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Liang, Xing-xin, Fan Li, Feng Gao, Yang Liu, Xiao-hui Qiao, Zheng Zhang, and Lian-fang Du. "The Value of the Model and Quantitative Parameters of Contrast-Enhanced Ultrasound in Judging the Severity of SHPT." BioMed Research International 2016 (2016): 1–5. http://dx.doi.org/10.1155/2016/6064526.
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Using the model and quantitative parameters of contrast-enhanced ultrasound (CEUS) to assess the severity of secondary hyperparathyroidism (SHPT) was proposed. 42 SHPT patients who underwent CEUS examination were divided into three groups, light, moderate, and heavy as per parathyroid hormone (PTH). The process of CEUS was divided into two phases, wash-in phase and wash-out phase. The three groups were analyzed with their enhancing model in the two phases. The quantitative parameters of CEUS such as Arrival Time (AT), Time to Peak (TTP), Mean Transit Time (MTT), and Maximum Intensity (IMAX) were measured by time-intensity curve (TIC) and compared among the three groups. The enhancing model of light SHPT, moderate SHPT, and heavy SHPT showed statistical significance in wash-in phase and wash-out phase (P<0.05). No difference was observed in AT and TTP among the three groups (P>0.05) while MTT and IMAX showed statistical significance (P<0.05). The CEUS of light SHPT was characterized by “slow-in, fast-out, and lower-enhancement” with short enhancement time; the CEUS of moderate SHPT was characterized by “fast-in, fast-out, and higher-enhancement” with slightly long enhancement time; the CEUS of heavy SHPT was characterized by “fast-in, slow-out, and higher-enhancement” with long enhancement time. Therefore, the model and quantitative parameters of CEUS can be benefit for the assessment of the severity of SHPT.
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Vavuranakis, Manolis, Fragiska Sigala, Dimitrios A. Vrachatis, Theodore G. Papaioannou, Konstantinos Filis, Nikolaos Kavantzas, Konstantinos I. Kalogeras, et al. "Quantitative analysis of carotid plaque vasa vasorum by CEUS and correlation with histology after endarterectomy." Vasa 42, no. 3 (May 1, 2013): 184–95. http://dx.doi.org/10.1024/0301-1526/a000267.
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Background: Intraplaque neovascularization and vasa vasorum (VV) proliferation contribute in the progression and rupture of atherosclerotic lesions. Contrast Enhanced Ultrasonography (CEUS) has been reported to attain data regarding intraplaque neovessels and VV. However, whether the detection of microbubbles by CEUS within atherosclerotic plaques truly represents microvessels is a point of concern. We aimed to evaluate stable and unstable carotid artery plaque (CAP) VV pattern by CEUS and its correlation with histology and immunochemistry. Patients and methods: Patients with CAP scheduled for plaque endarterectomy were enrolled. CAP was initially identified by conventional ultrasonography and subsequently CEUS (harmonic ultrasound imaging with simultaneous intravenous contrast agent injection) was performed. The recorded image loops were evaluated by a semi-automated method. Plaque specimens were excised and underwent histological and immunochemical (for CD34, Vascular Endothelial Growth Factor, CD68 and CD3 antibodies) analysis. Results: Fourteen patients (67.6 ± 10.2 years, 10 males) with a 86.9 ± 11.5 % degree of carotid artery stenosis were evaluated. Histology showed that half of the plaques were unstable. Enhancement of plaque brightness on CEUS was significant for both stable and unstable plaque subgroups (p = 0.018 for both). Immunochemistry showed that microvessels, as assessed by CD34 antibody, were more dense in unstable vs. stable plaques (36.6 ± 17.4 vs. 13.0 ± 7.2 respectively, p = 0.002). However, correlation between plaque brigthness enhancement on CEUS and microvessel density was significant only for stable (r = 0.800, p = 0.031) plaques. Conclusions: The identification of brightness enhacement during CEUS in carotid atherosclerotic plaques may not always reflect the presence of VV.
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Pavlovics, Sergejs, Maija Radzina, Rita Niciporuka, Madara Ratniece, Madara Mikelsone, Elina Tauvena, Mara Liepa, et al. "Contrast-Enhanced Ultrasound Qualitative and Quantitative Characteristics of Parathyroid Gland Lesions." Medicina 58, no. 1 (December 21, 2021): 2. http://dx.doi.org/10.3390/medicina58010002.
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Background and Objectives: preoperative differentiation of enlarged parathyroid glands may be challenging in conventional B-mode ultrasound. The aim of our study was to analyse qualitative and quantitative characteristics of parathyroid gland lesions, using multiparametric ultrasound protocol—B-mode, Colour Doppler (CD), and contrast-enhanced ultrasound (CEUS)—and to evaluate correlation with morphology in patients with hyperparathyroidism (HPT). Materials and Methods: consecutive 75 patients with 88 parathyroid lesions and biochemically confirmed HPT prior to parathyroidectomy were enrolled in the prospective study. B-mode ultrasound, CD, and CEUS were performed with the subsequent qualitative and quantitative evaluation of acquired data. We used 1 mL or 2 mL of intravenous ultrasound contrast agent during the CEUS examination. Correlation with post-surgical morphology was evaluated. Results: seventy parathyroid adenomas were hypoechoic and well contoured with increased central echogenicity (44.3%), peripheral-central vascularization (47%), and polar feeding vessel (100%). Twelve hyperplasias presented with similar ultrasound appearance and were smaller in volume (p = 0.036). Hyperplasias had a tendency for homogenous, marked intense enhancement vs. peripherally enhanced adenomas with central wash-out in CEUS after quantitative analysis. No significant difference was observed in contrasting dynamics, regardless of contrast media volume use (1 mL vs. 2 mL). We achieved 90.9% sensitivity and 72.7% specificity, 93% positive predictive value (PPV), 87.3% negative predictive value (NPV), and 87.3% accuracy in the differentiation of parathyroid lesions prior to post-processing. In a quantitative lesion analysis, our sensitivity increased up to 98%, specificity 80%, PPV 98%, and NPV 80% with an accuracy of 96.4%. Conclusions: CEUS of parathyroid lesions shows potential in the differentiation of adenoma from hyperplasia, regardless of the amount of contrast media injected. The quantitative analysis improved the sensitivity and specificity of differentiation between parathyroid lesions. Hyperplasia was characterized by homogeneous enhancement, fast uptake, and homogeneous wash-out appearance; adenoma—by peripheral uptake, central wash-out, and reduced hemodynamics. The use of CEUS quantification methods are advised to improve the ultrasound diagnostic role in suspected parathyroid lesions.
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Lu, Qin, Huihui Sun, Qian Yu, and Dongdong Tang. "Analysis of Contrast-Enhanced Ultrasound and Elastography in the Diagnosis of Benign and Malignant Apocrine Breast Tumors." Journal of Medical Imaging and Health Informatics 11, no. 7 (July 1, 2021): 1807–16. http://dx.doi.org/10.1166/jmihi.2021.3531.
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In the past thirty years, breast cancer in women has continued to rise. The age of onset for women has become lower. Contrast-enhanced ultrasound (CEUS) can clearly show the blood perfusion and neovascularization of breast masses. Elastography provides information on the stiffness of tissues. The combination of them shows a good advantage in the various early diagnosis of breast cancer. The combined electrograph can distinguish benign and malignant apocrine breast tumors. The shear wave electrograph (SWE) combined with CEUS has the strongest consistency in the diagnosis and pathology of breast benign tumors. When they were diagnosed separately, it was found that SWE has higher diagnostic value than CEUS; the quantitative diagnosis of SWE is slightly higher than the qualitative diagnosis, and the qualitative diagnosis of CEUS is higher than the quantitative diagnosis. Both SWE and CEUS are valuable in the diagnosis of benign and malignant apocrine breast tumor when combined treatment is made.
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Goertz, Ruediger S., Daniel Klett, Dane Wildner, Raja Atreya, Markus F. Neurath, and Deike Strobel. "Quantitative contrast-enhanced ultrasound for monitoring vedolizumab therapy in inflammatory bowel disease patients: a pilot study." Acta Radiologica 59, no. 10 (January 18, 2018): 1149–56. http://dx.doi.org/10.1177/0284185117752032.
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Background Microvascularization of the bowel wall can be visualized and quantified non-invasively by software-assisted analysis of derived time-intensity curves. Purpose To perform software-based quantification of bowel wall perfusion using quantitative contrast-enhanced ultrasound (CEUS) according to clinical response in patients with inflammatory bowel disease treated with vedolizumab. Material and Methods In a prospective study, in 18 out of 34 patients, high-frequency ultrasound of bowel wall thickness using color Doppler flow combined with CEUS was performed at baseline and after 14 weeks of treatment with vedolizumab. Clinical activity scores at week 14 were used to differentiate between responders and non-responders. CEUS parameters were calculated by software analysis of the video loops. Results Nine of 18 patients (11 with Crohn’s disease and seven with ulcerative colitis) showed response to treatment with vedolizumab. Overall, the responder group showed a significant decrease in the semi-quantitative color Doppler vascularization score. Amplitude-derived CEUS parameters of mural microvascularization such as peak enhancement or wash-in rate decreased in responders, in contrast with non-responders. Time-derived parameters remained stable or increased during treatment in all patients. Conclusion Analysis of bowel microvascularization by CEUS shows statistically significant changes in the wash-in-rate related to response of vedolizumab therapy.
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Kaltenbach, T. E. M., T. Graeter, R. A. Mason, S. Oeztuerk, M. M. Haenle, B. Gruener, M. Gottstein, and W. Kratzer. "Determination of vitality of liver lesions by alveolar echinococcosis." Nuklearmedizin 54, no. 01 (2015): 43–49. http://dx.doi.org/10.3413/nukmed-0670-14-05.
