1
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Yang Q, Zheng R, Zhou J, Tang L, Zhang R, Jiang T, Jing X, Liao J, Cheng W, Zhao C, Liu C, Dietrich CF, Cui X, Cai W, Wu J, Yu F, Cheng Z, Liu F, Han Z, Yu X, Yu J, Liang P. On-Site Diagnostic Ability of CEUS/CT/MRI for Hepatocellular Carcinoma (2019-2022): A Multicenter Study. J Ultrasound Med 2023; 42:2825-2838. [PMID: 37713625 DOI: 10.1002/jum.16321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 08/05/2023] [Accepted: 08/07/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVES To compare the on-site diagnostic performance of contrast-enhanced ultrasound (CEUS), computed tomography (CECT), and magnetic resonance imaging (CEMRI) for hepatocellular carcinoma (HCC) across diverse practice settings. METHODS Between May 2019 and April 2022, a total of 2085 patients with 2320 pathologically confirmed focal liver lesions (FLLs) were enrolled. Imaging reports were compared with results from pathology analysis. Diagnostic performance was analyzed in defined size, high-risk factors for HCC, and hospital volume categories. RESULTS Three images achieved similar diagnostic performance in classifying HCC from 16 types of FLLs, including HCC ≤2.0 cm. For HCC diagnosis at low-volume hospitals and HCC with high-risk factors, the accuracy and specificity of CEUS were comparable to CECT and CEMRI, while the sensitivity of CEUS (77.4 and 89.5%, respectively) was inferior to CEMRI (87.0 and 92.8%, respectively). The diagnostic accuracy of CEUS + CEMRI and CEUS + CECT increased by 7.8 and 6.2% for HCC ≤2.0 cm, 8.0 and 5.0% for HCC with high-risk factors, and 7.4 and 5.5% for HCC at low-volume hospitals, respectively, compared with CEMRI/CECT alone. CONCLUSIONS Compared with CECT and CEMRI, CEUS provides adequate diagnostic performance in clinical first-line applications at high-volume hospitals. Moreover, a higher diagnostic performance for HCC is achieved by combining CEUS with CECT/CEMRI compared with any single imaging technique.
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Affiliation(s)
- Qi Yang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
- Department of Medical Ultrasound, Peking University Shenzhen Hospital, Shenzhen, China
| | - Rongqin Zheng
- Department of Ultrasound, Guangdong Key Laboratory of Liver Disease Research, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Jianhua Zhou
- Department of Ultrasound, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Lina Tang
- Department of Diagnostic Ultrasound, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Ruifang Zhang
- Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Tianan Jiang
- Department of Ultrasound Medicine, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiang Jing
- Department of Ultrasound, Tianjin Third Central Hospital, Tianjin, China
| | - Jintang Liao
- Department of Diagnostic Ultrasound, Xiangya Hospital Central South University, Changsha, China
| | - Wen Cheng
- Department of Ultrasound, Harbin Medical University Cancer Hospital, Harbin, China
| | - Cheng Zhao
- Department of Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Cun Liu
- Department of Ultrasound, Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Chirstoph F Dietrich
- Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Beau Site, Bern, Switzerland
| | - Xinwu Cui
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenjia Cai
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - JiaPeng Wu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Fei Yu
- Department of Medical Ultrasound, Peking University Shenzhen Hospital, Shenzhen, China
| | - Zhigang Cheng
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Fangyi Liu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Zhiyu Han
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Xiaoling Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Jie Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
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Weinrebe W, Kreppenhofer S, Dietrich CF. [Geriatric ultrasound : Prospective evaluation of ultrasound as extended screening in acute geriatric patients]. Z Gerontol Geriatr 2023; 56:647-652. [PMID: 36478131 DOI: 10.1007/s00391-022-02144-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 11/08/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND The aim of this study was to evaluate ultrasound as a routinely used procedure and extended physical examination in geriatric patients in acute care. METHODS Prospective study of 86 patients using ultrasound as a screening examination (abdomen, basal sections of the thorax, thyroid glands) under comparative use of a hand-held ultrasound device (HHUSD) and a high-end ultrasound (HEUS = gold standard). RESULTS In 20/86 (23.2%) clinically relevant findings with therapeutic consequences were found (pleural effusion, urinary retention, choledocholithiasis metatases, colon tumor). In 22/86 (25.6%) patients, additional questions existed besides the screening indication: tumor search (9.3%), anemia (5.8%), liver value elevation (5.8%), dyspnea (5.8%), splenic pathologies (2.3%), weight loss (1.2%), infectious focus (1.2%), diarrhea (1.2%), intra-abdominal hematoma (1.1%), abdominal aortic aneurysm (1.2%). The most common sonographic findings included: cholecystolithiasis (32.6%); right pleural effusion (31.4%), thyroid nodules (30.2%), renal cysts (27.9%), and fatty liver (26.7%). There were significant differences in sizing between HHUSD and HEUS (kidneys, pancreatic corpus and pancreatic caudal diameters, portal vein, left hepatic vein) without diagnostic relevance. CONCLUSION The extended screening by ultrasound provided important answers to classical questions in geriatrics (e.g. urinary retention, volume deficiency/pleural effusion) in many cases. The new findings had therapeutic consequences in one fifth of the patients. The HHUSD can be used in screening.
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Affiliation(s)
- W Weinrebe
- Departement für Allgemeine Innere Medizin, Spital Campus Bern, Hirslanden, Schänzlistr. 39, 3013, Bern, Schweiz.
| | - S Kreppenhofer
- Medizinische Klinik II, Caritas-Krankenhaus Bad Mergentheim, Bad Mergentheim, Deutschland
| | - C F Dietrich
- Departement für Allgemeine Innere Medizin, Spital Campus Bern, Hirslanden, Schänzlistr. 39, 3013, Bern, Schweiz
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3
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Weinrebe W, Kreppenhofer S, Dietrich CF. Erratum zu: Geriatrischer Ultraschall. Z Gerontol Geriatr 2023:10.1007/s00391-022-02157-w. [PMID: 36662243 DOI: 10.1007/s00391-022-02157-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- W Weinrebe
- Departement für Allgemeine Innere Medizin, Spital Campus Bern, Hirslanden, Schänzlistr. 39, 3013, Bern, Schweiz.
| | - S Kreppenhofer
- Medizinische Klinik II, Caritas-Krankenhaus Bad Mergentheim, Bad Mergentheim, Deutschland
| | - C F Dietrich
- Departement für Allgemeine Innere Medizin, Spital Campus Bern, Hirslanden, Schänzlistr. 39, 3013, Bern, Schweiz
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4
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Thomsen T, Dietrich CF. [Postmortem sonography helpful in death of unknown origin]. Med Klin Intensivmed Notfmed 2021; 116:254-258. [PMID: 33559701 DOI: 10.1007/s00063-021-00784-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 11/19/2020] [Accepted: 12/24/2020] [Indexed: 10/22/2022]
Abstract
Postmortem imaging has been used primarily in forensic medicine since 1895. Conventional x‑ray, computed tomography (CT), and magnetic resonance imaging (MRI) are used. In studies, sonography is not considered to be of particular value, especially because of postmortem gas formation in adults. We report three cases in which postmortem sonography within three hours of death allowed clarification of a previously unclear cause of death.
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Affiliation(s)
- T Thomsen
- Klinik für Innere Medizin, Westküstenkliniken, Brunsbüttel, Deutschland
| | - C F Dietrich
- Department Allgemeine Innere Medizin, Kliniken Hirslanden, Beau Site, Salem und Permanence, Schänzlihalde 11, 3013, Bern, Schweiz.
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5
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Cantisani V, Dietrich CF, Badea R, Dudea S, Prosch H, Cerezo E, Nuernberg D, Serra AL, Sidhu PS, Radzina M, Piscaglia F, Bachmann Nielsen M, Ewertsen C, Săftoiu A, Calliada F, Gilja OH. EFSUMB Statement on Medical Student Education in Ultrasound [long version]. Ultrasound Int Open 2016; 2:E2-7. [PMID: 27689163 DOI: 10.1055/s-0035-1569413] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) recommends that ultrasound should be used systematically as an easy accessible and instructive educational tool in the curriculum of modern medical schools. Medical students should acquire theoretical knowledge of the modality and hands-on training should be implemented and adhere to evidence-based principles. In this paper we report EFSUMB policy statements on medical student education in ultrasound that in a short version is already published in Ultraschall in der Medizin 1.
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Affiliation(s)
- V Cantisani
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, University Sapienza, Rome, Italy
| | - C F Dietrich
- Medizinische Klinik 2, Caritas Krankenhaus Bad Mergentheim, Bad Mergentheim
| | - R Badea
- Department of Ultrasonography, 3rd Medical Clinic, Institute of Gastroenterology and Hepatology Octavian Fodor; Imaging Department, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj Napoca, Romania
| | - S Dudea
- Radiology Department "Iuliu Hatieganu" Univ. Med. Pharm. Cluj-Napoca, Romania
| | - H Prosch
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna General Hospital, Austria
| | - E Cerezo
- Calle Francisco Silvela #124, lo 3 Madrid, Spain
| | - D Nuernberg
- Department of Gastroenterology, Brandenburg University of Medicine Theodor Fontane, Neuruppin
| | - A L Serra
- Department of Internal Medicine and Nephrology, Ultrasound Learning Center, Hirslanden Clinic, Zürich, Switzerland
| | - P S Sidhu
- Department of Radiology, King's College Hospital, London, UK
| | - M Radzina
- Diagnostic Radiology Institute, Paula Stradins Clinical University Hospital, Riga, Latvia
| | - F Piscaglia
- Unit of Internal Medicine, Department of Medical and Surgical Sciences, University of Bologna, Italy
| | - M Bachmann Nielsen
- Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - C Ewertsen
- Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - A Săftoiu
- Gastroenterology Department, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy Craiova, Romania
| | | | - O H Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen and Department of Clinical Medicine, University of Bergen, Norway
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6
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Jenssen C, Brkljacic B, Hocke M, Ignee A, Piscaglia F, Radzina M, Sidhu PS, Dietrich CF. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part VI - Ultrasound-Guided Vascular Interventions. Ultraschall Med 2016; 37:473-476. [PMID: 26515965 DOI: 10.1055/s-0035-1553450] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The sixth part of the Guidelines on Interventional Ultrasound produced under the auspices of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) assesses the evidence for ultrasound guidance and assistance in vascular interventions. Based on convincing data, real-time sonographic guidance for central venous access is strongly recommended as a key safety measure. Systematic analysis of scientific literature shows that in difficult situations and special circumstances US guidance may also improve the efficacy and safety of peripheral venous and arterial access and endovascular interventions. Moreover, the recommendations of this guideline endorse the use of ultrasound to detect complications of vascular access and US-guided interventional treatment of arterial pseudoaneurysms.
