Capelli P, D’Onofrio M. Serous pancreatic neoplasia, data and review. World J Gastroenterol 2017; 23:5567-5578. [PMID: 28852316 PMCID: PMC5558120 DOI: 10.3748/wjg.v23.i30.5567] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 06/08/2017] [Accepted: 07/24/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To describe the imaging features of serous neoplasms of the pancreas using ultrasound, endoscopic ultrasound, computed tomography and magnetic resonance imaging.
METHODS This multicenter international collaboration enhances a literature review to date, reporting features of 287 histologically confirmed cases of serous pancreatic cystic neoplasms (SPNs).
RESULTS Female predominance is seen with most SPNs presenting asymptomatically in the 5th through 7th decade. Mean lesion size was 38.7 mm, 98% were single, 44.2% cystic, 46% mixed cystic and solid, and 94% hypoechoic on B-mode ultrasound. Vascular patterns and contrast-enhancement profiles are described as hypervascular and hyperenhancing.
CONCLUSION The described ultrasound features can aid differentiation of SPN from other neoplastic lesions under most circumstances.
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Ignee A, Atkinson NSS, Schuessler G, Dietrich CF. Ultrasound contrast agents. Endosc Ultrasound 2016; 5:355-362. [PMID: 27824024 PMCID: PMC5206822 DOI: 10.4103/2303-9027.193594] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 05/15/2016] [Indexed: 02/07/2023] Open
Abstract
Endoscopic ultrasound (EUS) plays an important role in imaging of the mediastinum and abdominal organs. Since the introduction of US contrast agents (UCA) for transabdominal US, attempts have been made to apply contrast-enhanced US techniques also to EUS. Since 2003, specific contrast-enhanced imaging was possible using EUS. Important studies have been published regarding contrast-enhanced EUS and the characterization of focal pancreatic lesions, lymph nodes, and subepithelial tumors. In this manuscript, we describe the relevant UCA, their application, and specific image acquisition as well as the principles of image tissue characterization using contrast-enhanced EUS. Safety issues, potential future developments, and EUS-specific issues are reviewed.
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Affiliation(s)
- Andre Ignee
- Department of Medical, Caritas-Krankenhaus, Bad Mergentheim, Germany
| | | | - Gudrun Schuessler
- Department of Medical, Caritas-Krankenhaus, Bad Mergentheim, Germany
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21
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Cui XW, Ignee A, Maros T, Straub B, Wen JG, Dietrich CF. Feasibility and Usefulness of Intra-Cavitary Contrast-Enhanced Ultrasound in Percutaneous Nephrostomy. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:2180-8. [PMID: 27262520 DOI: 10.1016/j.ultrasmedbio.2016.04.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 03/30/2016] [Accepted: 04/25/2016] [Indexed: 05/05/2023]
Abstract
The aim of this study was to evaluate the feasibility and utility of intra-cavitary contrast enhanced ultrasound (ICCEUS) in guiding percutaneous nephrostomy (PCN) and assessing complications. Forty-five ultrasound-guided PCNs were performed in 35 patients with hydronephrosis resulting from urinary tract obstruction. Ultrasound contrast agent (0.1 mL diluted in 20-30 mL saline) was injected through the puncture needle and the drainage tube to precisely locate the device and obstruction, with the fluoroscopy results considered the gold standard. ICCEUS was performed again the next day to assess complications. All 45 PCNs were successfully performed under the guidance of ultrasound. With ICCEUS, we could confirm the correct insertion of needle and catheter and locate the obstruction in all 35 patients, with fluoroscopic results as the gold standard. Catheter dislodgement was diagnosed by administration of ultrasound contrast agent in 5 patients. Hematoma (1 patient) and urine leakage (1 patient) were also observed. With the advantages of lack of exposure to radiation, performance in real time and bedside availability, ICCEUS has the potential to become a new modality to guide PCN and assess catheter-related complications.
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Affiliation(s)
- Xin-Wu Cui
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Medical Clinic 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Wuerzburg, Wuerzburg, Germany
| | - Andre Ignee
- Medical Clinic 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Wuerzburg, Wuerzburg, Germany
| | - Tiberius Maros
- Department of Urology, Caritas Krankenhaus, Bad Mergentheim, Academic Teaching Hospital of the University of Wuerzburg, Wuerzburg, Germany
| | - Bernd Straub
- Department of Urology, Caritas Krankenhaus, Bad Mergentheim, Academic Teaching Hospital of the University of Wuerzburg, Wuerzburg, Germany
| | - Jian-Guo Wen
- Department of Urology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Christoph F Dietrich
- Medical Clinic 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Wuerzburg, Wuerzburg, Germany; Sino-German Research Center of Ultrasound in Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
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Lan D, Qu HC, Li N, Zhu XW, Liu YL, Liu CL. The Value of Contrast-Enhanced Ultrasonography and Contrast-Enhanced CT in the Diagnosis of Malignant Renal Cystic Lesions: A Meta-Analysis. PLoS One 2016; 11:e0155857. [PMID: 27203086 PMCID: PMC4874594 DOI: 10.1371/journal.pone.0155857] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 05/05/2016] [Indexed: 12/12/2022] Open
Abstract
We compared the efficacy of contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT) for the diagnosis of renal cystic lesions via a meta-analysis to determine the value of CEUS in the prediction of the malignant potential of complex renal cysts. Eleven studies were evaluated: 4 control studies related to CEUS and CECT, 3 studies related to CEUS and 4 studies related to CECT. According to the random effects model, the pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio for CEUS/CECT were 0.95/0.90, 0.79/0.85, 4.39/5.00, and 0.10/0.15, respectively. The areas under the summary receiver operating characteristic (AUCs-SROC) curves for the two methods were 94.24% and 93.39%, and the estimated Q values were 0.8805 and 0.8698, respectively. Comparing the Q index values of CEUS and CECT revealed no significant difference between the two methods (P>0.05). When compared with conventional CECT, CEUS is also useful for diagnosing renal cystic lesions in the clinic.
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Affiliation(s)
- Dong Lan
- Department of Urological Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, P.R. China
| | - Hong-Chen Qu
- Department of Urological Surgery, Cancer Hospital of China Medical University/Liaoning Cancer Hospital & Institute, Shenyang, Liaoning, P.R. China
| | - Ning Li
- Department of Urological Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, P.R. China
| | - Xing-Wang Zhu
- Department of Urological Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, P.R. China
| | - Yi-Li Liu
- Department of Urological Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, P.R. China
| | - Chun-Lai Liu
- Department of Urological Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, P.R. China
- * E-mail:
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