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SummaryObjective of our study is qualitative and quantitative comparison of contrast enhanced ultrasound (CEUS) and 18F-FDG PETCT in monitoring hepatic alveolar echinococcosis (HAE). Parasitic liver lesions were examined regarding number, size, morphology, vascularization and metabolic activity. Patients, methods: 36 patients with medicallytreated HAE were included in this prospective clinical study. Abdominal ultrasound and CEUS were carried out using ultrasound contrast amplifier SonoVue®. As part of monitoring, patients were examined by 18F-FDG-PET-CT. Quantitative analysis of CEUS was performed using the Software Vue- Box™ Quantification Toolbox. Maximum contrast enhancement in lesions peak enhancement (PE) was used as parameter. For quantification of 18F-FDG PET-CT, maximum Standardized Uptake Value (SUVmax) of lesions was specified and statistically compared with PE. Results: 18F-FDG uptake in parasitic liver lesions was diagnosed by 18F-FDG PET-CT in 32 of 36 patients. Vascularization of liver lesions was detected by CEUS in 22 of 32 FDG-positive patients with sensitivity of 69% and specificity of 100%. Mean maximum diameter of lesions was 69.5mm in CEUS and 63.7mm in B-scan ultrasound (p < 0.0001). No significant correlation was found between SUVmax and PE (p = 0.8879). Conclusion: In comparison to FDG PET-CT, the gold standard for detecting viable lesions by depicting metabolism, CEUS detects viable lesions with high specificity and moderate sensitivity by showing vascularization. CEUS must be regarded as an important tool in monitoring HAE. Dimensions of parasitic lesions are displayed more precisely through CEUS than in B-scan. With currently available methods, CEUS quantification has no benefit in monitoring HAE lesions in daily clinical practice.
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Wakonig, Katharina Margherita, Markus Herbert Lerchbaumer, Steffen Dommerich, Heidi Olze, Bernd Hamm, Thomas Fischer, and Philipp Arens. "Assessment of Parotid Gland Tumors by Means of Quantitative Multiparametric Ultrasound (mpUS)." Diagnostics 13, no. 1 (December 21, 2022): 12. http://dx.doi.org/10.3390/diagnostics13010012.
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Objective: The preoperative diagnostical differentiation of parotid gland tumor (PGT) is not always simple due to several different entities. B-mode-ultrasound (US) remains the imaging modality of choice, while histopathology serves as the gold standard for finalizing the diagnosis. We aimed to evaluate the use of multiparametric US (mpUS) in the assessment of PGT. Methods: We included 97 PGTs from 96 patients. A standardized mpUS protocol using B-mode-US, shear-wave elastography (SWE), and standardized contrast-enhanced ultrasound (CEUS) was performed prior to surgical intervention. SWE was assessed by real-time measurement conducting a minimum of five measurements, while quantitative CEUS parameters were assessed with a post-processing perfusion software. Results: SWE allowed differentiation between benign PGT (Warthin’s Tumor (WT) paired with lymph nodes (LN) and pleomorphic adenoma (PA)), and WT and LN were softer compared to PA. WT showed lower velocities than squamous cell carcinoma (SCC): the most common malignant PGT. CEUS parameters showed significant group differences between WT and PA, WT and malignant lesions, WT and SCC, WT paired with LN versus PA, and WT paired with LN versus SCC. Conclusion: MpUS seems to be beneficial in the assessment of PGT characterization, with benign PGT appearing to be softer in SWE than tumors with malignant tendencies. The quantitative CEUS parameter shows higher perfusion in WT than in PA, and malignant PGTs are less vascularized than WTs.
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Wang, Ling, and Chandra Mohan. "Contrast-enhanced ultrasound: A promising method for renal microvascular perfusion evaluation." Journal of Translational Internal Medicine 4, no. 3 (September 1, 2016): 104–8. http://dx.doi.org/10.1515/jtim-2016-0033.
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Abstract This article reviews the application of contrast-enhanced ultrasound (CEUS) in gauging renal microvascular perfusion in diverse renal diseases. The unique nature of the contrast agents used in CEUS provides real-time and quantitative imaging of the vasculature. In addition to the traditional use of CEUS for evaluation of kidney masses, it also emerges as a safe and effective imaging approach to assess microvascular perfusion in diffuse renal lesions, non-invasively. Although the precise CEUS parameters that may best predict disease still warrant systematic evaluation, animal models and limited clinical trials in humans raise hopes that CEUS could outcompete competing modalities as a first-line tool for assessing renal perfusion non-invasively, even in ailments such as acute kidney injury and chronic kidney disease.
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Banzato, Tommaso, Silvia Burti, Giuseppe Rubini, Riccardo Orlandi, Paolo Bargellini, Federico Bonsembiante, and Alessandro Zotti. "Contrast-enhanced ultrasonography features of hepatobiliary neoplasms in cats." Veterinary Record 186, no. 10 (October 3, 2019): 320. http://dx.doi.org/10.1136/vr.105453.
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BackgroundContrast-enhanced ultrasonography (CEUS) features of primary hepatobiliary neoplasms have been reported in dogs but no information is available in cats.MethodsQualitative and quantitative features of bile duct adenomas (BDAs, n=20), bile duct carcinomas (BDCs, n=16), and hepatocellular carcinomas (HCCs, n=8) are described in 44 cats.ResultsThere was an overlap in CEUS qualitative features between different histotypes, both in wash-in and wash-out phases. Distinction between different neoplasms based only on the CEUS qualitative features was not possible. At peak of enhancement, the BDAs, BDCs and HCCs showed a large range of echogenicities, from hypoenhancement to hyperenhancement, in comparison to the liver parenchyma. Eight of 20 BDAs showed inhomogeneous hyperenhancement during wash-in, which is a feature reported as typical of malignant lesions in dogs. BDC had a significantly faster wash-in compared with both BDA and HCC but the diagnostic accuracy of all the included quantitative variables was only moderate. No significant differences in the wash-out quantitative features of BDA and BDC were evident.ConclusionThere is poor evidence that CEUS may be used to distinguish between different primary hepatobiliary neoplasms in cats.
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Sun, Jun, Fengyu Na, Bo Ma, Li Wang, Hanbing Shi, and Yan Ding. "Quantitative Parameters of Contrast-Enhanced Ultrasound Combined with Lung Biopsy Were Used to Evaluate the Benign and Malignant Lesions around the Lungs." Journal of Sensors 2021 (November 27, 2021): 1–14. http://dx.doi.org/10.1155/2021/2259408.
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In recent years, due to the influence of living habits and smoking, the number of lung cancer patients worldwide has increased year by year, and it has gradually developed into one of the common diseases endangering human life. CEUS can observe the lesion and realize the rapid identification of the location of the active area of the lesion. CEUS is the abbreviation of contrast-enhanced ultrasound technology. Contrast-enhanced ultrasound technology is to inject ultrasound contrast agent through a peripheral vein to perform ultrasound exploration to observe the enhancement of the internal nodules. Compared with color ultrasound, it can diagnose more accurately and improve the inspection effect. At present, this technology is used for the diagnosis of many types of space-occupying lesions, but it is rarely used for the diagnosis of lung lesions. The purpose of this study is to explore the role of CEUS quantitative parameters combined with lung biopsy in the assessment of benign and malignant peripheral lung diseases. Based on the relevant theoretical basis of CEUS and lung biopsy, 158 patients with peripheral lung disease were selected as experimental subjects, and they were divided into experimental group and control group for comparative experiments. Experiments proved the effectiveness of CEUS quantitative parameters combined with lung biopsy methods. The experimental results showed that, compared with the benign group, the time-intensity curve, the rise time, and the peak time of the malignant lesions were significantly prolonged. In addition, CEUS combined with the quantitative parameters of lung biopsy can effectively distinguish the activity of lung lesions and the site of necrosis and promote the effective increase of the positive rate of lung biopsy.
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da Silva, Natascha, Matthias Hornung, Lukas Beyer, Christina Hackl, Stefan Brunner, Hans Schlitt, Philipp Wiggermann, and Ernst Jung. "Intraoperative Shear Wave Elastography vs. Contrast-Enhanced Ultrasound for the Characterization and Differentiation of Focal Liver Lesions to Optimize Liver Tumor Surgery." Ultraschall in der Medizin - European Journal of Ultrasound 40, no. 02 (October 19, 2018): 205–11. http://dx.doi.org/10.1055/a-0649-1000.
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Abstract Purpose Assessment of intraoperative quantitative shear wave elastography (SWE) and contrast-enhanced ultrasound (CEUS) for the characterization of focal liver lesions (FLLs) during liver surgery using postoperative histopathological results as the gold standard. Materials and Methods US data of 79 consecutive patients with 98 FLLs who underwent liver surgery between 08/2015 – 06/2017 were prospectively acquired and retrospectively analyzed. Multifrequency linear/T-shaped probes (6 – 9 MHz) were used to store cine loops of at least 5 s and images of B-mode, SWE and CEUS. The first CEUS loop was continuously documented over 1 min. in each case. Quantitative SWE analysis of FLLs was performed by placing 5 regions of interest to measure shear wave speed (m/s) and stiffness (kPa). CEUS was evaluated during the arterial, portal venous and late phase after i. v. bolus injections of 2.4 – 10 ml sulfur hexafluoride microbubbles. Postoperative histopathology after tumor resection or intraoperative biopsy was obtained to confirm findings of SWE and CEUS. Results Of 98 FLLs in 79 patients (mean age: 58 years sd ± 12y) 88 were malignant and 10 were benign ranging from 0.69 to 15.2 cm in size (mean: 2.8 cm, sd ± 2.25 cm). SWE characterized 73/88 FLLs correctly as malignant and 7/10 as benign using a cut-off value of 2.5 m/s/21.3 kPa (p < 0.0005). The sensitivity was 83 %, specificity 70 %, accuracy 82 %. CEUS could correctly identify 86/88 malignant and 8/10 benign FLLs. The sensitivity was 98 %, specificity 80 %, accuracy 96 %. SWE could correctly identify 2 malignant FLLs which CEUS falsely characterized as benign. Conclusion Intraoperative CEUS and SWE are excellent tools for the highly accurate visualization, characterization and malignancy assessment of hepatic tumors during liver surgery.