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Affiliation(s)
- C Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch Oderland, Strausberg/ Wriezen, Germany
| | - B Brkljacic
- University of Zagreb School of Medicine, Department of Diagnostic and Interventional Radiology, University Hospital "Dubrava", Zagreb, Croatia
| | - M Hocke
- Department of Internal Medicine 2, Helios Hospital Meiningen GmbH, Meiningen, Germany
| | - A Ignee
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - F Piscaglia
- Unit of Internal Medicine, Dept of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - M Radzina
- Diagnostic Radiology Institute, Paula Stradins Clinical University Hospital, Riga, Latvia
| | - P S Sidhu
- Department of Radiology, King's College Hospital, London, UK
| | - C F Dietrich
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
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7
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Jenssen C, Brkljacic B, Hocke M, Ignee A, Piscaglia F, Radzina M, Sidhu PS, Dietrich CF. Erratum: EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part VI - Ultrasound-Guided Vascular Interventions. Ultraschall Med 2016; 37:e1. [PMID: 26579832 DOI: 10.1055/s-0035-1566900] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- C Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch Oderland, Strausberg/ Wriezen, Germany
| | - B Brkljacic
- University of Zagreb School of Medicine, Department of Diagnostic and Interventional Radiology, University Hospital "Dubrava", Zagreb, Croatia
| | - M Hocke
- Department of Internal Medicine 2, Helios Hospital Meiningen GmbH, Meiningen, Germany
| | - A Ignee
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - F Piscaglia
- Unit of Internal Medicine, Dept of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - M Radzina
- Diagnostic Radiology Institute, Paula Stradins Clinical University Hospital, Riga, Latvia
| | - P S Sidhu
- Department of Radiology, King's College Hospital, London, UK
| | - C F Dietrich
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
- Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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8
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Chiorean L, Cui XW, Klein SA, Budjan J, Sparchez Z, Radzina M, Jenssen C, Dong Y, Dietrich CF. Clinical value of imaging for lymph nodes evaluation with particular emphasis on ultrasonography. Z Gastroenterol 2016; 54:774-90. [PMID: 27529528 DOI: 10.1055/s-0042-108656] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Enlarged or irregular lymph nodes (LNs) are clinical and imaging findings in a large variety of malignant and non-malignant diseases. A comprehensive diagnostic work up is usually necessary in order to differentiate the benign or the malignant nature of the altered LNs. The diagnosis has to be made using all clinical information and, if necessary, assessed LNs need to be biopsied and further, histologically or microbiologically characterized. However, imaging techniques, and particularly ultrasonography (US), are essential on the way to the final diagnosis, from initial detection and characterization to follow-up of biopsy guidance. Computed-tomography (CT) and/or magnetic resonance imaging (MRI) are of great value for oncological diseases staging and treatment monitoring. Imaging techniques are helpful in distinguishing between benign and malignant LNs disease as well as between LNs metastases and lymphoma in most cases. Furthermore, imaging can define the extent and distribution of malignant diseases. It may assist, through the use of particular techniques such as elastography, to identify the most suspicious LN to be biopsied and to guide targeted biopsies from the most suspicious areas. It also serves as the main tool for the evaluation of treatment response in malignant diseases. The quality of LNs imaging has remarkably improved in recent years. New methods, such as contrast-enhanced ultrasonography (CEUS), elastography, positron emission tomography (PET)/PET-CT, as well as diffusion weighted imaging (DWI) in MRI, have already led to substantial changes in clinical practice. This review describes the most recent imaging techniques for LNs assessment, and their particular clinical value, with a special emphasis on the role of US techniques. Strengths and weaknesses of different imaging tools are discussed comprehensively, highlighting the importance of a corroborative attitude for successful management of each particular case.
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Affiliation(s)
- L Chiorean
- Medizinische Klinik 2, Caritas-Krankenhaus, Bad Mergentheim, Germany
| | - X W Cui
- Medizinische Klinik 2, Caritas-Krankenhaus, Bad Mergentheim, Germany
| | - S A Klein
- III. Medizinische Klinik, Universitätsmedizin Mannheim
| | - J Budjan
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University
| | - Z Sparchez
- 3rd Medical Department, Institute for Gastroenterology and Hepatology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - M Radzina
- Diagnostic Radiology Institute, Paula Stradina Clinical University Hospital, Riga, Latvia
| | - C Jenssen
- Medical Department, Krankenhaus Märkisch Oderland, Strausberg, Germany
| | - Y Dong
- Medizinische Klinik 2, Caritas-Krankenhaus, Bad Mergentheim, Germany
| | - C F Dietrich
- Medizinische Klinik 2, Caritas-Krankenhaus, Bad Mergentheim, Germany
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9
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Fusaroli P, Jenssen C, Hocke M, Burmester E, Buscarini E, Havre RF, Ignee A, Saftoiu A, Vilmann P, Nolsøe CP, Nürnberg D, D'Onofrio M, Gilja OH, Lorentzen T, Piscaglia F, Sidhu PS, Dietrich CF. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part V - EUS-Guided Therapeutic Interventions (short version). Ultraschall Med 2016; 37:412-420. [PMID: 27490463 DOI: 10.1055/s-0035-1553742] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The fifth section of the Guidelines on Interventional Ultrasound (INVUS) of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) assesses the evidence for all the categories of endoscopic ultrasound-guided treatment reported to date. Celiac plexus neurolysis and block, vascular intervention, drainage of fluid collections, drainage of biliary and pancreatic ducts, and experimental tumor ablation techniques are discussed. For each topic, all current evidence has been extensively analyzed and summarized into major recommendations for reader consultation (short version; the long version is published online).
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Affiliation(s)
- P Fusaroli
- Gastroenterology Unit, Department of Medical and Surgical Sciences University of Bologna,Hospital of Imola, Italy
| | - C Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch Oderland, Strausberg/ Wriezen, Germany
| | - M Hocke
- Dept of Internal Medicine 2, Helios Hospital Meiningen GmbH, Meiningen, Germany
| | - E Burmester
- Department of Internal Medicine I, Sana Kliniken, Luebeck, Germany
| | - E Buscarini
- UO Gastroenterologia, Ospedale Maggiore Crema, Italy
| | - R F Havre
- Department of Medicine and National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway
| | - A Ignee
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - A Saftoiu
- Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy, Craiova, Romania and Department of Endoscopy, Gastrointestinal Unit, Copenhagen University Hospital Herlev, Denmark
| | - P Vilmann
- Gastrointestinal Unit, Department of Surgery, University Hospital Herlev, Copenhagen, Denmark
| | - C P Nolsøe
- Department of Gastric Surgery, Ultrasound Section, Herlev Hospital, University of Copenhagen, Denmark
| | - D Nürnberg
- Department of Gastroenterology, Brandenburg University of Medicine Theodor Fontane, Neuruppin, Germany
| | - M D'Onofrio
- Department of Radiology, GB Rossi University Hospital, University of Verona, Italy
| | - O H Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen and Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - T Lorentzen
- Department of Gastric Surgery, Ultrasound Section, Herlev Hospital, University of Copenhagen, Denmark
| | - F Piscaglia
- Unit of Internal Medicine, Dept of Medical and Surgical Sciences, University of Bologna, Hospital S.Orsola Malpighi, Bologna, Italy
| | - P S Sidhu
- Department of Radiology, King's College Hospital, London, UK
| | - C F Dietrich
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
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10
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Fusaroli P, Jenssen C, Hocke M, Burmester E, Buscarini E, Havre RF, Ignee A, Saftoiu A, Vilmann P, Nolsøe CP, Nürnberg D, D'Onofrio M, Gilja OH, Lorentzen T, Piscaglia F, Sidhu PS, Dietrich CF. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part V. Ultraschall Med 2016; 37:77-99. [PMID: 26632995 DOI: 10.1055/s-0035-1553738] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The fifth section of the Guidelines on Interventional Ultrasound (INVUS) of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) assesses the evidence for all the categories of endoscopic ultrasound-guided treatment reported to date. Celiac plexus neurolysis and block, vascular intervention, drainage of fluid collections, drainage of biliary and pancreatic ducts, and experimental tumor ablation techniques are discussed. For each topic, all current evidence has been extensively analyzed and summarized into major recommendations for reader consultation in clinical practice (long version).
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Affiliation(s)
- P Fusaroli
- Gastroenterology Unit, Department of Medical and Surgical Sciences University of Bologna/Hospital of Imola, Italy
| | - C Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch Oderland, Strausberg/ Wriezen, Germany
| | - M Hocke
- Department of Internal Medicine 2, Helios Hospital Meiningen GmbH, Meiningen, Germany
| | - E Burmester
- Department of Internal Medicine I, Sana Kliniken, Luebeck, Germany
| | - E Buscarini
- UO Gastroenterologia, Ospedale Maggiore Crema, Italy
| | - R F Havre
- Department of Medicine and National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway
| | - A Ignee
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - A Saftoiu
- Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy, Craiova, Romania and Department of Endoscopy, Gastrointestinal Unit, Copenhagen University Hospital Herlev, Denmark
| | - P Vilmann
- Gastrointestinal Unit, Department of Surgery, University Hospital Herlev, Copenhagen, Denmark
| | - C P Nolsøe
- Department of Gastric Surgery, Ultrasound Section, Herlev Hospital, University of Copenhagen, Denmark
| | - D Nürnberg
- Department of Gastroenterology, Brandenburg University of Medicine Theodor Fontane, Neuruppin, Germany
| | - M D'Onofrio
- Department of Radiology, GB Rossi University Hospital, University of Verona, Italy
| | - O H Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen and Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - T Lorentzen
- Department of Gastric Surgery, Ultrasound Section, Herlev Hospital, University of Copenhagen, Denmark
| | - F Piscaglia
- Unit of Internal Medicine, Dept of Medical and Surgical Sciences, University of Bologna/Hospital S.Orsola Malpighi, Bologna, Italy
| | - P S Sidhu
- Department of Radiology, King's College Hospital, London, UK
| | - C F Dietrich
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
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11
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Richter J, Botelho MC, Holtfreter MC, Akpata R, El Scheich T, Neumayr A, Brunetti E, Hatz C, Dong Y, Dietrich CF. Ultrasound assessment of schistosomiasis. Z Gastroenterol 2016; 54:653-60. [PMID: 27429103 DOI: 10.1055/s-0042-107359] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
In 2000, the World Health Organization (WHO) issued an ultrasound field protocol for assessing the morbidity due to Schistosoma (S.) haematobium and S. mansoni. The experience with this classification has recently been reviewed systematically. The WHO protocol was well accepted worldwide. Here we review the use of ultrasound to assess the morbidity due to schistosomiasis with emphasis on easy, quick, and reproducible ways that can be used in the field. Findings obtained with high-end ultrasound scanners in the hospital setting that might eventually have applications in the field are also described.
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Affiliation(s)
- J Richter
- Tropenmedizinische Ambulanz, Klinik für Gastroenterologie, Hepatologie und Infektiologie, Medizinische Fakultät, Heinrich-Heine Universität Düsseldorf, Germany
| | - M C Botelho
- INSA National Institute of Health Dr. Ricardo Jorge, Porto, Portugal
| | - M C Holtfreter
- Tropenmedizinische Ambulanz, Klinik für Gastroenterologie, Hepatologie und Infektiologie, Medizinische Fakultät, Heinrich-Heine Universität Düsseldorf, Germany
| | - R Akpata
- Hôpital Saint Jean de Dieu, Tangueta, Benin
| | - T El Scheich
- Tropenmedizinische Ambulanz, Klinik für Gastroenterologie, Hepatologie und Infektiologie, Medizinische Fakultät, Heinrich-Heine Universität Düsseldorf, Germany
| | - A Neumayr
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - E Brunetti
- Division of Infectious and Tropical Diseases, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - C Hatz
- Epidemiology, Biostatistics and Prevention Institute, Zürich, Switzerland
| | - Y Dong
- Innere Medizin 2, Caritas Krankenhaus Bad Mergentheim, Germany
| | - C F Dietrich
- Innere Medizin 2, Caritas Krankenhaus Bad Mergentheim, Germany
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12
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Meloni MF, Galimberti S, Dietrich CF, Lazzaroni S, Goldberg SN, Abate A, Sironi S, Andreano A. Microwave ablation of hepatic tumors with a third generation system: loco‑regional efficacy in a prospective cohort study with intermediate term follow-up. Z Gastroenterol 2016; 54:541-7. [PMID: 27284928 DOI: 10.1055/s-0042-100627] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To evaluate the safety and intermediate-term efficacy of percutaneous microwave ablation (MWA) in primary and secondary liver tumors using a third generation MWA device, under ultrasound guidance. PATIENTS AND METHODS Sixty-two patients (median age 74 years, 73 % males) with 69 liver tumors were enrolled in this prospective observational study. Forty-seven patients (76 %) had hepatocellular carcinoma (HCC) and 15 (24 %) metastases. Median follow-up was 3.6 years. RESULTS Median tumor diameter at contrast enhanced computed tomography was 23 mm (I-III quartiles, 18 - 31 mm). All procedures were performed percutaneously using a 2.45 GHz generator. Median ablation time was 10 minutes (I-III quartiles, 10 - 14 minutes). A single percutaneous antenna insertion was performed for 56/69 (81 %) of the tumors. Technical success was obtained in all tumors. Primary efficacy at 24 hours was achieved in 68/69 (99 %) tumors. The overall one-year cumulative local tumor progression rate was 15.1 % (95 % CI, 7.7 - 24.8 %) with no significant difference between HCC and metastases (p = 0.26). There was one procedure-related mortality (1.6 %) and one major bleeding (1.6 %). CONCLUSION Microwave ablation is a valid option for thermal ablation of HCC and liver metastases with comparable complication rate to other local ablative procedures.