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Hillaert, Amber, Emmelie Stock, Sophie Favril, Luc Duchateau, Jimmy H. Saunders, and Katrien Vanderperren. "Intra- and Inter-Observer Variability of Quantitative Parameters Used in Contrast-Enhanced Ultrasound of Kidneys of Healthy Cats." Animals 12, no. 24 (December 15, 2022): 3557. http://dx.doi.org/10.3390/ani12243557.
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Contrast-enhanced ultrasound (CEUS) is a non-invasive imaging technique which allows qualitative and quantitative assessment of tissue perfusion. Although CEUS offers numerous advantages, a major challenge remains the variability in tissue perfusion quantification. This study aimed to assess intra- and inter-observer variability for quantification of renal perfusion. Two observers with different levels of expertise performed a quantitative analysis of 36 renal CEUS studies, twice. The CEUS data were collected from 12 healthy cats at 3 different time points with a 7-day interval. The inter- and intra-observer agreement was assessed by the intraclass correlation coefficient. Within and between observers, a good agreement was demonstrated for intensity-related parameters in the cortex, medulla, and interlobular artery. For some parameters, ICCinter was considerably lower than ICCintra, mostly when the ROI encompassed the entire kidney or medulla. With the exception of time to peak (TTP) and mean transit time (mTTI), time-related and slope-related parameters showed poor agreement among observers. In conclusion, it may be advised against having the quantitative assessment of renal perfusion performed by different observers, especially if their experience levels differ. The cortical mTTI seemed to be the most appropriate parameter as it showed a favorable inter-observer agreement and inter-period agreement.
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Tantawi, Mohamed, Susan Shamimi-Noori, Colette M. Shaw, and John R. Eisenbrey. "State of the Art: Contrast Enhanced 4D Ultrasound to Monitor or Assess Locoregional Therapies." Digestive Disease Interventions 06, no. 01 (January 11, 2022): 003–12. http://dx.doi.org/10.1055/s-0041-1741520.
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AbstractLocoregional therapies (LRTs) are an essential management tool in the treatment of primary liver cancers or metastatic liver disease. LRTs include curative and palliative modalities. Monitoring treatment response of LRTs is crucial for maximizing benefit and improving clinical outcomes. Clinical use of contrast-enhanced ultrasound (CEUS) was introduced more than two decades ago. Its portability, cost effectiveness, lack of contraindications and safety make it an ideal tool for treatment monitoring in numerous situations. Two-dimensional dynamic CEUS has been proved to be equivalent to the current imaging standard in the guidance of LRTs, assessment of their adequacy, and detection of early tumor recurrence. Recent technical advances in ultrasound transducers and image processing have made 3D CEUS scanning widely available on most commercial ultrasound systems. 3D scanning offers a broad multiplanar view of anatomic structures, overcoming many limitations of two-dimensional scanning. Furthermore, many ultrasound systems provide real-time dynamic 3D CEUS, also known as 4D CEUS. Volumetric CEUS has shown to perform better than 2D CEUS in the assessment and monitoring of some LRTs. CEUS presents a valid alternative to the current imaging standards with reduced cost and decreased risk of complications. Future efforts will be directed toward refining the utility of 4D CEUS through approaches such as multi-parametric quantitative analysis and machine learning algorithms.
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Haimerl, M., S. Poelsterl, L. P. Beyer, I. Wiesinger, C. Nießen, C. Stroszczynski, P. Wiggermann, and E. M. Jung. "Chronic liver disease: Quantitative MRI vs CEUS-based microperfusion." Clinical Hemorheology and Microcirculation 64, no. 3 (January 21, 2017): 435–46. http://dx.doi.org/10.3233/ch-168112.
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Macrì, Francesco, Vito Angileri, Teresa Russo, Maria Tomiko Russo, Marco Tabbì, and Simona Di Pietro. "Evaluation of Bone Healing Using Contrast-Enhanced Ultrasonography in Non-Operative Treatment of Tibial Fracture in a Puppy Dog." Animals 11, no. 2 (January 23, 2021): 284. http://dx.doi.org/10.3390/ani11020284.
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A 10-month-old mixed-breed male dog was presented with an oblique tibial fracture. The dog was treated with a Robert Jones-like bandage as a conservative approach, and was subjected to X-ray, B-mode, Color Doppler and contrast-enhanced ultrasound (CEUS) examinations during the fracture healing, in order to assess bone hemodynamic changes. B-mode, Power Doppler and CEUS examinations of the fracture gap were performed at 7, 20, 35, and 50 days post-trauma. Quantitative analysis of CEUS and perfusion parameters were obtained. On CEUS, a steep incline in signal numbers was visible in fracture gap at 7 days with peaks at 35 days, after which the vascularization decreases gradually over the next days. In this study, CEUS provided important information on the early stages of the callus formation and on the healing of neighboring tissues, allowing recognition of a correct bone healing. Moreover, the number of vascular signals on CEUS was greater than that on Doppler images on the same day. This report showed the application of CEUS in controlling the fracture healing process. CEUS could be a method of monitoring the remedial processes, assessing the tibial fracture perfusion characterized by low-velocity, small-volume blood flows.
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Dong, Yi, Yijie Qiu, Daohui Yang, Lingyun Yu, Dan Zuo, Qi Zhang, Xiaofan Tian, Wen-Ping Wang, and Ernst Michael Jung. "Potential application of dynamic contrast enhanced ultrasound in predicting microvascular invasion of hepatocellular carcinoma." Clinical Hemorheology and Microcirculation 77, no. 4 (May 6, 2021): 461–69. http://dx.doi.org/10.3233/ch-201085.
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OBJECTIVE: To investigate the clinical value of dynamic contrast enhanced ultrasound (D-CEUS) in predicting the microvascular invasion (MVI) of hepatocellular carcinoma (HCC). PATIENTS AND METHODS: In this retrospective study, 16 patients with surgery and histopathologically proved HCC lesions were included. Patients were classified according to the presence of MVI: MVI positive group (n = 6) and MVI negative group (n = 10). Contrast enhanced ultrasound (CEUS) examinations were performed within a week before surgery. Dynamic analysis was performed by VueBox® software (Bracco, Italy). Three regions of interests (ROIs) were set in the center of HCC lesions, at the margin of HCC lesions and in the surrounding liver parenchyma accordingly. Time intensity curves (TICs) were generated and quantitative perfusion parameters including WiR (wash-in rate), WoR (wash-out rate), WiAUC (wash-in area under the curve), WoAUC (wash-out area under the curve) and WiPi (wash-in perfusion index) were obtained and analyzed. RESULTS: All of HCC lesions showed arterial hyperenhancement (100 %) and at the late phase as hypoenhancement (75%) in CEUS. Among all CEUS quantitative parameters, the WiAUC and WoAUC were higher in MVI positive group than in MVI negative group in the center HCC lesions (P < 0.05), WiAUC, WoAUC and WiPI were higher in MVI positive group than in MVI negative group at the margin of HCC lesions. WiR and WoR were significant higher in MVI positive group. CONCLUSIONS: D-CEUS with quantitative perfusion analysis has potential clinical value in predicting the existence of MVI in HCC lesions.
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Sharma, Anant, Shabnam Bhandari Grover, Chinta Mani, and Charanjeet Ahluwalia. "Contrast enhanced ultrasound quantitative parameters for assessing neoadjuvant chemotherapy response in patients with locally advanced breast cancer." British Journal of Radiology 94, no. 1121 (May 1, 2021): 20201160. http://dx.doi.org/10.1259/bjr.20201160.
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Objectives: To evaluate the role of contrast-enhanced ultrasound (CEUS) quantitative parameters in predicting neoadjuvant chemotherapy (NACT) response in patients with locally advanced breast cancer (LABC). Methods: 30 patients with histologically proven LABC scheduled for NACT were recruited. CEUS was performed using a contrast bolus of 4.8 ml and time intensity curves (TICs) were obtained by contrast dynamics software. CEUS quantitative parameters assessed were peak enhancement (PE), time-to-peak (TTP), area under the curve (AUC) and mean transit time (MTT). The parameters were documented on four consecutive instances: before NACT and 3 weeks after each of the three cycles. The gold-standard was pathological response using Miller Payne Score obtained pre NACT and post-surgery. Results: A decrease in mean values of PE and an increase in mean values of TTP and MTT was observed with each cycle of NACT among responders. Post each cycle of NACT (compared with baseline pre-NACT), there was a statistically significant difference in % change of mean values of PE, TTP and MTT between good responders and poor responders (p-value < 0.05). The diagnostic accuracy of TTP post-third cycle was 87.2% (p = 0.03), and MTT post--second and third cycle was 76.7% (p = 0.004) and 86.7% (p = 0.006) respectively. Conclusion: In responders, a decrease in the tumor vascularity was reflected in the CEUS quantitative parameters as a reduction in PE, and a prolongation in TTP, MTT. Advances in knowledge: Prediction of NACT response by CEUS has the potential to serve as a diagnostic modality for modification of chemotherapy regimens during ongoing NACT among patients with LABC, thus affecting patient prognosis.
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Cantisani, Vito, Nicola Di Leo, Emanuele David, and Dirk-André Clevert. "Role of CEUS in Vascular Pathology." Ultraschall in der Medizin - European Journal of Ultrasound 42, no. 04 (April 29, 2021): 348–66. http://dx.doi.org/10.1055/a-1403-2400.
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AbstractIn recent years, the implementation of contrast-enhanced ultrasound (CEUS) in clinical practice has opened new horizons in the arterial pathologies research field, since this technique is able to supply new sets of data that can be crucial in patient management. The main applications of CEUS in the arterial system are the detection, characterization, and follow-up of carotid plaques and endoleaks after EVAR. Other situations in which CEUS was demonstrated to be a useful tool are large vessel vasculitis, dissections, and untreated aneurysms. In carotid atherosclerosis CEUS is not only able to acquire quantitative data about stenosis but also to perform a qualitative assessment of the plaque. The most important plaque features that CEUS is able to depict are ulceration, neovascularization, and the presence of inflammatory infiltrates. All of these factors contribute to plaque vulnerability. Thus, CEUS is crucial in order to allow better risk stratification and management of patients. In follow-up after EVAR, CEUS shows sensitivity and specificity values similar to CTA while ensuring several advantages, such as lower cost and the absence of ionizing radiation and nephrotoxic agents. Moreover, CEUS is able to offer real-time evaluation of endoleaks and thus is a useful tool in cases that are ambiguous on CTA. Most limitations are patient-related and are the same as in all other ultrasound techniques, such as high BMI and meteorism.
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Evdokimenko, A. N., A. O. Chechetkin, L. D. Druina, and M. M. Tanashyan. "Contrast-enhanced ultrasonography for assessing neovascularization of carotid atherosclerotic plaque." Exosomes, no. 4 (July 31, 2019): 24–31. http://dx.doi.org/10.24075/brsmu.2019.057.
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Neovascularization of a carotid atherosclerotic plaque (AP) is associated with an increased risk of stroke. Contrast-enhanced ultrasonography (CEUS) is a widely used method for imaging intraplaque neovascularization in vivo. Unfortunately, there are no standardized guidelines for CEUS interpretation. The aim of this study was to identify the most reliable method for CEUS-based assessment of AP neovascularization. Seventy-eight AP were removed during carotid endarterectomy in 73 patients, of whom 5 had AP on both sides, and examined morphologically. All patients underwent preoperative duplex scanning and CEUS; Sonovue was used as a contrast agent. AP neovascularization was assessed on a 4-grade visual scale and with 3 different quantitative methods using QLAB software. On the visual scale (method 1), poorly (37%) and moderately (51%) vascularized plaques were the most common. Quantitative analysis (data were presented as Me (Q1; Q3)) revealed that the number of blood vessels per 1 cm2 of the plaque (method 2) was 16 (10; 26), the ratio of the total vessel area to the plaque area (method 3) was 6% (3; 9), and AP ROI (method 4) was 2.6 dB (1.8; 4.1). Significant correlations were demonstrated between the results produced by method 2 and method 3 (р < 0.0001), method 3 and method 2 (p = 0.0006), and between pathomorphological findings and the results produced by methods 1–3, especially method 2 (p < 0.004). AP ROI brightness did not correlate with other results. The presence of hyperechoic components (calcifications) in AP dramatically reduced the reliability of US-based intraplaque neovascularization assessment. The most accurate CEUS-based quantitative method for assessing intraplaque neovascularization is estimation of blood vessel number per 1 cm2 of the plaque.
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Quartuccio, Marco, Luigi Liotta, Santo Cristarella, Giovanni Lanteri, Antonio Ieni, Tiziana D’Arrigo, and Massimo De Majo. "Contrast-Enhanced Ultrasound in Cystic Endometrial Hyperplasia–Pyometra Complex in the Bitch: A Preliminary Study." Animals 10, no. 8 (August 7, 2020): 1368. http://dx.doi.org/10.3390/ani10081368.
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In cystic endometrial hyperplasia (CEH)–pyometra syndrome, toxic factors and endometrial remodeling culminate in changes characterized by exudative and degenerative inflammatory reaction. Recent studies on hemodynamic found an increased blood flow and lower vascular resistance in uterine arteries, suggesting color Doppler ultrasound as an adjunctive tool for quantitative assessment of endometrial vascularization during pyometra. The aim of this study was to assess, through contrast-enhanced ultrasound (CEUS) exam, the vascularization in endometrial microvessels in CEH-pyometra in order to evaluate the possibility of application in this syndrome. In twelve female dogs with clinical symptoms related to pyometra, B-mode, color Doppler and CEUS exams were performed. In CEH-pyometra uteri, histopathological examination revealed severe CEH and pyometra, immunohistochemical stain with CD 34 confirmed the presence of angiogenesis. CEUS exams revealed a widespread, intense and rapidly developing homogeneous enhancement of the hyperplastic endometrium, with absence of signal only in cystic areas. All parameters of the quantitative analysis were not significantly influenced by region of interest dimension and position. CEUS has the potential to improve clinical not invasive evaluations in the CEH-pyometra syndrome and virtually in CEH-mucometra.
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Hillaert, Amber, Emmelie Stock, Luc Duchateau, Hilde de Rooster, Nausikaa Devriendt, and Katrien Vanderperren. "B-Mode and Contrast-Enhanced Ultrasonography Aspects of Benign and Malignant Superficial Neoplasms in Dogs: A Preliminary Study." Animals 12, no. 20 (October 14, 2022): 2765. http://dx.doi.org/10.3390/ani12202765.
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Contrast-enhanced ultrasonography (CEUS) is considered a promising technique for differentiation of benign and malignant tumors in humans. However, few studies have assessed superficial neoplasms in dogs by means of CEUS. The aim of this study was to identify ultrasonographic criteria evaluated by B-mode ultrasound (US) and CEUS that may be used to distinguish benign and malignant superficial neoplasms in dogs. A total of 63 superficial neoplasms from 59 dogs were evaluated using B-mode US and CEUS prior to histopathologic examination. Qualitative and quantitative parameters were compared between benign and malignant neoplasms by Fischer’s exact test or fixed effects model. With B-mode US, a significant difference was found for border definition, echogenicity and echotexture. With CEUS, a significant difference was found for the enhancement pattern at wash-in and the wash-out area under the curve at the center of the neoplasm. Malignant neoplasms had on average a lower regional blood volume during the wash-out phase compared to benign neoplasms. Despite these significant differences, there was a considerable overlap in B-mode and CEUS parameters between benign and malignant neoplasms. In conclusion, B-mode US and CEUS might contribute to malignancy prediction; however, based on individual ultrasonographic parameters, they seem unable to replace cytology or histopathology.
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Petrasova, Hana, Radka Slaisova, Tomas Rohan, Karel Stary, Jitka Kyclova, Tomas Pavlik, Petra Kovalcikova, Tomas Kazda, and Vlastimil Valek. "Contrast-Enhanced Ultrasonography for Differential Diagnosis of Benign and Malignant Thyroid Lesions: Single-Institutional Prospective Study of Qualitative and Quantitative CEUS Characteristics." Contrast Media & Molecular Imaging 2022 (April 23, 2022): 1–10. http://dx.doi.org/10.1155/2022/8229445.
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Objectives. To extend and revise the diagnostic value of contrast-enhanced ultrasonography (CEUS) for differentiation between malignant and benign thyroid nodules. Methods. This single-institution prospective study aims to compare CEUS qualitative and objective quantitative parameters in benign and malignant thyroid nodules. Consecutive cohort of 100 patients was examined by CEUS, 68 out of them were further analysed in detail. All included patients underwent cytological and/or histopathological verification of the diagnosis. Results. Fifty-five (81%) thyroid nodules were benign, and 13 (19%) were malignant. Ring enhancement pattern was strongly associated with a benign aetiology (positive predictive value 100%) and heterogeneous enhancement pattern with malignant aetiology (positive predictive value 72.7%). The shape of the TIC (time-intensity curve) was more often identical in the benign lesion (98.2%) than in malignant lesions (69.2%), p = 0.004 . Conclusions. This study indicates that CEUS enhancement patterns were significantly different in benign and malignant lesions. Ring enhancement was a very strong indicator of benign lesions, whereas heterogeneous enhancement was valuable to detect malignant lesions.
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Maxeiner, Andreas, Thomas Fischer, Julia Schwabe, Alexander Daniel Jacques Baur, Carsten Stephan, Robert Peters, Torsten Slowinski, et al. "Contrast-Enhanced Ultrasound (CEUS) and Quantitative Perfusion Analysis in Patients with Suspicion for Prostate Cancer." Ultraschall in der Medizin - European Journal of Ultrasound 40, no. 03 (June 6, 2018): 340–48. http://dx.doi.org/10.1055/a-0594-2093.
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Abstract Purpose The aim of this study was to investigate contrast-enhanced ultrasound (CEUS) parameters acquired by software during magnetic resonance imaging (MRI) US fusion-guided biopsy for prostate cancer (PCa) detection and discrimination. Materials and Methods From 2012 to 2015, 158 out of 165 men with suspicion for PCa and with at least 1 negative biopsy of the prostate were included and underwent a multi-parametric 3 Tesla MRI and an MRI/US fusion-guided biopsy, consecutively. CEUS was conducted during biopsy with intravenous bolus application of 2.4 mL of SonoVue® (Bracco, Milan, Italy). In the latter CEUS clips were investigated using quantitative perfusion analysis software (VueBox, Bracco). The area of strongest enhancement within the MRI pre-located region was investigated and all available parameters from the quantification tool box were collected and analyzed for PCa and its further differentiation was based on the histopathological results. Results The overall detection rate was 74 (47 %) PCa cases in 158 included patients. From these 74 PCa cases, 49 (66 %) were graded Gleason ≥ 3 + 4 = 7 (ISUP ≥ 2) PCa. The best results for cancer detection over all quantitative perfusion parameters were rise time (p = 0.026) and time to peak (p = 0.037). Within the subgroup analysis (> vs ≤ 3 + 4 = 7a (ISUP 2)), peak enhancement (p = 0.012), wash-in rate (p = 0.011), wash-out rate (p = 0.007) and wash-in perfusion index (p = 0.014) also showed statistical significance. Conclusion The quantification of CEUS parameters was able to discriminate PCa aggressiveness during MRI/US fusion-guided prostate biopsy.