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Affiliation(s)
- M F Meloni
- Department of Radiology, San Gerardo Hospital, Monza, Italy
| | - S Galimberti
- Center of Biostatistics for Clinical Epidemiology, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - C F Dietrich
- Medizinische Klinik 2, Caritas-Krankenhaus Bad Mergentheim, Germany
| | - S Lazzaroni
- Depart of Internal Medicine, Ospedale "M.O.A Locatelli" Piario (BG), Italy
| | - S N Goldberg
- Division of Image-Guided Therapy and Interventional Oncology, Department of Radiology, Hadassah Hebrew University Medical Centre, Jerusalem, Israel
| | - A Abate
- Department of Radiology, San Gerardo Hospital, Monza, Italy
| | - S Sironi
- Department of Radiology, San Gerardo Hospital, Monza, Italy
| | - A Andreano
- Department of Radiology, San Gerardo Hospital, Monza, Italy
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13
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Jenssen C, Tuma J, Möller K, Cui XW, Kinkel H, Uebel S, Dietrich CF. [Ultrasound artifacts and their diagnostic significance in internal medicine and gastroenterology - part 2: color and spectral Doppler artifacts]. Z Gastroenterol 2016; 54:569-78. [PMID: 27284933 DOI: 10.1055/s-0042-103248] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Artifacts in ultrasonographic diagnostics are a result of the physical properties of the ultrasound waves and are caused by interaction of the ultrasound waves with biological structures and tissues of the body and with foreign materials. On the one hand, they may be diagnostically helpful. On the other hand, they may be distracting and may lead to misdiagnosis. Profound knowledge of the causes, avoidance, and interpretation of artifacts is a necessary precondition for correct clinical appraisal of ultrasound images. Part 1 of this review commented on the physics of artifacts and described the most important B-mode artifacts. Part 2 focuses on the clinically relevant artifacts in Doppler and color-coded duplex sonography. Problems and pitfalls of interpretation arising from artifacts, as well as the diagnostic use of Doppler and colour-coded duplex sonography, are discussed.
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Affiliation(s)
- C Jenssen
- Krankenhaus Märkisch Oderland GmbH, Strausberg, Deutschland
| | - J Tuma
- Sonografie Institut, Uster, Switzerland
| | - K Möller
- SANA-Klinikum Lichtenberg, Berlin, Deutschland
| | - X W Cui
- Caritas-Krankenhaus Bad Mergentheim, Bad Mergentheim, Deutschland
| | - H Kinkel
- Krankenhaus Düren GmbH, Düren, Deutschland
| | - S Uebel
- Hitachi Medical Systems GmbH, Wiesbaden, Deutschland
| | - C F Dietrich
- Caritas-Krankenhaus Bad Mergentheim, Bad Mergentheim, Deutschland
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14
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Friedrich-Rust M, Vorlaender C, Dietrich CF, Kratzer W, Blank W, Schuler A, Broja N, Cui XW, Herrmann E, Bojunga J. Evaluation of Strain Elastography for Differentiation of Thyroid Nodules: Results of a Prospective DEGUM Multicenter Study. Ultraschall Med 2016; 37:262-270. [PMID: 27070127 DOI: 10.1055/s-0042-104647] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE Many patients with thyroid nodules are presently referred to surgery for not only therapeutic but also diagnostic purposes. The aim of noninvasive diagnostic methods is to optimize the selection of patients for surgery. Strain elastography (SE) enables the ultrasound-based determination of tissue elasticity. The aim of the present study was to evaluate the value of SE for the differentiation of thyroid nodules in a prospective multicenter study. MATERIALS AND METHODS The study was registered at clinicaltrials.gov and was approved by the local ethics committees of all participating centers. All patients received an ultrasound (US) of the thyroid gland including color Doppler US. In addition, all nodules were evaluated by SE (Hitachi Medical Systems) using qualitative image interpretation of color distribution (SE-ES), strain value and strain ratio. RESULTS Overall, 602 patients with 657 thyroid nodules (567 benign, 90 malignant) from 7 centers were included in the final analysis. The sensitivity, specificity, NPV, PPV, +LR were 21 %, 73 %, 86 %, 11 %, 0.8, respectively, for color Doppler US; 69 %, 75 %, 94 %, 30 %, 2.9, respectively, for SE-ES; 56 %, 81 %, 92 %, 32 %, 2.9, respectively, for SE-strain value; and 58 %, 78 %, 92 %, 30 %, 2.6, respectively, for SE-strain ratio. The diagnostic accuracy was 71 % for both strain value and strain ratio of nodules. CONCLUSION SE as an additional ultrasound tool improves the value of ultrasound for the work-up of thyroid nodules. It might reduce diagnostic surgery of thyroid nodules in the future.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Biopsy, Fine-Needle
- Diagnosis, Differential
- Elasticity Imaging Techniques/methods
- Female
- Germany
- Goiter, Nodular/diagnostic imaging
- Goiter, Nodular/pathology
- Goiter, Nodular/surgery
- Humans
- Image Interpretation, Computer-Assisted
- Male
- Middle Aged
- Prospective Studies
- Sensitivity and Specificity
- Societies, Medical
- Thyroid Gland/diagnostic imaging
- Thyroid Gland/pathology
- Thyroid Neoplasms/diagnostic imaging
- Thyroid Neoplasms/pathology
- Thyroid Neoplasms/surgery
- Thyroid Nodule/diagnostic imaging
- Thyroid Nodule/pathology
- Thyroid Nodule/surgery
- Ultrasonography, Doppler, Color
- Young Adult
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Affiliation(s)
- M Friedrich-Rust
- Department of Internal Medicine 1, J.W. Goethe-University Hospital, Frankfurt, Germany
| | - C Vorlaender
- Department of General Surgery, Buergerhospital Frankfurt, Germany
| | - C F Dietrich
- Innere Medizin 2, Caritas Hospital, Bad Mergentheim, Germany
| | - W Kratzer
- Department of Internal Medicine I, University Hospital Ulm, Germany
| | - W Blank
- Medizinische Klinik 1, Hospital am Steinenberg, Reutlingen, Germany
| | - A Schuler
- Department of Internal Medicine, Helfenstein Hospital, Geislingen, Germany
| | - N Broja
- Department of Internal Medicine 1, J.W. Goethe-University Hospital, Frankfurt, Germany
| | - X W Cui
- Innere Medizin 2, Caritas Hospital, Bad Mergentheim, Germany
| | - E Herrmann
- Institute of Biostatistics and Mathematical Modelling, Faculty of Medicine, J.W. Goethe-University, Frankfurt, Germany
| | - J Bojunga
- Department of Internal Medicine 1, J.W. Goethe-University Hospital, Frankfurt, Germany
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15
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Tuma J, Jenssen C, Möller K, Cui XW, Kinkel H, Uebel S, Dietrich CF. [Ultrasound artifacts and their diagnostic significance in internal medicine and gastroenterology - Part 1: B-mode artifacts]. Z Gastroenterol 2016; 54:433-50. [PMID: 27171335 DOI: 10.1055/s-0042-103247] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Artifacts in ultrasonographic diagnostics are a result of the physical properties of the ultrasound waves and are caused by interaction of the ultrasound waves with biological structures and tissues and with foreign bodies. On the one hand, they may be distracting and may lead to misdiagnosis. On the other hand, they may be diagnostically helpful. Ultrasound imaging suffers from artifacts, because in reality, parameters assumed to be constant values, such as sound speed, sound rectilinear propagation, attenuation, etc., are often different from the actual parameters. Moreover, inadequate device settings may cause artifacts. Profound knowledge of the causes, avoidance, and interpretation of artifacts is a necessary precondition for correct clinical appraisal of ultrasound images. Part 1 of this review comments on the physics of artifacts and describes the most important B-mode artifacts. Pitfalls, as well as diagnostic chances resulting from B-mode artifacts, are discussed.
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Affiliation(s)
- J Tuma
- Sonografie-Institut, Uster, Switzerland
| | - C Jenssen
- Krankenhaus Märkisch Oderland GmbH, Strausberg, Germany
| | - K Möller
- SANA-Klinikum Lichtenberg, Berlin, Germany
| | - X W Cui
- Caritas-Krankenhaus Bad Mergentheim, Bad Mergentheim, Germany
| | - H Kinkel
- Krankenhaus Düren GmbH, Düren, Germany
| | - S Uebel
- Hitachi Medical Systems GmbH, Wiesbaden, Germany
| | - C F Dietrich
- Caritas-Krankenhaus Bad Mergentheim, Bad Mergentheim, Germany
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16
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Ignee A, Boerner N, Bruening A, Dirks K, von Herbay A, Jenssen C, Kubale R, Sattler H, Schuler A, Weiss H, Schuessler G, Dietrich CF. Duplex sonography of the mesenteric vessels--a critical evaluation of inter-observer variability. Z Gastroenterol 2016; 54:304-11. [PMID: 27056458 DOI: 10.1055/s-0041-107544] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION The number of publications concerning mesenteric Doppler sonography (mesDS) is immense and does not correlate with the frequency of its use in clinical practice. This is astonishing since it provides real time blood flow (perfusion) information without side effects. Despite uncontrollable parameters like the technical limitations in some situations the optimization of (possibly) controllable parameters like standardization, production of normal values and reduction of the investigator variability by evaluating stable parameters could change the situation. PATIENTS AND METHODS 10 investigators experienced in abdominal sonography ("DEGUM-Seminarleiter") performed mesenteric Doppler sonography in 5 healthy subjects with 5 different machines. RESULTS The portal vein at the confluence and the common hepatic artery provide a significant portion of investigations with intromission angles of more than 60°. Values of diameter, resistance index and pulsatility index of the celiac trunc could be obtained with inter-observer variability values below 25 %. The proper and the common hepatic artery show no differences in inter-observer variability values, whereas the intrahepatic measure point of the portal vein showed a higher reproducibility. DISCUSSION We define frame conditions for future mesenteric Doppler studies: the portal vein should be investigated at the intrahepatic measure point. Pathophysiological studies should refrain from velocity parameters except in the case of larger vessels running in a straight course towards the probe.
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Affiliation(s)
- A Ignee
- Caritas-Krankenhaus Bad Mergentheim, Medizinische Klinik 2, Bad Mergentheim, Germany
| | - N Boerner
- Gastroenterologische Gemeinschaftspraxis, Mainz, Germany
| | - A Bruening
- Facharztpraxis für Innere Medizin, Bad Malente/Gremsmühlen, Germany
| | - K Dirks
- Rems-Murr-Klinikum Winnenden, Winnenden, Germany
| | - A von Herbay
- St. Marien-Hospital Hamm, Klinik für Innere Medizin/Gastroenterologie, Hamm, Germany
| | - C Jenssen
- Krankenhaus Märkisch-Oderland, Strausberg, Germany
| | - R Kubale
- Gemeinschaftspraxis für Radiologie und Nuklearmedizin, Pirmasens, Germany
| | - H Sattler
- Praxis Dr. med. Sattler, Bad Dürkheim, Germany
| | - A Schuler
- Helfenstein Klinik, Geislingen/Steige, Germany
| | | | - G Schuessler
- Caritas-Krankenhaus Bad Mergentheim, Medizinische Klinik 2, Bad Mergentheim, Germany
| | - C F Dietrich
- Caritas-Krankenhaus Bad Mergentheim, Medizinische Klinik 2, Bad Mergentheim, Germany
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17
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Jenssen C, Hocke M, Fusaroli P, Gilja OH, Buscarini E, Havre RF, Ignee A, Saftoiu A, Vilmann P, Burmester E, Nolsøe CP, Nürnberg D, D'Onofrio M, Lorentzen T, Piscaglia F, Sidhu PS, Dietrich CF. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part IV - EUS-guided Interventions: General aspects and EUS-guided sampling (Long Version). Ultraschall Med 2016; 37:E33-E76. [PMID: 27058434 DOI: 10.1055/s-0035-1553785] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The fourth part of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Guidelines on Interventional Ultrasound describes general aspects of endoscopic ultrasound-guided diagnostic and therapeutic interventions and assesses the evidence for endoscopic ultrasound-guided sampling. Endoscopic ultrasound combines the most advanced high-resolution ultrasound imaging of lesions within the wall and in the vicinity of the gastrointestinal tract and safe and effective fine needle based tissue acquisition from these lesions. The guideline addresses the indications, contraindications, techniques, adverse events, training and clinical impact of EUS-guided sampling. Advantages and drawbacks are weighed in comparison with image-guided percutaneous biopsy. Based on the most current evidence, clinical practice recommendations are given for crucial preconditions and steps of EUS-guided sampling as well as for safe performance. Additionally, the guideline deals with the principles and reliability of cytopathological reporting in endoscopic ultrasound-guided sampling (long version).
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Affiliation(s)
- C Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch Oderland Strausberg/Wriezen, Germany
| | - M Hocke
- Department of Internal Medicine 2, Helios Hospital Meiningen GmbH, Meiningen, Germany
| | - P Fusaroli
- Gastroenterology Unit, Department of Medical and Surgical Sciences University of Bologna/Hospital of Imola, Italy
| | - O H Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen and Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - E Buscarini
- Department of Gastroenterology and Endoscopy, Ospedale Maggiore Crema, Italy
| | - R F Havre
- Department of Medicine and National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway
| | - A Ignee
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - A Saftoiu
- Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy, Craiova, Romania and Department of Endoscopy, Gastrointestinal Unit, Copenhagen University Hospital Herlev, Denmark
| | - P Vilmann
- GastroUnit, Department of Surgery, University Hospital Herlev, Copenhagen, Denmark
| | - E Burmester
- Department of Internal Medicine I, Sana Kliniken, Luebeck, Germany
| | - C P Nolsøe
- Department of Gastric Surgery, Ultrasound Section, Herlev Hospital, University of Copenhagen, Denmark
| | - D Nürnberg
- Department of Gastroenterology, Brandenburg University of Medicine Theodor Fontane, Neuruppin, Germany
| | - M D'Onofrio
- Department of Radiology, GB Rossi University Hospital, University of Verona, Italy
| | - T Lorentzen
- Department of Gastric Surgery, Ultrasound Section, Herlev Hospital, University of Copenhagen, Denmark
| | - F Piscaglia
- Unit of Internal Medicine, Department of Medical and Surgical Sciences, University of Bologna, Italy
| | - P S Sidhu
- Department of Radiology, King's College Hospital, London, UK
| | - C F Dietrich
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
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18
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Jenssen C, Hocke M, Fusaroli P, Gilja OH, Buscarini E, Havre RF, Ignee A, Saftoiu A, Vilmann P, Burmester E, Nolsøe CP, Nürnberg D, D'Onofrio M, Lorentzen T, Piscaglia F, Sidhu PS, Dietrich CF. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part IV - EUS-guided interventions: General Aspects and EUS-guided Sampling (Short Version). Ultraschall Med 2016; 37:157-169. [PMID: 26515966 DOI: 10.1055/s-0035-1553788] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The fourth part of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Guidelines on Interventional Ultrasound describes general aspects of endoscopic ultrasound-guided diagnostic and therapeutic interventions and assesses the evidence for endoscopic ultrasound-guided sampling. Endoscopic ultrasound combines the most advanced high-resolution ultrasound imaging of lesions within the wall and in the vicinity of the gastrointestinal tract and safe and effective fine needle-based tissue acquisition from these lesions. The guideline addresses the indications, contraindications, techniques, adverse events, training and clinical impact of EUS-guided sampling. Advantages and drawbacks are weighed in comparison with image-guided percutaneous biopsy. Based on the most current evidence, clinical practice recommendations are given for crucial preconditions and steps of EUS-guided sampling as well as for safe performance. Additionally, the guideline deals with the principles and reliability of cytopathological reporting in endoscopic ultrasound-guided sampling (short version; the long version is published online).
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Affiliation(s)
- C Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch Oderland Strausberg/Wriezen, Germany
| | - M Hocke
- Department of Internal Medicine 2, Helios Hospital Meiningen GmbH, Meiningen, Germany
| | - P Fusaroli
- Gastroenterology Unit, Department of Medical and Surgical Sciences University of Bologna/Hospital of Imola, Italy
| | - O H Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen and Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - E Buscarini
- Departement of Gastroenterology and Endoscopy, Ospedale Maggiore Crema, Italy
| | - R F Havre
- Department of Medicine and National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway
| | - A Ignee
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - A Saftoiu
- Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy, Craiova, Romania and Department of Endoscopy, Gastrointestinal Unit, Copenhagen University Hospital Herlev, Denmark
| | - P Vilmann
- GastroUnit, Department of Surgery, University Hospital Herlev, Copenhagen, Denmark
| | - E Burmester
- Department of Internal Medicine I, Sana Kliniken, Luebeck, Germany
| | - C P Nolsøe
- Department of Gastric Surgery, Ultrasound Section, Herlev Hospital, University of Copenhagen, Denmark
| | - D Nürnberg
- Department of Gastroenterology, Brandenburg University of Medicine Theodor Fontane, Neuruppin, Germany
| | - M D'Onofrio
- Department of Radiology, GB Rossi University Hospital, University of Verona, Italy
| | - T Lorentzen
- Department of Gastric Surgery, Ultrasound Section, Herlev Hospital, University of Copenhagen, Denmark
| | - F Piscaglia
- Unit of Internal Medicine, Department of Medical and Surgical Sciences, University of Bologna, Italy
| | - P S Sidhu
- Department of Radiology, King's College Hospital, London, UK
| | - C F Dietrich
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
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Abstract
Thyroid nodules and thyroid abnormalities are common findings in the general population. Ultrasonography is the most important imaging tool for diagnosing thyroid disease. In the majority of cases a correct diagnosis can already be made in synopsis of the sonographic together with clinical findings and basal thyroid hormone parameters and an appropriate therapy can be initiated thereafter. A differentiation of hormonally active vs. inactive nodes, and in particular benign vs. malignant nodules is sonographically, however, not reliably possible. In this context, radioscanning has its clinical significance predominantly in diagnosing hormonal activity of thyroid nodules. Efforts of the past years aimed to improve sonographic risk stratification to predict malignancy of thyroid nodules through standardized diagnostic assessment of evaluated risk factors in order to select patients, who need further diagnostic work up. According to the "Breast Imaging Reporting and Data System" (BI-RADS), "Thyroid Imaging Reporting and Data Systems" (TI-RADS) giving standardized categories with rates of malignancy were evaluated as a basis for further clinical management. Recent technological developments, such as elastography, also showpromising data and could gain entrance into clinical practice. The ultrasound-guided fineneedle aspiration is the key element in the diagnosis of sonographically suspicious thyroid nodules and significantly contributes to the diagnosis of malignancy versus benignity.
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Affiliation(s)
- C F Dietrich
- Innere Medizin 2, Caritas Krankenhaus Bad Mergentheim
| | - J Bojunga
- Schwerpunkt Endokrinologie und Diabetologie, Medizinische Klinik I, Johann Wolfgang Goethe-Universität, Frankfurt am Main
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20
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Dietrich CF, Chiorean L, Potthoff A, Ignee A, Cui X, Sparchez Z. Percutaneous sclerotherapy of liver and renal cysts, comments on the EFSUMB guidelines. Z Gastroenterol 2016; 54:155-66. [PMID: 26854836 DOI: 10.1055/s-0041-106594] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Cystic lesions in the liver and kidneys are common incidental findings. They are generally benign and require no treatment. They can appear sporadically or as part of a syndrome, and are characterised by their anechoic structure and posterior enhancement in ultrasound imaging. Increased size, haemorrhage or infection of a cyst can lead to development of symptoms. Along with surgical options and laparoscopic cyst fenestration, ultrasound-guided sclerotherapy of symptomatic cysts represents an effective and safe minimally invasive treatment option.
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Affiliation(s)
- C F Dietrich
- Innere Medizin 2, Caritas Krankenhaus Bad Mergentheim, Germany
| | - L Chiorean
- Innere Medizin 2, Caritas Krankenhaus Bad Mergentheim, Germany
| | - A Potthoff
- Gastroenterology, Hepatology and Endocrinology, Medizinische Hochschule, Hannover, Germany
| | - A Ignee
- Innere Medizin 2, Caritas Krankenhaus Bad Mergentheim, Germany
| | - X Cui
- Innere Medizin 2, Caritas Krankenhaus Bad Mergentheim, Germany
| | - Z Sparchez
- Gastroenterology, University of Medicine and Pharmacy "Iuliu Hatieganu", Institute for Gastroenterology and Hepatology "O.Fodor", Cluj-Napoca, Romania
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21
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Cantisani V, Dietrich CF, Badea R, Dudea S, Prosch H, Cerezo E, Nuernberg D, Serra AL, Sidhu PS, Radzina M, Piscaglia F, Bachmann Nielsen M, Calliada F, Gilja OH. EFSUMB statement on medical student education in ultrasound [short version]. Ultraschall Med 2016; 37:100-102. [PMID: 26871409 DOI: 10.1055/s-0035-1566959] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) recommends that ultrasound should be used systematically as an easy accessible and instructive educational tool in the curriculum of modern medical schools. Medical students should acquire theoretical knowledge of the modality and hands-on training should be implemented and adhere to evidence-based principles. In this paper we summarise EFSUMB policy statements on medical student education in ultrasound.
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Affiliation(s)
- V Cantisani
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, University Sapienza, Rome, Italy
| | - C F Dietrich
- Medizinische Klinik 2, Caritas Krankenhaus Bad Mergentheim, Germany
| | - R Badea
- Department of Ultrasonography, 3rd Medical Clinic, Institute of Gastroenterology and Hepatology Octavian Fodor; Imaging Department, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj Napoca, Romania
| | - S Dudea
- Radiology Dept. "Iuliu Hatieganu" Univ. Med. Pharm. Cluj-Napoca, Romania
| | - H Prosch
- Dept. of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna General Hospital, Austria
| | - E Cerezo
- Calle Francisco Silvela #124, lo 3 Madrid, Spain
| | - D Nuernberg
- Department of Gastroenterology, Brandenburg University of Medicine Theodor Fontane, Neuruppin, Germany
| | - A L Serra
- Department of Internal Medicine and Nephrology, Ultrasound Learning Center, Hirslanden Clinic, Zürich, Switzerland
| | - P S Sidhu
- Department of Radiology, King's College Hospital, London, UK
| | - M Radzina
- Diagnostic Radiology Institute, Paula Stradins Clinical University Hospital, Riga, Latvia
| | - F Piscaglia
- Unit of Internal Medicine, Department of Medical and Surgical Sciences, University of Bologna, Italy
| | - M Bachmann Nielsen
- Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - F Calliada
- Department of Radiology. Policlinico San Matteo, University Hospital, Pavia, Italy
| | - O H Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen and Department of Clinical Medicine, University of Bergen, Norway
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22
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Dietrich CF, Lorentzen T, Appelbaum L, Buscarini E, Cantisani V, Correas JM, Cui XW, D'Onofrio M, Gilja OH, Hocke M, Ignee A, Jenssen C, Kabaalioğlu A, Leen E, Nicolau C, Nolsøe CP, Radzina M, Serra C, Sidhu PS, Sparchez Z, Piscaglia F. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part III - Abdominal Treatment Procedures (Long Version). Ultraschall Med 2016; 37:E1-E32. [PMID: 26871408 DOI: 10.1055/s-0035-1553917] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The third part of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Guidelines on Interventional Ultrasound (INVUS) assesses the evidence for ultrasound-guided and assisted interventions in abdominal treatment procedures. Recommendations for clinical practice are presented covering indications, contraindications, and safe and effective performance of the broad variety of these techniques. In particular, drainage of abscesses and fluid collections, interventional tumor ablation techniques, interventional treatment of symptomatic cysts and echinococcosis, percutaneous transhepatic cholangiography and drainage, percutaneous gastrostomy, urinary bladder drainage, and nephrostomy are addressed (long version).