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Cicirelli, Vincenzo, Francesco Macrì, Simona Di Pietro, Raffaella Leoci, Giovanni Michele Lacalandra, and Giulio Guido Aiudi. "Use of Contrast-Enhanced Ultrasound of the Testes after Non-Surgical Sterilization of Male Dogs with CaCl2 in Alcohol." Animals 12, no. 5 (February 25, 2022): 577. http://dx.doi.org/10.3390/ani12050577.
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Sterilization by intratesticular injection of chemical agents is a non-surgical alternative to neutering male companion animals. We used contrast-enhanced ultrasound (CEUS) to monitor vascular alterations to testes immediately after the intratesticular injection of CaCL2 in alcohol. We evaluated the CEUS features of normal and damaged testes in 20 dogs after the intratesticular injection of CaCl2. The CEUS evaluation was performed at the site of the chemical agent inoculation. In treated testes, qualitative CEUS showed a lower intensity enhancement of the parenchyma than pre-treatment normal testes with a predominantly anechoic pattern and only a few hyperechoic vascular focal spots. Quantitative CEUS showed significantly lower values of time-intensity curve (TIC) parameters, including signal intensity (Peak: 4.72 ± 2.1), regional blood volume (RBV: 134.3 ± 63.7), and regional blood flow (RBF: 4.36 ± 2.18) than normal testes (p < 0.001). Sonographic findings from CEUS showed hypovascularization of the canine testicular parenchyma caused by the hardening agent. This diagnostic technique helps clinicians define testicular vascular alterations achieved by chemical castration more efficiently. Nevertheless, more studies are required to apply this methodology to more subjects with a broader weight range and stray dogs.
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Schwarz, Sonja, Dirk-André Clevert, Michael Ingrisch, Thomas Geyer, Vincent Schwarze, Johannes Rübenthaler, and Marco Armbruster. "Quantitative Analysis of the Time–Intensity Curve of Contrast-Enhanced Ultrasound of the Liver: Differentiation of Benign and Malignant Liver Lesions." Diagnostics 11, no. 7 (July 12, 2021): 1244. http://dx.doi.org/10.3390/diagnostics11071244.
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Background: To evaluate the diagnostic accuracy of quantitative perfusion parameters in contrast-enhanced ultrasound to differentiate malignant from benign liver lesions. Methods: In this retrospective study 134 patients with a total of 139 focal liver lesions were included who underwent contrast enhanced ultrasound (CEUS) between 2008 and 2018. All examinations were performed by a single radiologist with more than 15 years of experience using a second-generation blood pool contrast agent. The standard of reference was histopathology (n = 60), MRI or CT (n = 75) or long-term CEUS follow up (n = 4). For post processing regions of interests were drawn both inside of target lesions and the liver background. Time–intensity curves were fitted to the CEUS DICOM dataset and the rise time (RT) of contrast enhancement until peak enhancement, and a late-phase ratio (LPR) of signal intensities within the lesion and the background tissue, were calculated and compared between malignant and benign liver lesion using Student’s t-test. Quantitative parameters were evaluated with respect to their diagnostic accuracy using receiver operator characteristic curves. Both features were then combined in a logistic regression model and the cumulated accuracy was assessed. Results: RT of benign lesions (14.8 ± 13.8 s, p = 0.005), and in a subgroup analysis, particular hemangiomas (23.4 ± 16.2 s, p < 0.001) differed significantly to malignant lesions (9.3 ± 3.8 s). The LPR was significantly different between benign (1.59 ± 1.59, p < 0.001) and malignant lesions (0.38 ± 0.23). Logistic regression analysis with RT and LPR combined showed a high diagnostic accuracy of quantitative CEUS parameters with areas under the curve of 0.923 (benign vs. malignant) and 0.929 (hemangioma vs. malignant. Conclusions: Quantified CEUS parameters are helpful to differentiate malignant from benign liver lesions, in particular in case of atypical hemangiomas.
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Lerchbaumer, Markus H., Katharina Margherita Wakonig, Philipp Arens, Steffen Dommerich, and Thomas Fischer. "Quantitative Multiparametric Ultrasound (mpUS) in the Assessment of Inconclusive Cervical Lymph Nodes." Cancers 14, no. 7 (March 22, 2022): 1597. http://dx.doi.org/10.3390/cancers14071597.
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Background: Enlarged cervical lymph nodes (CLN) are preferably examined by ultrasound (US) by using criteria such as size and echogenicity to assess benign and suspicious CLN, which should be histologically evaluated. This study aims to assess the differentiation of malign and benign CLN by using multiparametric US applications (mpUS). Methods: 101 patients received a standardized US protocol prior to surgical intervention using B-mode–US, shear-wave elastography (SWE) and contrast-enhanced ultrasound (CEUS). SWE was assessed by 2D real-time SWE conducting a minimum of five measurements, CEUS parameters were assessed with post-processing perfusion software. Histopathological confirmation served as the gold standard. Results: B-mode–US and SWE analysis of 104 CLN (36 benign, 68 malignant) showed a significant difference between benign and malignant lesions, presenting a larger long axis and higher tissue stiffness (both p < 0.001). Moreover, tissue stiffness assessed by SWE was significantly higher in CLN with regular B-mode–US criteria (Solbiati Index > 2 and short-axis < 1 cm, p < 0.001). No perfusion parameter on CEUS showed a significant differentiation between benign and malignant CLN. Discussion: As the only multiparametric parameter, SWE showed higher tissue stiffness in malignant CLN, also in subgroups with regular B-mode criteria. This fast and easy application may be a promising noninvasive tool to US examination to ameliorate the sonographic differentiation of inconclusive CLN.
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Nedelmann, Max, Nouha Ritschel, Simone Doenges, Alexander C. Langheinrich, Till Acker, Peter Reuter, Mesut Yeniguen, et al. "Combined Contrast-Enhanced Ultrasound and rt-PA Treatment is Safe and Improves Impaired Microcirculation after Reperfusion of Middle Cerebral Artery Occlusion." Journal of Cerebral Blood Flow & Metabolism 30, no. 10 (June 9, 2010): 1712–20. http://dx.doi.org/10.1038/jcbfm.2010.82.
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In monitoring of recanalization and in sonothrombolysis, contrast-enhanced ultrasound (CEUS) is applied in extended time protocols. As extended use may increase the probability of unwanted effects, careful safety evaluation is required. We investigated the safety profile and beneficial effects of CEUS in a reperfusion model. Wistar rats were subjected to filament occlusion of the right middle cerebral artery (MCA). Reperfusion was established after 90 minutes, followed by recombinant tissue-type plasminogen activator (rt-PA) treatment and randomization to additional CEUS (contrast agent: SonoVue; 60 minutes). Blinded outcome evaluation consisted of magnetic resonance imaging (MRI), neurologic assessment, and histology and, in separate experiments, quantitative 3D nano-computed tomography (CT) angiography (900 nm3 voxel size). Nano-CT revealed severely compromised microcirculation in untreated animals after MCA reperfusion. The rt-PA partially improved hemispheric perfusion. Impairment was completely reversed in animals receiving rt-PA and CEUS. This combination was more effective than treatment with either CEUS without rt-PA or rt-PA and ultrasound or ultrasound alone. In MRI experiments, CEUS and rt-PA treatment resulted in a significantly reduced ischemic lesion volume and edema formation. No unwanted effects were detected on MRI, histology, and intracranial temperature assessment. This study shows that CEUS and rt-PA is safe in the situation of reperfusion and displays beneficial effects on the level of the microvasculature.
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Tikhankova, A. V., A. V. Borsukov, A. O. Buyeverov, V. V. Ivanov, and Yu V. Ivanov. "Improved methods of the contrast-enhanced ultrasound in patient with chronic viral hepatitis." Journal of Clinical Practice 10, no. 1 (April 25, 2019): 4–9. http://dx.doi.org/10.17816/clinpract1014-9.
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Rationale. The article presents the data obtained by an improved method of contrast-enhanced ultrasound (CEUS) in patients with chronic viral hepatitis.
Methods. We compared the quantitative and qualitative CEUS parameters in 2 groups of patients: the 1st group was administered 2.5 ml of the contrast agent, and the 2nd group was administered 1.0 ml of the contrast agent.
Results. The results showed that the quantitative parameters had no statistical differences in the arterial and portal phases.
Conclusion. The parameters of the late venous phase were not clinically significant, since the study objective included the assessment of diffuse liver disease, not focal liver lesions.
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Marticorena Garcia, S., J. Schwabe, E. Jung, and T. Fischer. "Quantitative Perfusionsanalyse mittels Kontrastmittelsonografie (CEUS) zur Differenzierung eines aggressiven Prostatakarzinoms." RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren 189, S 01 (March 23, 2017): S1—S124. http://dx.doi.org/10.1055/s-0037-1600496.
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Weber, Marc-André, Martin Krix, and Stefan Delorme. "Quantitative evaluation of muscle perfusion with CEUS and with MR." European Radiology 17, no. 10 (April 24, 2007): 2663–74. http://dx.doi.org/10.1007/s00330-007-0641-y.