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Affiliation(s)
- C F Dietrich
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - T Lorentzen
- Department of Gastric Surgery, Ultrasound Section, Herlev Hospital, University of Copenhagen, Denmark
| | - L Appelbaum
- Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - E Buscarini
- Department of Gastroenterology and Endoscopy, Ospedale Maggiore Crema, Italy
| | - V Cantisani
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, Univ. Sapienza, Rome, Italy
| | - J M Correas
- Department of Adult Radiology, Paris-Descartes University and Necker University Hospital, Paris, and Institut Langevin - Inserm U979, Paris, France
| | - X W Cui
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - M D'Onofrio
- Department of Radiology, GB Rossi University Hospital, University of Verona, Italy
| | - O H Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen Norway and Department of Clinical Medicine, University of Bergen, Norway
| | - M Hocke
- Department of Internal Medicine 2, Helios Hospital Meiningen GmbH, Meiningen, Germany
| | - A Ignee
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - C Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch Oderland Strausberg/Wriezen, Germany
| | - A Kabaalioğlu
- Department of Radiology, Akdeniz University Medical Faculty, Antalya, Turkey
| | - E Leen
- Imperial College London and Imaging Department, Hammersmith Hospital Campus, London, UK
| | - C Nicolau
- Radiology Department, Hospital Clinic, Barcelona, Spain
| | - C P Nolsøe
- Department of Gastric Surgery, Ultrasound Section, Herlev Hospital, University of Copenhagen, Denmark
| | - M Radzina
- Diagnostic Radiology Institute, Paula Stradins Clinical University Hospital, Riga, Latvia
| | - C Serra
- Diagnostic and Interventional Ultrasound Unit, Department of Organ Failure and Transplantation, S. Orsola-Malpighi Hospital Bologna, Italy
| | - P S Sidhu
- Department of Radiology, King's College Hospital, London, UK
| | - Z Sparchez
- Department of Gastroenterology, Institute for Gastroenterology and Hepatology, University of Medicine and Pharmacy, "Iuliu Hatieganu" Cluj-Napoca, Institute for Gastroenterology and Hepatology "O.Fodor" Cluj-Napoca, Romania
| | - F Piscaglia
- Unit of Internal Medicine, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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23
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Dietrich CF, Lorentzen T, Appelbaum L, Buscarini E, Cantisani V, Correas JM, Cui XW, D'Onofrio M, Gilja OH, Hocke M, Ignee A, Jenssen C, Kabaalioğlu A, Leen E, Nicolau C, Nolsøe CP, Radzina M, Serra C, Sidhu PS, Sparchez Z, Piscaglia F. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part III - Abdominal Treatment Procedures (Short Version). Ultraschall Med 2016; 37:27-45. [PMID: 26670019 DOI: 10.1055/s-0035-1553965] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The third part of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Guidelines on Interventional Ultrasound assesses the evidence for ultrasound-guided and assisted interventions in abdominal treatment procedures. Recommendations for clinical practice are presented covering indications, contraindications, safety and efficacy of the broad variety of these techniques. In particular, drainage of abscesses and fluid collections, interventional tumor ablation techniques, interventional treatment of symptomatic cysts and echinococcosis, percutaneous transhepatic cholangiography and drainage, percutaneous gastrostomy, urinary bladder drainage, and nephrostomy are addressed (short version; a long version is published online).
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Affiliation(s)
- C F Dietrich
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - T Lorentzen
- Department of Gastric Surgery, Ultrasound Section, Herlev Hospital, University of Copenhagen, Denmark
| | - L Appelbaum
- Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - E Buscarini
- Department of Gastroenterology and Endoscopy, Ospedale Maggiore Crema, Italy
| | - V Cantisani
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, Univ. Sapienza, Rome, Italy
| | - J M Correas
- Department of Adult Radiology, Paris-Descartes University and Necker University Hospital, Paris, and Institut Langevin - Inserm U979, Paris, France
| | - X W Cui
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - M D'Onofrio
- Department of Radiology, GB Rossi University Hospital, University of Verona, Italy
| | - O H Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen Norway and Department of Clinical Medicine, University of Bergen, Norway
| | - M Hocke
- Department of Internal Medicine 2, Helios Hospital Meiningen GmbH, Meiningen, Germany
| | - A Ignee
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - C Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch Oderland Strausberg/Wriezen, Germany
| | - A Kabaalioğlu
- Department of Radiology, Akdeniz University Medical Faculty, Antalya, Turkey
| | - E Leen
- Imperial College London and Imaging Department, Hammersmith Hospital Campus, London, UK
| | - C Nicolau
- Radiology Department, Hospital Clinic, Barcelona, Spain
| | - C P Nolsøe
- Department of Gastric Surgery, Ultrasound Section, Herlev Hospital, University of Copenhagen, Denmark
| | - M Radzina
- Diagnostic Radiology Institute, Paula Stradins Clinical University Hospital, Riga, Latvia
| | - C Serra
- Diagnostic and Interventional Ultrasound Unit, Department of Organ Failure and Transplantation, S. Orsola-Malpighi Hospital Bologna, Italy
| | - P S Sidhu
- Department of Radiology, King's College Hospital, London, UK
| | - Z Sparchez
- Department of Gastroenterology, Institute for Gastroenterology and Hepatology, University of Medicine and Pharmacy, "Iuliu Hatieganu" Cluj-Napoca, Institute for Gastroenterology and Hepatology "O.Fodor" Cluj-Napoca, Romania
| | - F Piscaglia
- Unit of Internal Medicine, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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24
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Sidhu PS, Brabrand K, Cantisani V, Correas JM, Cui XW, D'Onofrio M, Essig M, Freeman S, Gilja OH, Gritzmann N, Havre RF, Ignee A, Jenssen C, Kabaalioğlu A, Lorentzen T, Mohaupt M, Nicolau C, Nolsøe CP, Nürnberg D, Radzina M, Saftoiu A, Serra C, Spârchez Z, Sporea I, Dietrich CF. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part II. Diagnostic Ultrasound-Guided Interventional Procedures (Long Version). Ultraschall Med 2015; 36:E15-E35. [PMID: 26669869 DOI: 10.1055/s-0035-1554036] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This is the second part of the series on interventional ultrasound guidelines of the Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB). It deals with the diagnostic interventional procedure. General points are discussed which are pertinent to all patients, followed by organ-specific imaging that will allow the correct pathway and planning for the interventional procedure. This will allow for the appropriate imaging workup for each individual interventional procedure (Long version).
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Affiliation(s)
- P S Sidhu
- Department of Radiology, King's College Hospital, London, UK
| | - K Brabrand
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, Norway
| | - V Cantisani
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, University Sapienza, Rome, Italy
| | - J M Correas
- Department of Adult Radiology, Paris-Descartes University and Necker University Hospital, Paris, and Institut Langevin - Inserm U979, Paris, France
| | - X W Cui
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - M D'Onofrio
- Department of Radiology, GB Rossi University Hospital, University of Verona, Italy
| | - M Essig
- Clinic of Gastroenterology, Departement Visceral Medicine, Inselspital, University Hospital of Bern, Switzerland
| | - S Freeman
- Department of Radiology, Derriford Hospital, Plymouth, UK
| | - O H Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen and Department of Clinical Medicine, University of Bergen, Norway
| | - N Gritzmann
- Radiology, Esslinger Hauptstraße 89, 1220 Vienna, Austria
| | - R F Havre
- Department of Medicine and National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway
| | - A Ignee
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - C Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch Oderland Strausberg/Wriezen, Germany
| | - A Kabaalioğlu
- Department of Radiology, Akdeniz University Medical Faculty, Antalya, Turkey
| | - T Lorentzen
- Department of Gastric Surgery, Ultrasound Section, Herlev Hospital, University of Copenhagen, Denmark
| | - M Mohaupt
- Department of Nephrology, Hypertension and Clinical Pharmacology, Division of Hypertension, University Hospital Berne, Switzerland
| | - C Nicolau
- Radiology Department, Hospital Clinic, Barcelona, Spain
| | - C P Nolsøe
- Department of Gastric Surgery, Ultrasound Section, Herlev Hospital, University of Copenhagen, Denmark
| | - D Nürnberg
- Department of Gastroenterology, Brandenburg University of Medicine Theodor Fontane, Neuruppin, Germany
| | - M Radzina
- Diagnostic Radiology Institute, Paula Stradins Clinical University Hospital, Riga, Latvia
| | - A Saftoiu
- Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy, Craiova, Romania
| | - C Serra
- Diagnostic and Interventional Ultrasound Unit, Department of Organ Failure and Transplantation S. Orsola-Malpighi Hospital Bologna, Italy
| | - Z Spârchez
- Department of Gastroenterology, Institute for Gastroenterology and Hepatology, University of Medicine and Pharmacy, "Iuliu Hatieganu" Cluj-Napoca and Institute for Gastroenterology and Hepatology "O. Fodor" Cluj-Napoca, Romania
| | - I Sporea
- Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy Victor Babes, Timisoara, Romania
| | - C F Dietrich
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
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25
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Bernatik T, Schuler A, Kunze G, Mauch M, Dietrich CF, Dirks K, Pachmann C, Börner N, Fellermann K, Menzel J, Strobel D. Benefit of Contrast-Enhanced Ultrasound (CEUS) in the Follow-Up Care of Patients with Colon Cancer: A Prospective Multicenter Study. Ultraschall Med 2015; 36:590-593. [PMID: 26544634 DOI: 10.1055/s-0041-107833] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE According to the German guidelines on colorectal cancer, unenhanced ultrasound is recommended for follow-up. On the other hand, ultrasound and radiology societies specify the use of contrast-enhanced ultrasound for ruling out liver metastases. Studies focusing on the follow-up of cancer patients are lacking. The goal of this multicenter study initiated by the German Ultrasound Society (DEGUM) was to determine the potential benefit of contrast-enhanced ultrasound in the follow-up of patients with colon cancer. MATERIALS AND METHODS Follow-up patients with colon cancer (UICC > IIa) were investigated. As scheduled according to the German guidelines, unenhanced ultrasound was performed followed by contrast-enhanced ultrasound. All liver lesions were recorded. In case of additional metastases detected on contrast-enhanced ultrasound, contrast-enhanced CT, MRI or biopsy was performed to confirm additional liver metastases. RESULTS A total of 45 liver metastases were detected in 26/290 patients (= 9 %) using unenhanced ultrasound. A further 28 metastases were detected on contrast-enhanced ultrasound in these 26 patients. In 18 patients showing no liver metastases, 40 additional metastases were detected on unenhanced ultrasound. This means that 44 patients with a total of 113 liver metastases were detected on contrast-enhanced ultrasound (p = 0.0006). CONCLUSION Contrast-enhanced ultrasound should be recommended in the follow-up of patients with colon cancer in addition to unenhanced ultrasound - the up-to-date standard.