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Li, Hongbo, Hui Huang, Yun Luan, Niu Liu, Hui Gao, and Huijuan Sun. "Contrast-Enhanced Ultrasonography Characteristics in the Evaluation of Different Nature of Carotid Artery Plaques." Journal of Medical Imaging and Health Informatics 10, no. 3 (March 1, 2020): 688–92. http://dx.doi.org/10.1166/jmihi.2020.2919.
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To investigate the value of contrast-enhanced ultrasonography (CEUS) in the evaluation of neovascular density in plaques with different carotid atherosclerosis. 97 patients with carotid plaques were observed by conventional ultrasound from January 2016 to December 2018. The CEUS test was used to grade and quantify the new blood vessels in the plaque. The results showed of the 97 patients with 101 plaques, 49 were soft plaques, 45 were mixed plaques, and 7 were hard plaques. CEUS clearly showed the continuity of plaque fibrous caps and found plaque ulcers that were easily missed by conventional ultrasound. The lower the echo of the plaque, the more obvious contrast enhancement in the plaques. Quantitative analysis of CEUS showed the peak time of soft plaques was shorter and the peak intensity of soft plaques was higher compared with mixed plaques. The difference was statistically significant (P <0.01). The results displayed that carotid CEUS is a convenient and intuitive new technology that can better help analyze plaque morphology and determine and quantify the extent of neovascularization in plaque. It can be used for clinical evaluation of potential cerebrovascular risk and also provides an accurate and reproducible detection method for clinical efficacy evaluation.
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Rogalska, Marta, Lukasz Antkowiak, Anna Kasperczuk, and Wojciech Scierski. "Contrast-Enhanced Ultrasound in the Differentiation between the Most Common Benign Parotid Gland Tumors: A Systematic Review and Meta-Analysis." Journal of Clinical Medicine 11, no. 24 (December 12, 2022): 7360. http://dx.doi.org/10.3390/jcm11247360.
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Recently, contrast-enhanced ultrasound (CEUS) has become a promising tool in distinguishing benign from malignant parotid gland tumors. However, its usefulness in differentiating various benign parotid tumors has not been determined so far. This study aimed to systematically review the literature to determine the utility of CEUS in the preoperative differentiation between pleomorphic adenomas (PAs) and Warthin’s tumors (WTs) of the parotid gland. PubMed, Embase, and Cochrane were searched for English-language articles published until 21 July 2022. Fifteen studies were included. On CEUS examination, a significantly greater percentage of PAs displayed heterogeneous enhancement texture compared to WTs. Contrarily, the enhanced lesion size, the enhancement margin, and the presence of the enhancement rim did not differ significantly between the entities. Significantly longer normalized mean transit time (nMTT) and time to peak (TTP) were observed in PAs. Contrarily, the mean values of area under the curve (AUC) and time from peak to one half (TPH) were significantly higher for WTs. Due to the considerable overlap among the qualitative CEUS characteristics of PAs and WTs, the reproducible, investigator-independent quantitative CEUS measurements have a greater potential to distinguish PAs from WTs, which might influence the selection of an appropriate management strategy.
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Rüffer, André, Ferdinand Knieling, Robert Cesnjevar, Adrian Regensburger, Ariawan Purbojo, Sven Dittrich, Frank Münch, Joachim Wölfle, and Jörg Jüngert. "Equal cerebral perfusion during extended aortic coarctation repair." European Journal of Cardio-Thoracic Surgery 61, no. 2 (October 29, 2021): 299–306. http://dx.doi.org/10.1093/ejcts/ezab415.
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Abstract OBJECTIVES Aortic coarctation with distal aortic arch hypoplasia can be effectively addressed by coarctation resection with extended end-to-end-anastomosis (REEEA). Particularly, when unilateral cerebral perfusion (UCP) is established by clamping of left-sided supra-aortic vessels, the extent of cerebral blood flow distribution during repair remains undetermined, so far. Transfontanellar contrast-enhanced ultrasound (T-CEUS) can be utilized for real-time visualization and quantitative evaluation of cerebral blood flow. This study quantitatively evaluates cerebral perfusion during REEEA by using intraoperative T-CEUS. METHODS In a prospective study, 9 infants with open fontanelle undergoing REEEA [median age: 13 days (range 1–34) and median weight 3.1 kg (range 2.2–4.4)] were intraoperatively examined with T-CEUS at 3 consecutive time-points: before skin incision, during UCP and after skin suture. A software-based analysis of 11 parameters was used for data evaluation. Absolute and relative blood flow in contralateral hemispheres was measured in side-by-side comparison, and referenced to baseline measurements. RESULTS No side-depend absolute or relative cerebral perfusion differences were found during REEEA, except for an increased relative ‘wash-out-rate’ (P = 0.0013) in favour of the right hemisphere after surgery. Compared to ipsilateral baseline levels, ‘rise time’ was transiently increased in right (P = 0.0277) and ‘time-to-peak’ in both hemispheres (right: P = 0.0403 and left: P = 0.0286), all during UCP. CONCLUSIONS The use of T-CEUS provided evidence for homogenous distribution of contrast agent in both hemispheres during UCP. T-CEUS can be utilized for the postprocedural evaluation of cerebral perfusion during congenital cardiac surgery. Clinical Trial Registration URL: http://www.clinicaltrials.gov Unique, Identifier: NCT03215628.
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Tufano, Antonio, Francesco Maria Drudi, Flavia Angelini, Eleonora Polito, Milvia Martino, Antonio Granata, Giovanni Battista Di Pierro, et al. "Contrast-Enhanced Ultrasound (CEUS) in the Evaluation of Renal Masses with Histopathological Validation—Results from a Prospective Single-Center Study." Diagnostics 12, no. 5 (May 12, 2022): 1209. http://dx.doi.org/10.3390/diagnostics12051209.
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Background: To evaluate the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) in characterizing between malignant and benign renal lesions confirmed by histological examination. Methods: Overall, 110 patients, for a total of 118 renal masses previously identified at CT and MRI underwent CEUS. An expert radiologist evaluated morphological, qualitative and quantitative parameters. Acquired data were analyzed to assess the value of each parameter to differentiate between malignant and benign lesions. Results: Histological results of 118 renal masses showed 88 (75%) malignant lesions and 30 (25%) benign lesions. Among morphological features, inhomogeneous echogenicity was the best predictor of malignancy depicting a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 76%, 76%, 88% and 57%, respectively. Among qualitative parameters, the most reliable parameter was the presence of pseudo-capsule. Here, sensitivity, specificity, positive PPV and NPV were 85%, 86%, 94% and 71%, respectively. Among quantitative parameters, the most reliable parameters were peak intensity (PI) and the area under the (AUC) with sensitivity, specificity, PPV and NPV values of 94%, 92%, 96% and 87% and 99%, 92%, 97% and 97%, respectively. Finally, the most reliable parameters were combined to distinguish between benign and malignant lesions. The best combination obtained was restricted to CEUS parameters (PI and AUC). Here, sensitivity, specificity, PPV, NPV and accuracy rate were 93%, 100%, 100%, 83% and 93%, respectively. Conclusions: CEUS increases the US accuracy to discriminate between benign and malignant renal lesions.
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Simeoni, Francesco, Rossella Terragni, Giuseppe Rubini, Roberto Tamburro, Francesca Del Signore, Ilaria Falerno, Giovanni Aste, Marco Russo, Giovanni Mastromatteo, and Massimo Vignoli. "B-Mode and Contrast Enhanced Ultrasonography Features of Gastric Inflammatory and Neoplastic Diseases in Cats." Animals 10, no. 8 (August 18, 2020): 1444. http://dx.doi.org/10.3390/ani10081444.
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Alimentary lymphoma (AL) is the most common malignancy of the feline gastrointestinal tract and may cause variable mild to severe alteration of the gastric wall on ultrasonography (US) that can be very similar to those caused by inflammation (INF). The aim of this prospective study is to establish the value of B-mode and contrast-enhanced US (CEUS) in describing specific features of normal, inflammatory, and neoplastic gastric diseases in feline species. B-mode US and CEUS of the stomach were performed in anesthetized cats with or without gastric disorders. Gastric wall qualitative and quantitative parameters were evaluated on B-mode US and CEUS examination. A total of 29 cats were included: six healthy (HEA) cats as the control group; nine INF; three low-grade lymphoma (LGAL); 10 high-grade lymphoma (HGAL). On B-mode US, there were significant differences in thickness, the wall’s layer definition and echogenicity between HGAL and all the other groups (<0.001). For CEUS, statistical differences between groups were found in the following: HGAL vs. HEA, HGAL vs. INF; HGAL vs. LGAL; INF vs. HEA. Diagnostic accuracy (AUC) and cut-off value were calculated and found to be significant for thickness (3.8 mm) for INF vs. LGAL (AUC > 0.70) and “benign” vs. “malignant” (AUC > 0.90) as well as peak enhancement (34.87 dB) for “benign” vs. “malignant” (AUC > 0.70). INF and LGAL showed an overlap of qualitative and quantitative parameters both on B-mode and CEUS, while HGAL usually appears as a severe wall thickening with absent layer definition, high-contrast uptake, a specific enhancement pattern, regional lymphadenopathy and local steatitis. Thickness and peak enhancement can be useful parameters in the characterization of gastric infiltrates in cats.
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Yi, Huiming, Baohuan Cai, Xi Ai, Kaiyan Li, Pengfei Song, and Wei Zhang. "Early Identification of Residual Tumors following Microwave Ablation Using Contrast-Enhanced Ultrasonography in a Rabbit VX2 Liver Cancer Model." BioMed Research International 2020 (September 27, 2020): 1–9. http://dx.doi.org/10.1155/2020/2462058.
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Objective. It is difficult to evaluate the ablation effect immediately after thermal ablation of liver cancer by clinical imaging methods, due to the immediate formation of an annular inflammatory reaction band (IRB). This study is aimed at exploring the early identification indicators of the IRB and residual tumor postmicrowave ablation (MVA) using contrast-enhanced ultrasonography (CEUS). Methods. MVA was used to inactivate part of the tumor nodules in rabbit VX2 liver cancer models, leading to the coexistence of the IRB with residual tumors. Quantitative analysis of the perfusion parameters of the tumor and ablation zone was performed using CEUS, followed by liver biopsy and VEGFR-2 immunohistochemical staining. Results. All rabbits successfully tolerated VX2 tumor inoculation and MVA operation. No statistically significant difference existed between the IRB vs. residual tumors, the IRB vs. junctional areas, and residual tumors postablation vs. VX2 tumors before ablation in regional blood volume, blood velocity, and blood flow estimated by parameters A, k, and A∗k of CEUS quantitative analysis. There was a statistically significant difference between the IRB and normal liver parenchyma in regional blood velocity and blood flow (p=0.005 and p=0.023, respectively). Normal liver parenchyma showed nonspecific VEGFR-2 staining, while VX2 tumor before ablation and residual tumor after ablation both showed positive VEGFR-2 staining; the necrosis zone showed negative staining by VEGFR-2 immunohistochemical staining. Conclusion. MVA had no significant effect on the residual tumor hemodynamics. The blood flow in the IRB increased significantly as compared to normal liver parenchyma, resembling tumor hemodynamic patterns. CEUS can detect residual tumors immediately postablation only when they protrude from the annular-shaped IRB. In addition, VEGFR-2 targeted CEUS may have a great potential for detecting residual tumor after thermal ablation of hepatocellular carcinoma.
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Han, Byoung Hee, and Sung Bin Park. "Usefulness of Contrast-enhanced Ultrasound in the Evaluation of Chronic Kidney Disease." Current Medical Imaging Formerly Current Medical Imaging Reviews 17, no. 8 (August 24, 2021): 1003–9. http://dx.doi.org/10.2174/1573405617666210127101926.
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Background: Contrast-enhanced ultrasound (CEUS) can provide more improved images of renal blood flow and much more information of both macro- and microcirculation of the kidney as compared to Doppler US. Objective: To investigate the usefulness of CEUS by analyzing differences in perfusion-related parameters among the three chronic kidney disease (CKD) subgroups and the control group. Methods: Thirty-eight patients with CKD and 21 controls who were age-matched (20−49 years) were included. Included CKD patients were stratified into three groups according to their eGFR: group I, eGFR ≥ 60 ml/min/1.73 m2 (GFR category I and II); group II, 30 ml/min/1.73 m2 ≤ eGFR < 60 ml/min/1.73 m2 (GFR category III); and group III, eGFR < 30 ml/min/1.73 m2 (GFR category IV and V). Comparisons with the controls (eGFR > 90 ml/min/1.73 m2) were performed. Real-time and dynamic renal cortex imaging was performed using CEUS. Time-intensity curves and several bolus model quantitative perfusion parameters were created using the VueBox® quantification software. We compared the parameters among the CKD subgroups and between the CKD and control groups. Results: Eight patients were included in group I, 12 patients in group II, and 18 patients in group III. Significant differences were noted in the wash-in and wash-out rates between the CKD and control groups (p = 0.027 and p = 0.018, respectively), but not between those of the CKD subgroups. There were no significant differences of other perfusion parameters among the CKD subgroups and between the CKD and control groups. Conclusion: A few perfusion related CEUS parameters (WiR and WoR) can be used as markers of renal microvascular perfusion relating renal function. CEUS can effectively and quantitatively exhibit the renal microvascular perfusion in patients with CKD as well as normal control participants.
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Greis, Christian. "Quantitative evaluation of microvascular blood flow by contrast-enhanced ultrasound (CEUS)." Clinical Hemorheology and Microcirculation 49, no. 1-4 (2011): 137–49. http://dx.doi.org/10.3233/ch-2011-1464.
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Freitas, M., V. Macedo Silva, C. Arieira, T. Cúrdia Gonçalves, F. Dias de Castro, S. Leite, M. J. Moreira, and J. Cotter. "P134 Ultrasonographic scores for Crohn’s disease activity assessment – still lag behind CEUS." Journal of Crohn's and Colitis 15, Supplement_1 (May 1, 2021): S222—S223. http://dx.doi.org/10.1093/ecco-jcc/jjab076.261.
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Abstract Background Intestinal ultrasound (IUS) is an increasingly used non-invasive tool to monitor Crohn‘s disease (CD) activity. Currently, there is no widely accepted, reproducible IUS activity index to evaluate inflammatory activity. In 2020, two new scores emerged: the Simple Ultrasound Activity Score for CD (SUS-CD) and International Bowel Ultrasound Segmental Activity Score (IBUS-SAS). We aimed to compare the accuracy of SUS-CD, IBUS-SAS and contrast ultrasound (CEUS) in predicting inflammatory activity in the terminal ileum in ileocolonoscopy. Methods Retrospective study including all IBD patients submitted to conventional IUS and CEUS with contrast SonoVue® directed to the terminal ileum performed by a single operator between April 2016 and March 2020. Examinations were performed using an ultrasound Hitachi HI VISION Avius®. Qualitative and quantitative parameters from the conventional IUS analysis including wall thickness, stratification, colour Doppler and inflammatory fat were evaluated, and segmental SUS-CD and IBUS-SAS were calculated. A quantitative measurement of contrast bowel wall enhancement, peak intensity, was evaluated using CEUS. The CD activity was assessed with ileocolonoscopy by Simple Endoscopic Score for CD (SES-CD). Disease activity was graded as inactive (SES-CD<7) or active (SES-CD≥7). Results Fifty patients were included, 54.0% female, with mean age of 33±12years. Patients had a mean SUS-CD of 3.4±1.0, IBUS-SAS of 58.9±25.9 and CEUS peak intensity of 12.6±12.2. SUS-CD and IBUS-SAS were not different between patients with active or inactive disease (p=0.15; 0.57, respectively) with a poor capability to predict endoscopic activity (AUC 0.62, 95% CI 0.45–0.78; 0.55, 95% CI 0.38–0.72, respectively). Peak intensity in CEUS was significantly different in patients with active or inactive disease (p=0.004) with a good capability to predict endoscopic activity (AUC 0.80; 95% CI 0.64–0.92). A peak intensity optimal cut-off to predict active disease was 8.2 with a sensitivity of 71.4% and a specificity of 78.9%. Conclusion SUS-CD and IBUS-SAS were not able to predict with good accuracy endoscopic activity in terminal ileum in CD. On the other hand, CEUS with peak intensity assessment showed a good diagnostic accuracy for active inflammation in CD. Therefore, CEUS is a non-invasive emerging method, that should be routinely integrated in the ultrasonographic evaluation in CD.
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Sun, Di, Qijie Lu, Cong Wei, Yi Li, Yuanyi Zheng, and Bing Hu. "Differential diagnosis of <3 cm renal tumors by ultrasonography: a rapid, quantitative, elastography self-corrected contrast-enhanced ultrasound imaging mode beyond screening." British Journal of Radiology 93, no. 1112 (August 2020): 20190974. http://dx.doi.org/10.1259/bjr.20190974.
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Objectives: To assess the combined diagnostic strategy of contrast-enhanced ultrasound (CEUS) and acoustic radiation force impulse (ARFI) in the precise differential diagnosis of clear cell renal cell carcinoma (CCRCC) and urothelium carcinoma of the renal pelvis (UCRP) with other small renal tumors (SRTs) ＜3 cm in size. Methods: The elastography self-corrected CEUS (ESC) mode was established to perform the quantitative differential diagnosis of SRTs (<3 cm). The kidney shear wave velocity (SWV) value recorded by ARFI showed substantial variability in patients with CCRCC (high elasticity value) and UCRP (low elasticity value) compared with other renal masses, thus providing critical self-correction information for the ultrasound differential diagnosis of SRTs. Results: In this work, the ESC observations and the corresponding ESC criteria show a remarkable 94.6% accuracy in reference to the gold standards, thus allowing the quantitative, early triple distinction of CCRCC with UCRP and other SRTs in patients with suspicious SRTs. Conclusions: This ARFI self-corrected CEUS diagnostic strategy is far beyond a screening method and may have the potential to identify a window of therapeutic opportunity in which emerging therapies might be applied to patients with CCRCC and UCRP, reducing overtreatment and medical costs. Advances in knowledge: In our study, a new rapid and non-invasive elastography self-corrected CEUS (ESC) ultrasound imaging mode was developed, which was useful in the triple distinction of CCRCC, UCRP, and other SRTs with 94.6% accuracy. ESC is a promising method in the differential diagnosis of SRTs with accuracy and practicability far beyond a single screening model.
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Kljucevsek, Damjana, Dubravka Vidmar, Darja Urlep, and Rok Dezman. "Dynamic contrast-enhanced ultrasound of the bowel wall with quantitative assessment of Crohn’s disease activity in childhood." Radiology and Oncology 50, no. 4 (December 1, 2016): 347–54. http://dx.doi.org/10.1515/raon-2015-0042.