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Affiliation(s)
- T Bernatik
- Dept. of Internal Medicine, Kreisklinik Ebersberg, Germany
| | - A Schuler
- Dept. of Internal Medicine, Helfenstein Klinik, Geislingen, Germany
| | - G Kunze
- Dept. of Internal Medicine, KH Villingen-Schwenningen, Villingen-Schwenningen, Germany
| | - M Mauch
- Dept. of Internal Medicine, Kreisklinik Sigmaringen, Germany
| | - C F Dietrich
- Dept. of Internal Medicine2, Caritas-Krankenhaus, Bad Mergentheim, Germany
| | - K Dirks
- Dept. of Internal Medicine, Rems-Murr-Klinik, Winnenden, Germany
| | - C Pachmann
- Dept. of Internal Medicine, Israelisches Krankenhaus, Hamburg, Germany
| | - N Börner
- MED Facharztzentrum, Gastroenterologische Praxis, Mainz, Germany
| | - K Fellermann
- Dept. of Internal Medicine1, university, Lübeck, Germany
| | - J Menzel
- Dept. of Internal Medicine2, Klinikum Ingolstadt, Germany
| | - D Strobel
- Dept. of Medicine 1, University of Erlangen, Germany
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26
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Sidhu PS, Brabrand K, Cantisani V, Correas JM, Cui XW, D'Onofrio M, Essig M, Freeman S, Gilja OH, Gritzmann N, Havre RF, Ignee A, Jenssen C, Kabaalioğlu A, Lorentzen T, Mohaupt M, Nicolau C, Nolsøe CP, Nürnberg D, Radzina M, Saftoiu A, Serra C, Spârchez Z, Sporea I, Dietrich CF. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part II. Diagnostic Ultrasound-Guided Interventional Procedures (Short Version). Ultraschall Med 2015; 36:566-580. [PMID: 26669871 DOI: 10.1055/s-0035-1566760] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This is the second part of the series on interventional ultrasound guidelines of the Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB). It deals with the diagnostic interventional procedure. General points are discussed which are pertinent to all patients, followed by organ-specific imaging that will allow the correct pathway and planning for the interventional procedure. This will allow for the appropriate imaging workup for each individual interventional procedure (Long version/ short version; the long version is published online).
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Affiliation(s)
- P S Sidhu
- Department of Radiology, King's College Hospital, London, UK
| | - K Brabrand
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, Norway
| | - V Cantisani
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, University Sapienza, Rome, Italy
| | - J M Correas
- Department of Adult Radiology, Paris-Descartes University and Necker University Hospital, Paris, and Institut Langevin - Inserm U979, Paris, France
| | - X W Cui
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - M D'Onofrio
- Department of Radiology, GB Rossi University Hospital, University of Verona, Italy
| | - M Essig
- Clinic of Gastroenterology, Departement Visceral Medicine, Inselspital, University Hospital of Bern, Switzerland
| | - S Freeman
- Department of Radiology, Derriford Hospital, Plymouth, UK
| | - O H Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen and Department of Clinical Medicine, University of Bergen, Norway
| | - N Gritzmann
- Radiology, Esslinger Hauptstraße 89, 1220 Vienna, Austria
| | - R F Havre
- Department of Medicine and National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway
| | - A Ignee
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - C Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch Oderland Strausberg/Wriezen, Germany
| | - A Kabaalioğlu
- Department of Radiology, Akdeniz University Medical Faculty, Antalya, Turkey
| | - T Lorentzen
- Department of Gastric Surgery, Ultrasound Section, Herlev Hospital, University of Copenhagen, Denmark
| | - M Mohaupt
- Department of Nephrology, Hypertension and Clinical Pharmacology, Division of Hypertension, University Hospital Berne, Switzerland
| | - C Nicolau
- Radiology Department, Hospital Clinic, Barcelona, Spain
| | - C P Nolsøe
- Department of Gastric Surgery, Ultrasound Section, Herlev Hospital, University of Copenhagen, Denmark
| | - D Nürnberg
- Department of Gastroenterology, Brandenburg University of Medicine Theodor Fontane, Neuruppin, Germany
| | - M Radzina
- Diagnostic Radiology Institute, Paula Stradins Clinical University Hospital, Riga, Latvia
| | - A Saftoiu
- Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy, Craiova, Romania
| | - C Serra
- Diagnostic and Interventional Ultrasound Unit, Department of Organ Failure and Transplantation S. Orsola-Malpighi Hospital Bologna, Italy
| | - Z Spârchez
- Department of Gastroenterology, Institute for Gastroenterology and Hepatology, University of Medicine and Pharmacy, "Iuliu Hatieganu" Cluj-Napoca and Institute for Gastroenterology and Hepatology "O. Fodor" Cluj-Napoca, Romania
| | - I Sporea
- Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy Victor Babes, Timisoara, Romania
| | - C F Dietrich
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
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27
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Lorentzen T, Nolsøe CP, Ewertsen C, Nielsen MB, Leen E, Havre RF, Gritzmann N, Brkljacic B, Nürnberg D, Kabaalioglu A, Strobel D, Jenssen C, Piscaglia F, Gilja OH, Sidhu PS, Dietrich CF. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part I. General Aspects (long Version). Ultraschall Med 2015; 36:E1-E14. [PMID: 26468774 DOI: 10.1055/s-0035-1553593] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This is the first part of the Guidelines on Interventional Ultrasound of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) and covers all general aspects of ultrasound-guided procedures (long version).
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Affiliation(s)
- T Lorentzen
- Department of Gastric Surgery, Ultrasound Section, Herlev Hospital, University of Copenhagen, Denmark
| | - C P Nolsøe
- Department of Gastric Surgery, Ultrasound Section, Herlev Hospital, University of Copenhagen, Denmark
| | - C Ewertsen
- Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Denmark
| | - M B Nielsen
- Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Denmark
| | - E Leen
- Imperial College London and Imaging Department, Hammersmith Hospital Campus, London, UK
| | - R F Havre
- National Centre for Ultrasound in Gastroenterology, Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - N Gritzmann
- Radiologist, Esslinger Hauptstraße 89, 1220 Wien, Austria
| | - B Brkljacic
- University of Zagreb School of Medicine, Department of Diagnostic and Interventional Radiology, University Hospital "Dubrava", Zagreb, Croatia
| | - D Nürnberg
- Department of Gastroenterology, Brandenburg University of Medicine Theodor Fontane, Neuruppin, Germany
| | - A Kabaalioglu
- Department of Radiology, Akdeniz University Medical Faculty, Antalya, Turkey
| | - D Strobel
- Department of Medicine I, University Hospital Erlangen, Germany
| | - C Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch Oderland, Strausberg/Wriezen, Germany
| | - F Piscaglia
- Unit of Internal Medicine, Department of Medical and Surgical Sciences, University of Bologna Hospital, Bologna, Italy
| | - O H Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen Norway and Department of Clinical Medicine, University of Bergen, Norway
| | - P S Sidhu
- Department of Radiology, King's College Hospital, London, UK
| | - C F Dietrich
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
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28
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Dietrich CF, Lorentzen T, Sidhu PS, Jenssen C, Gilja OH, Piscaglia F. An Introduction to the EFSUMB Guidelines on Interventional Ultrasound (INVUS). Ultraschall Med 2015; 36:460-463. [PMID: 26468771 DOI: 10.1055/s-0035-1553462] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- C F Dietrich
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - T Lorentzen
- Department of Gastroenterology, Surgical Section, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - P S Sidhu
- Department of Radiology, King's College Hospital, London, UK
| | - C Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch Oderland, Strausberg/Wriezen, Germany
| | - O H Gilja
- National Centre for Ultrasound in Gastroenterology, Department of Medicine, Haukeland University Hospital, Bergen, Norway and Department of Clinical Medicine, University of Bergen, Norway
| | - F Piscaglia
- Unit of Internal Medicine, Dept of Medical and Surgical Sciences, University of Bologna Hospital S.Orsola Malpighi, Bologna, Italy
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29
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Dietrich CF, Lembcke B, Jenssen C, Hocke M, Ignee A, Hollerweger A. Intestinal Ultrasound in Rare Gastrointestinal Diseases, Update, Part 2. Ultraschall Med 2015; 36:428-456. [PMID: 26091002 DOI: 10.1055/s-0034-1399730] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Intestinal ultrasound has become an established and valid diagnostic method for inflammatory bowel disease, diverticulitis, appendicitis, bowel obstruction, perforation and intussusception. However, little is known about sonographic findings in other rarer intestinal diseases. Ultrasound may display the transformation of the intestinal wall from a normal to a pathological state both in inflammatory and neoplastic disease. Besides demonstrating the transmural aspect, it also shows the mesenteric reaction as well as complications such as fistula, abscesses, stenosis, or ileus. Furthermore, in some diseases intestinal ultrasound may serve as a diagnostic clue if typical patterns of the bowel wall and impaired peristalsis can be demonstrated. This may lead to an important reduction of invasive and expensive (follow-up) procedures. The information gained by ultrasound regarding intestinal disease, however, is as important and valid as e. g. in case of focal lesions of the liver. Serving as tertiary referral centers for a broad spectrum of intestinal diseases, we therefore report some aspects of ultrasound in patients with less often recognized diseases. The article is divided into two parts, the first focusing on examination techniques, infectious diseases and celiac sprue and the second on hereditary, vascular and neoplastic diseases and varia.
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Affiliation(s)
- C F Dietrich
- Department of Internal Medicine, Caritas-Krankenhaus, Bad Mergentheim, Germany
| | - B Lembcke
- Department of Internal Medicine, St.-Barbara-Hospital, Gladbeck, Germany
| | - C Jenssen
- Department of Internal Medicine, Märkisch Oderland Hospital, Strausberg/Wriezen, Germany
| | - M Hocke
- Internal Medicine II, Klinikum Meiningen, Germany
| | - A Ignee
- Department of Internal Medicine, Caritas-Krankenhaus, Bad Mergentheim, Germany
| | - A Hollerweger
- Department of Radiology, Hospital Barmherzige Brüder, Salzburg, Austria
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30
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Lorentzen T, Nolsøe CP, Ewertsen C, Nielsen MB, Leen E, Havre RF, Gritzmann N, Brkljacic B, Nürnberg D, Kabaalioglu A, Strobel D, Jenssen C, Piscaglia F, Gilja OH, Sidhu PS, Dietrich CF. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part I. General Aspects (Short Version). Ultraschall Med 2015; 36:464-472. [PMID: 26468772 DOI: 10.1055/s-0035-1553601] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This is the first part of the Guidelines on Interventional Ultrasound of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) and covers all general aspects of ultrasound-guided procedures (short version; the long version is published online).
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Affiliation(s)
- T Lorentzen
- Department of Gastric Surgery, Ultrasound Section, Herlev Hospital, University of Copenhagen, Denmark
| | - C P Nolsøe
- Department of Gastric Surgery, Ultrasound Section, Herlev Hospital, University of Copenhagen, Denmark
| | - C Ewertsen
- Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Denmark
| | - M B Nielsen
- Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Denmark
| | - E Leen
- Imperial College London and Imaging Department, Hammersmith Hospital Campus, London, UK
| | - R F Havre
- National Centre for Ultrasound in Gastroenterology, Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - N Gritzmann
- Radiologist, Esslinger Hauptstraße 89, 1220 Wien, Austria
| | - B Brkljacic
- University of Zagreb School of Medicine, Department of Diagnostic and Interventional Radiology, University Hospital "Dubrava", Zagreb, Croatia
| | - D Nürnberg
- Department of Gastroenterology, Brandenburg University of Medicine Theodor Fontane, Neuruppin, Germany
| | - A Kabaalioglu
- Department of Radiology, Akdeniz University Medical Faculty, Antalya, Turkey
| | - D Strobel
- Department of Medicine I, University Hospital Erlangen, Germany
| | - C Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch Oderland, Strausberg/Wriezen, Germany
| | - F Piscaglia
- Unit of Internal Medicine, Department of Medical and Surgical Sciences, University of Bologna Hospital, Bologna, Italy
| | - O H Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen Norway and Department of Clinical Medicine, University of Bergen, Norway
| | - P S Sidhu
- Department of Radiology, King's College Hospital, London, UK
| | - C F Dietrich
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
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Fröhlich E, Jenssen C, Schuler A, Dietrich CF. [Contrast-enhanced ultrasound for characterisation of focal liver lesions, practical advice]. Z Gastroenterol 2015; 53:1099-107. [PMID: 26367027 DOI: 10.1055/s-0035-1553491] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This review article reports on evidence-based and clinical aspects of contrast-enhanced ultrasound of liver masses. The advanced possibilities of contrast-enhanced ultrasound to detect and characterise liver tumors are described as well as limitations and pitfalls of the method. The choice of the ultrasound device and contrast agents as well as the qualifications of the examiners according to guidelines are discussed.
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Affiliation(s)
- E Fröhlich
- Medizinische Klinik, Karl-Olga-Krankenhaus, Stuttgart, Germany
| | - C Jenssen
- Medizinische Klinik, Krankenhaus Märkisch Oderland GmbH, Wriezen, Germany
| | - A Schuler
- Medizinische Klinik, Helfenstein Klinik, Geislingen, Germany
| | - C F Dietrich
- Medizinische Klinik, Caritas-Krankenhaus Bad Mergentheim, Germany
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Abstract
Local ablative therapies have become an important part in the portfolio of treatment for patients with malignant tumors especially in the liver. Although percutaneous ethanol injection still plays a role, current guidelines favor radiofrequency ablation with a higher efficacy for complete tumor destruction. Nevertheless transplantation and surgical resection remain the gold standard due to their superiority in local control and improved survival. In this manuscript we discuss the technique in detail.
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Affiliation(s)
- C F Dietrich
- Sino-German Research Center of Ultrasound in Medicine, The first Affiliated Hospital of Zhengzhou University, China
| | - X W Cui
- Sino-German Research Center of Ultrasound in Medicine, The first Affiliated Hospital of Zhengzhou University, China
| | - L Chiorean
- Sino-German Research Center of Ultrasound in Medicine, The first Affiliated Hospital of Zhengzhou University, China
| | - L Appelbaum
- Radiology Department, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - E Leen
- Imaging Department, Imperial College London, Hammersmith Hospital Campus, London, United Kingdom
| | - A Ignee
- II. Medizinische Klinik, Caritas Krankenhaus, Bad Mergentheim, Germany
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Ignee A, Cui X, Schuessler G, Dietrich CF. Percutaneous transhepatic cholangiography and drainage using extravascular contrast enhanced ultrasound. Z Gastroenterol 2015; 53:385-90. [PMID: 25965985 DOI: 10.1055/s-0034-1398796] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND PURPOSE Percutaneous transhepatic cholangiography and drainage (PTCD) is a common procedure for the diagnosis and treatment of benign and malignant biliary diseases. Ultrasound (US) is frequently used for the guidance of PTCD. Conventional fluoroscopy is applied to evaluate the biliary system, but delivers significant X-ray dosage to the patient and the interventional team. The purpose of this study is to test the ability of extravascular contrast-enhanced ultrasound (EV-CEUS) in US-guided PTCD to reduce or replace fluoroscopy. PATIENTS AND METHODS 38 patients underwent PTCD. 2 - 4 mL doses of a SonoVue dilution were repeatedly injected to demonstrate correct needle and drainage positions in the biliary system and in the intestine during the intervention and during follow-up to screen for complications. The results were compared to those of conventional radiography. RESULTS The success rate for cholangiography was 100 % for EV-CEUS and fluoroscopy each. 27/38 patients (71 %) received a ring catheter, 5/38 patients (13 %) received a metal stent. Only external drainage was possible in 6/38 patients (16 %) in the first session. In 50 % of them (3/38, 8 %) internalization was possible in the second attempt. With EV-CEUS the level of obstruction could be correctly diagnosed in 100 % of the patients. The degree of obstruction (complete/incomplete) could be correctly diagnosed in 37/38 patients (97 %). EV-CEUS was not able to demonstrate the guide wire. In 1/38 patient a hematoma appeared which was managed conservatively. Dislodgement was diagnosed in 2/38 (5 %) patients during follow-up by injecting EV-CEUS solution into the drain. Pleural injury with fistula could be demonstrated in 1/38 (3 %) patients. CONCLUSION EV-CEUS can monitor the success of insertion of needle and catheter, demonstrate or exclude complications, and therefore significantly reduce fluoroscopy time in US-guided PTCD. Fluoroscopy is needed whenever subtle wire steering is necessary as in most cases when the intestinal position of the drain is sought. If only external drainage is necessary fluoroscopy can be omitted.
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Abstract
This review summarizes ultrasound guided interventions in palliative care medicine.
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Affiliation(s)
| | - C Jenssen
- Innere Medizin, Krankenhaus Märkisch Oderland GmbH, Wriezen, Germany
| | - X Cui
- II. Medizinische Klinik, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - A Ignee
- II. Medizinische Klinik, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - C F Dietrich
- Innere Medizin 2, Caritas Krankenhaus Bad Mergentheim, Germany
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Abstract
Fasciolosis is a zoonosis affecting ruminants, caused by the liver flukes Fasciola (F.) hepatica, and F. gigantica, which infect at least 2.4 million people worldwide. This disease may occur in cluster or family infections or after travel in high-risk areas such as the Nile Delta in Egypt, Iran, Turkey, South-East Asia, Mexico, the Caribbean and the Andean Altiplano. In Europe, fasciolosis occurs more frequently in Portugal, Spain and France, although autochthonous infections have also been reported from Ireland and Germany. Infectious metacercariae are ingested with contaminated water or raw or undercooked vegetables. During their larval stage immature flukes migrate through the liver producing an acute febrile syndrome some weeks after infection, followed by a chronic-latent stage which may last for years or decades. Acute fasciolosis is characterized by fever, high eosinophilia and hepatosplenomegaly. At this stage ova are usually not yet produced. Diagnosis relies on the detection of specific antibodies and/or antigens in serum. Typical imaging features include multiple, ill-defined, fleeting hypodense or hypoechoic areas in the liver. Intraabdominal bleeding due to fluke's penetration of the bowel wall or liver capsule, may occur. In chronic latent fasciolosis the diagnosis is achieved by specific serology tests, detection of eggs in bile and parasitological examinations of multiple enriched stools samples. Ultrasonography may sometimes reveal a dilated and thickened common bile duct or crescent-like parasites in the gallbladder or bile ducts. Some patients exhibit sludge which typically does not sediment. Triclabendazole at a single dose of 10 mg/kg body weight is the treatment of choice.
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Affiliation(s)
- C F Dietrich
- Innere Medizin 2, Caritas Krankenhaus Bad Mergentheim
| | - A Kabaalioglu
- Akdeniz University Hospital, Department of Radiology, Antalya-Turkey
| | - E Brunetti
- Division of Infectious and Tropical Diseases, San Matteo Hospital Foundation, University of Pavia
| | - J Richter
- Tropenmedizinische Ambulanz, Klinik für Gastroenterologie, Hepatologie und Infektiologie, Heinrich-Heine Universität Düsseldorf
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Affiliation(s)
- C Tana
- Internal Medicine Unit, Guastalla Hospital, AUSL Reggio Emilia, Italy
| | - M Silingardi
- Internal Medicine Unit, Guastalla Hospital, AUSL Reggio Emilia, Italy
| | - C F Dietrich
- Innere Medizin 2, Caritas Krankenhaus Bad Mergentheim, Germany
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Abstract
Thyroid nodules and thyroid abnormalities are common findings in the general population. Ultrasonography is the most important imaging tool for diagnosing thyroid disease. In the majority of cases a correct diagnosis can already be made in synopsis of the sonographic together with clinical findings and basal thyroid hormone parameters and an appropriate therapy can be initiated thereafter. A differentiation of hormonally active versus inactive nodes, and in particular benign versus malignant nodules is sonographically, however, not reliably possible. In this context, radioscanning has its clinical significance predominantly in diagnosing hormonal activity of thyroid nodules. Efforts of the past years aimed to improve sonographic risk stratification to predict malignancy of thyroid nodules through standardized diagnostic assessment of evaluated risk factors in order to select patients, who need further diagnostic work up. According to the "Breast Imaging Reporting and Data System" (BI-RADS), "Thyroid Imaging Reporting and Data Systems" (TI-RADS) giving standardized categories with rates of malignancy were evaluated as a basis for further clinical management. Recent technological developments, such as elastography, also show promising data and could gain entrance into clinical practice. The ultrasound-guided fine-needle aspiration is the key element in the diagnosis of sonographically suspicious thyroid nodules and significantly contributes to the diagnosis of malignancy versus benignity.
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Affiliation(s)
- C F Dietrich
- Innere Medizin 2, Caritas Krankenhaus Bad Mergentheim
| | - J Bojunga
- Schwerpunkt Endokrinologie und Diabetologie, Medizinische Klinik I, Johann Wolfgang Goethe-Universität, Frankfurt am Main
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Cui XW, Dietrich CF. Authors reply. Ultraschall Med 2015; 36:74-75. [PMID: 25802905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Abstract
Ultrasound is often the first imaging procedure performed in the evaluation of individuals with suspected or known liver disease. Despite technical advances in ultrasound techniques, sonographic detection and evaluation of diffuse liver disease still remains difficult. This is due to the fact that diffuse liver disease does not always cause distortion of the liver parenchymal texture, internal liver architecture, or shape of the liver. On the other hand, the size of the liver, the echo pattern of the hepatic parenchyma, the analysis of intrahepatic vessels and alterations in perihepatic structures and lymph nodes can be helpful sonographic parameters of diffuse liver disease. Until now, the sonographic appearance of some rare diffuse liver diseases is not well known. However, there are some typical sonomorphological signs that, once identified, can facilitate the differentiation between various diseases. The aim of this paper is to highlight some typical ultrasound findings of liver parenchyma and perihepatic lymph node structures in rare diffuse liver diseases based on a review of published data.
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Affiliation(s)
- A P Barreiros
- Medical Department I, University Hospital, University of Regensburg, Regensburg, Germany
| | - L Chiorean
- Department of Ultrasonography, "Octavian Fodor" Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
| | - B Braden
- Translational Gastroenterology Unit, Oxford University Hospitals, Oxford, U. K
| | - C F Dietrich
- Medical Department II, Caritaskrankenhaus, Bad Mergentheim, Germany
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Ingravallo F, Dietrich CF, Gilja OH, Piscaglia F. Guidelines, clinical practice recommendations, position papers and consensus statements: definition, preparation, role and application. Ultraschall Med 2014; 35:395-399. [PMID: 25317551 DOI: 10.1055/s-0034-1385158] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- F Ingravallo
- Legal Medicine, Dpt of Medical and Surgical Sciences DIMEC, Alma Mater Studiorum, University of Bologna, Italy
| | - C F Dietrich
- Med. Klinik 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - O H Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, and Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - F Piscaglia
- Internal Medicine, Dpt of Medical and Surgical Sciences DIMEC, Alma Mater Studiorum, University of Bologna, Italy
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Dietrich CF, Lembcke B, Jenssen C, Hocke M, Ignee A, Hollerweger A. Intestinal ultrasound in rare gastrointestinal diseases, update, part 1. Ultraschall Med 2014; 35:400-421. [PMID: 25317552 DOI: 10.1055/s-0034-1385154] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- C F Dietrich
- Innere Medizin 2, Caritas-Krankenhaus, Bad Mergentheim
| | - B Lembcke
- Klinik für Innere Medizin, St.-Barbara-Hospital, Gladbeck
| | - C Jenssen
- Klinik für Innere Medizin, Krankenhaus Märkisch Oderland Strausberg/ Wriezen
| | - M Hocke
- Internal Medicine II, Klinikum Meiningen
| | - A Ignee
- Innere Medizin 2, Caritas-Krankenhaus, Bad Mergentheim
| | - A Hollerweger
- Radiologie, Krankenhaus Barmherzige Brüder, Salzburg
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Cui XW, Pirri C, Ignee A, De Molo C, Hirche TO, Schreiber-Dietrich DG, Dietrich CF. Measurement of shear wave velocity using acoustic radiation force impulse imaging is not hampered by previous use of ultrasound contrast agents. Z Gastroenterol 2014; 52:649-53. [PMID: 25026006 DOI: 10.1055/s-0034-1366036] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE To assess the inter-observer reproducibility of acoustic radiation force impulse imaging (ARFI) between 2 skilled physicians and to evaluate if ultrasound contrast agents (UCA) affect the measurement of shear wave velocity (SWV) using ARFI. PATIENTS AND METHODS 53 patients (29 males, 24 females, 59 ± 15 [22-84] years) who underwent contrast enhanced ultrasound (CEUS) examination were included. ARFI was performed on liver segment V by physicians A and B before CEUS, and by physician A within 4-6 minutes and 7-10 minutes after contrast injection. In a subgroup of 31 patients (15 males, 16 females, 57 ± 18 [22-84] years), ARFI was also performed on focal liver lesions (FLL) by physician A before CEUS, and within 4-6 minutes and 7-10 minutes after contrast injection. RESULTS The SWV values obtained by physician A and B before CEUS yielded an intra-class correlation coefficient value of 0.913 (95% CI, 0.849-0.950). No significant differences were shown between the SWV values of liver segment V in all 53 patients and of FLL in the subgroup of 31 patients obtained before CEUS and that of within 4-6 minutes and 7-10 minutes after contrast injection (all P > 0.05). CONCLUSION ARFI showed excellent inter-observer reproducibility between 2 skilled physicians. UCA did not affect the measurement of SWV in both liver parenchyma and FLL, at least when performed 4 minutes after the contrast injection. ARFI may become an additional tool in the differential diagnosis of FLL.
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Affiliation(s)
- X W Cui
- Medizinische Klinik 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - C Pirri
- Medizinische Klinik 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - A Ignee
- Medizinische Klinik 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - C De Molo
- Medizinische Klinik 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - T O Hirche
- Innere Medizin, Deutsche Klinik für Diagnostik, Wiesbaden, Germany
| | | | - C F Dietrich
- Medizinische Klinik 2, Caritas Krankenhaus, Bad Mergentheim, Germany
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Cui XW, Ignee A, Hocke M, Seitz K, Schrade G, Dietrich CF. Prolonged heterogeneous liver enhancement on contrast-enhanced ultrasound. Ultraschall Med 2014; 35:246-252. [PMID: 23888425 DOI: 10.1055/s-0033-1350202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
INTRODUCTION Prolonged heterogeneous liver enhancement (PHLE) is a rare phenomenon that is similar to the ultrasound findings of portal venous gas. The purpose of this report is to describe the phenomenon of PHLE after the injection of the ultrasound contrast agent SonoVue(®). PATIENTS AND METHODS From 2000 to 2013, 13 patients with PHLE ("cloudy", "wool-like") after bolus injection of SonoVue(®) were observed. The height, weight, and body mass index (BMI) of the patients, and the number of injections were analyzed. In addition, the literature was reviewed. RESULTS The phenomenon occurred as early as 2 minutes after bolus contrast administration and lasted up to 5 hours on both B-mode and contrast-specific ultrasound. 8/13 (62 %) patients received two or more boluses. None of the patients experienced SonoVue(®)-related side effects or health problems. The phenomenon was not reproducible in 3 patients who received a second SonoVue(®) injection 24 hours after receiving the first. CONCLUSION This phenomenon is more likely to occur in patients who receive high-dose (or multiple) injections of UCA. It may occur as early as 2 minutes after contrast administration, and therefore, may affect the evaluation of focal liver lesions in the late phase. This phenomenon should not be misdiagnosed as a pathological finding of the liver.
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Affiliation(s)
- X W Cui
- Medical department 2, Caritas-Krankenhaus, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim
| | - A Ignee
- Medical department 2, Caritas-Krankenhaus, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim
| | - M Hocke
- Medical department 2, Hospital Meiningen GmbH, Academic Teaching Hospital of the University of Jena, Meiningen
| | - K Seitz
- Medizinische Klinik, Ultraschall, Kreiskrankenhaus Sigmaringen
| | - G Schrade
- Medical department, Klinikum Westallgäu, Hospital Wangen
| | - C F Dietrich
- Medical department 2, Caritas-Krankenhaus, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim
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Dietrich CF, Ignee A, Greis C, Cui XW, Schreiber-Dietrich DG, Hocke M. Artifacts and pitfalls in contrast-enhanced ultrasound of the liver. Ultraschall Med 2014; 35:108-127. [PMID: 24477558 DOI: 10.1055/s-0033-1355872] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Ultrasound technology is always connected to possible artefacts. Since introduction of ultrasound technology the knowledge of those artefacts is eminent to avoid misinterpretations. It is important to know that with the introduction of new ultrasound technology the possibility of artefacts are rising.Whereas artefacts initially were limited to B-mode sonography, every technological step (colour Doppler sonography, contrast enhanced sonography) comes with a range of new artefacts. This article is written to explain the technological basics of ultrasound artefacts and provide the reader with examples in daily practice and how to avoid them.
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Affiliation(s)
- C F Dietrich
- Medical Department, Caritas-Krankenhaus, Bad Mergentheim
| | - A Ignee
- Medical Department, Caritas-Krankenhaus, Bad Mergentheim
| | - C Greis
- Ultrasound Department, Bracco Imaging Deutschland, Konstanz
| | - X W Cui
- Medical Department, Caritas-Krankenhaus, Bad Mergentheim
| | | | - M Hocke
- Medical Department, Klinikum Meiningen
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Barreiros AP, Cui XW, Ignee A, De Molo C, Pirri C, Dietrich CF. EchoScopy in scanning abdominal diseases: initial clinical experience. Z Gastroenterol 2014; 52:269-75. [PMID: 24622868 DOI: 10.1055/s-0033-1350114] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND AIMS The introduction of a new type of small handheld ultrasound device brings greater portability and affordability. The basic ultrasound approach with these handheld devices has been defined by European Federation of Societies of Ultrasound in Medicine and Biology (EFSUMB) as "EchoScopy". The current study aimed to assess the image quality, indications and limitations of a portable pocket "EchoScope" compared with a high-end ultrasound system in abdominal diseases. METHODS 231 consecutive patients were included in this study. Physician A performed ultrasound examinations with a high-end ultrasound system (HEUS), then physician B performed the same ultrasound examination using an EchoScope (Vscan™). In patients with focal lesions, physician B also measured the largest diameters and graded the vascularity by using colour Doppler imaging (CDI) within the lesion on the same plane with both ultrasound systems. Compared with the excellent image quality using HEUS, the image quality of the EchoScope was graded as good, sufficient or non-sufficient. RESULTS Out of all 231 patients, 167 had focal lesions, 19 patients were found with diffuse pathological findings, six with ascites, six after liver puncture and 33 without any pathological findings. The image quality of the pocket device was considered as being good or sufficient to delineate the pathology in 225/231 (97.4 %). The detection rate of the EchoScope for abdominal focal lesion was 162/167 (97 %), only five superficially located lesions could not be detected. Both systems showed agreement in determination of the best positioning to perform abdominal paracentesis and assessing complications after intervention. CONCLUSIONS The investigated EchoScope displays a sufficient image quality, in some indications such as detection of focal lesions > 20 mm, detection of ascites, hydronephrosis and other pathological findings with comparable results to HEUS. We conclude that pocket sized EchoScopy devices have a promising future but the indications have to be determined by a prospective study.
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Affiliation(s)
- A P Barreiros
- Department of Internal Medicine I, Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - X W Cui
- Medical Clinic 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany
| | - A Ignee
- Medical Clinic 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany
| | - C De Molo
- Medical Clinic 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany
| | - C Pirri
- Medical Clinic 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany
| | - C F Dietrich
- Medical Clinic 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany
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Hirche TO, Wagner TOF, Schreiber-Dietrich D, Ignee A, Dietrich CF. Evaluation der Mediastinalsonografie zur Diagnostik der Lymphadenopathie bei Patienten mit Sarkoidose. Pneumologie 2014. [DOI: 10.1055/s-0034-1367995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Cui XW, Hocke M, Jenssen C, Ignee A, Klein S, Schreiber-Dietrich D, Dietrich CF. Conventional ultrasound for lymph node evaluation, update 2013. Z Gastroenterol 2014; 52:212-21. [PMID: 24526406 DOI: 10.1055/s-0033-1356153] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Conventional ultrasound is regarded as the first method of choice to evaluate lymph node disease due to its high resolution. The combination of various features obtained from the patients history including age, acute or chronic onset, symptoms, and a knowledge of underlying systemic diseases as well as imaging criteria, most importantly B-mode (gray-scale) and colour Doppler imaging (CDI) are the basis for the differential diagnosis of lymphadenopathy. New ultrasound techniques such as elastography and contrast-enhanced ultrasound may provide further information. In addition, ultrasound evaluation of lymph nodes is an essential adjunct to the clinical investigation in staging of malignant neoplasia and lymphoma. In this paper the current literature is reviewed regarding conventional B-mode and Doppler ultrasound for the evaluation of lymphadenopathy. The ultrasound criteria for the differential diagnosis of enlarged and structurally altered lymph nodes are summarized and also limitations are described.
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Affiliation(s)
- X W Cui
- Department of Internal Medicine, Caritas-Krankenhaus, Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany
| | - M Hocke
- Department of Internal Medicine 2, Hospital Meiningen, Meiningen, Germany
| | - C Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch Oderland, Strausberg/Wriezen, Germany
| | - A Ignee
- Department of Internal Medicine, Caritas-Krankenhaus, Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany
| | - S Klein
- Department (Hematology and Oncology), Universitätsklinik Mannheim, Mannheim, Germany
| | - D Schreiber-Dietrich
- Department of Internal Medicine, Caritas-Krankenhaus, Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany
| | - C F Dietrich
- Department of Internal Medicine, Caritas-Krankenhaus, Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany
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Ignee A, Schuessler G, Cui XW, Dietrich CF. [Intracavitary contrast medium ultrasound - different applications, a review of the literature ad future prospects]. Ultraschall Med 2013; 34:504-528. [PMID: 23804197 DOI: 10.1055/s-0033-1335546] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Abstract
BACKGROUND AND AIM Up to now, little is known about the mobility of the pancreas due to changes in posture. The present study was conducted to assess the position of the pancreas in the left recumbent posture (endoscopy posture), the pancreatic mobility during changes of the posture from supine to endoscopy posture and also evaluates the possible factors associated with pancreatic mobility. METHODS 199 patients with (68) or without chronic pancreatitis were examined using conventional gray-scale transabdominal ultrasound to image the position and mobility of the pancreatic head with reference to the vertebral spine and aorta in the supine and left recumbent position. In a subgroup of 75 consecutive healthy subjects regarding the pancreas, the exact moving distance of the central line of the pancreatic head from the supine to left recumbent position was obtained regarding the central line of the spine as the reference. Besides the 199 patients, 50 patients without pancreatic pathology were evaluated by endoscopic ultrasound with radial transducers. RESULTS On conventional ultrasound in supine (left lateral) position the percentage of patients with right-aortal, pre-aortal, left-aortal pancreatic head were 91.0 % (49 %), 8.0 % (31 %) and 1.0 % (20 %), respectively. Significant movement of the pancreatic head in relation to the aorta was observed in 48 % of patients. The moving distance was correlated to the age, sex and the presence of chronic pancreatitis. Pancreas mobility was more pronounced in young healthy females. No association was found between the moving distance and the body mass index (BMI) and splenic size. On endoscopic ultrasound, the orientation of the pancreas with a view of more (or equal) than 180o was observed in 48 % and less than 180o in 52 % of patients. CONCLUSION Pancreas mobile is a common phenomenon (about 50 %) which has not often been recognized in daily routine. This phenomenon is more likely in healthy young females. This knowledge might be of importance for improved interpretation of endoscopic ultrasound imaging examinations in patients with and without peripancreatic infiltration.
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Affiliation(s)
- C De Molo
- Medizinische Klinik 2, Caritas-Krankenhaus, Bad Mergentheim
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Jenssen C, Hocke M, Dietrich CF. The Role of Endoscopic Ultrasound in Solid Pancreatic Lesions: Detection, Characterization, and Assessment of Resectability. Video Journal and Encyclopedia of GI Endoscopy 2013; 1:593-598. [DOI: 10.1016/s2212-0971(13)70253-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
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