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Abstract Background Contrast-enhanced ultrasound (CEUS) has become an established non-invasive, patient-friendly imaging technique which improves the characterization of lesions. In addition, dynamic contrast-enhanced ultrasound (DCE-US) provides valuable information concerning perfusion of examined organs. This review addresses current applications of CEUS in children, focused on DCE-US of the bowel wall in patients with Crohn disease, which enables realtime assessment of the bowel wall vascularity with semi-quantitative and quantitative assessment of disease activity and response to medical treatment. Conclusions Crohn’s disease is a chronic inflammatory relapsing disease. Frequent imaging re-evaluation is necessary. Therefore, imaging should be as little invasive as possible, children friendly with high diagnostic accuracy. US with wide varieties of techniques, including CEUS/DCE-US, can provide an important contribution for diagnosing and monitoring a disease activity. Even if the use of US contrast agent is off-label in children, it is welcome and widely accepted for intravesical use, and a little less for intravenous use, manly in evaluation of parenchymal lesions. To our knowledge this is the first time that the use of DCE-US in the evaluation of activity of small bowel Crohn disease with quantitative assessment of kinetic parameters is being described in children. Even if the results of the value and accuracy of different quantitative kinetic parameters in published studies in adult population often contradict one another there is a great potential of DCE-US to become a part of the entire sonographic evaluation not only in adults, but also in children. Further control studies should be performed.
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Simeoni, Francesco, Francesca Del Signore, Giovanni Aste, Paolo Bargellini, Giuseppe Rubini, Rossella Terragni, Roberto Tamburro, et al. "B-Mode and Contrast Enhanced Ultrasonography Features of Gastric Inflammatory and Neoplastic Diseases in Dogs." Animals 11, no. 3 (March 3, 2021): 670. http://dx.doi.org/10.3390/ani11030670.
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Canine gastric disorders are common in veterinary clinical practice and among these neoplasms require rapid identification and characterization. Standard ultrasound (US) is the imaging modality of choice for gastric wall assessment. The aim of this prospective study is to describe the specific B-mode and contrast enhanced US (CEUS) features of normal, inflammatory, and neoplastic gastric wall in dogs. B-mode US and CEUS of the stomach were performed in anesthetized dogs with or without gastric disorders. Gastric wall qualitative and quantitative parameters were evaluated on B-mode US and CEUS examination. A total of 41 dogs were included: 6 healthy (HEA) as the control group; 9 gastritis (INF); 8 adenocarcinoma (AC); 8 alimentary lymphoma (AL); 4 leiomyosarcoma (LEIS); 2 gastrointestinal stromal tumor (GIST); 2 leiomyoma; 1 undifferentiated sarcoma; 1 metastatic gastric hemangiosarcoma. Gastric tumors appear as a marked wall thickness with absent layers definition and possible regional lymphadenopathy (AC and AL) and steatitis (AC) while gastritis generally shows no/mild thickening and no other alterations on B-mode US. On CEUS, neoplasm shows a higher and faster wash in if compared to that of gastritis. B-mode and CEUS assessment may be useful in the evaluation of canine gastric disorders in the distinction between gastritis and gastric neoplasms, even if there are no specific features able to discriminate between the different tumor histotypes.
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Borsukov, A. V., and O. A. Gorbatenko. "Standardization of the method of contrast-enhanced ultrasound of kidneys in patients with type 2 diabetes." Medical Visualization 25, no. 3 (September 18, 2021): 50–65. http://dx.doi.org/10.24835/1607-0763-978.
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Aim of the research. Standardization of the quantitative assessment of the contrast-enhanced ultrasound examination of the kidneys in patients with type 2 diabetes.Materials and methods. On the basis of the Fundamental research laboratory “Diagnostic researches and minimally invasive technologies”, of the Federal State Budgetary Educational Institution of Higher Education “Smolensk State Medical University” of Smolensk State Medical University, the Ministry of Health of the Russian Federation, 12 patients with type 2 diabetes were examined in 2020. The age of the examined patients was 36–64 years old. Average age – 44 ± 1.8 years, of which 7 women (58.33%) and 5 men (41.67%). All patients were examined using a single diagnostic algorithm, which included 2 stages: 1 stage. Ultrasound examination of the kidneys (Aloka Hitachi Arietta 850 (Hitachi Medical Corporation, Japan) in B-mode; stage 2 – contrast-enhanced ultrasound examination (CEUS) of the kidneys. All patients were divided into 2 groups: the 1st group consisted of patients with type 2 diabetes type (n = 6), who underwent CEUS with subsequent assessment of the renal parenchyma in different areas of the cortex and medulla; group 2 consisted of patients with type 2 diabetes (n = 6) who underwent CEUS with subsequent standardized assessment in the indicated 5-th points of the arterial bed and 3 points of the venous bed.Results and discussions. Taking into account the current epidemiological situation in 2020, the number of performed radiation diagnostic methods, such as X-ray and computer examinations of the chest organs, significantly increased the overall background of radiation exposure on the bulk of patients. Taking into account the anxiety index of patients, ionizing research methods for the diagnosis of angionephrosclerosis are undesirable. The standardized method for quantitative parameters of CEUS showed good agreement (0.61–0.76). In turn, the assessment of the quantitative parameters of renal CEUS when using the routine technique showed low consistency (0.21–0.3). Cohen's kappa (CK) scores of 0 to 0.2 indicate a lack of agreement among clinicians; 0.21–0.4 – weak consistency; 0.41–0.6 – moderate agreement between doctors; 0.61–0.8 – good consistency; 0.81–1.0 – complete consistency.The circulatory system of the kidneys is characterized by the presence of a developed capillary network and, accordingly, low peripheral resistance, which confirms the importance of a standardized approach in conducting this study. In the context of the prevailing epidemiological circumstances, we understand that it is necessary to choose a reference research method that would allow us to accurately assess the characteristics of the experimental evaluation of this method. As a result of renal C EUS using a routine technique, hypoperfusion of the right kidney was revealed in 50% (n = 3) cases and the data were interpreted as normal in 50% (n = 3) cases. As a result of the renal CEUS using the proposed method, pronounced hypoperfusion of the right kidney was revealed in 100% (n = 6) cases. Dynamic nephroscintigraphy was used as a reference method to determine the functional work of the kidneys. According to the results of dynamic nephroscintigraphy of the kidneys, hypoperfusion of the right kidney was revealed in all cases in both groups of patients.Conclusion. 1. The standardized method for assessing the quantitative parameters of the kidney CEUS is more reproducible by the ultrasound doctors than the routine one. 2. Enhanced ultrasound can be used to assess the efficacy of hypoperfusion with the maximum efficacy of an equivalent dose per patient.
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Kasoji, Sandeep K., Emily H. Chang, Lee B. Mullin, Wui K. Chong, W. Kimryn Rathmell, and Paul A. Dayton. "A Pilot Clinical Study in Characterization of Malignant Renal-cell Carcinoma Subtype with Contrast-enhanced Ultrasound." Ultrasonic Imaging 39, no. 2 (September 22, 2016): 126–36. http://dx.doi.org/10.1177/0161734616666383.
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Malignant renal cell carcinoma (RCC) is a diverse set of diseases, which are independently difficult to characterize using conventional MRI and CT protocols due to low temporal resolution to study perfusion characteristics. Because different disease subtypes have different prognoses and involve varying treatment regimens, the ability to determine RCC subtype non-invasively is a clinical need. Contrast-enhanced ultrasound (CEUS) has been assessed as a tool to characterize kidney lesions based on qualitative and quantitative assessment of perfusion patterns, and we hypothesize that this technique might help differentiate disease subtypes. Twelve patients with RCC confirmed pathologically were imaged using contrast-enhanced ultrasound. Time intensity curves were generated and analyzed quantitatively using 10 characteristic metrics. Results showed that peak intensity ( p = 0.001) and time-to-80% on wash-out ( p = 0.004) provided significant differences between clear cell, papillary, and chromophobe RCC subtypes. These results suggest that CEUS may be a feasible test for characterizing RCC subtypes.
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Boca (Bene), Ioana, Sorin M. Dudea, and Anca I. Ciurea. "Contrast-Enhanced Ultrasonography in the Diagnosis and Treatment Modulation of Breast Cancer." Journal of Personalized Medicine 11, no. 2 (January 30, 2021): 81. http://dx.doi.org/10.3390/jpm11020081.
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The aim of this paper is to highlight the role of contrast-enhanced ultrasound in breast cancer in terms of diagnosis, staging and follow-up of the post-treatment response. Contrast-enhanced ultrasound (CEUS) is successfully used to diagnose multiple pathologies and has also clinical relevance in breast cancer. CEUS has high accuracy in differentiating benign from malignant lesions by analyzing the enhancement characteristics and calculating the time-intensity curve’s quantitative parameters. It also has a significant role in axillary staging, especially when the lymph nodes are not suspicious on clinical examination and have a normal appearance on gray-scale ultrasound. The most significant clinical impact consists of predicting the response to neoadjuvant chemotherapy, which offers the possibility of adjusting the therapy by dynamically evaluating the patient. CEUS is a high-performance, feasible, non-irradiating, accessible, easy-to-implement imaging method and has proven to be a valuable addition to breast ultrasound.
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Yu, Ping, Sihua Niu, Shuang Gao, Hui Tian, and Jiaan Zhu. "Benefits of Contrast-Enhanced Ultrasonography to the Differential Diagnosis of TI-RADS 4-5 Thyroid Nodules." Applied Bionics and Biomechanics 2022 (April 15, 2022): 1–7. http://dx.doi.org/10.1155/2022/7386516.
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Objective. The early detection, diagnosis, and treatment of thyroid cancer are of great significance to the prognosis for patients. This study was aimed at exploring the benefits of contrast-enhanced ultrasonography (CEUS) to the differential diagnosis of thyroid nodules classified as TI-RADS class 4 or 5. Method. A total of 46 patients with TI-RADS 4-5 thyroid nodules admitted in Peking University People’s Hospital from January 2019 to January 2021 were selected to study. The sensitivity, specificity, accuracy, and positive and negative predictive values of conventional ultrasonography (US) and conventional ultrasonography combined with contrast-enhanced ultrasonography (US + CEUS) in the diagnosis of benign and malignant thyroid nodules were compared by referring to the results of the surgical pathology report, which is seen as the “gold standard” for diagnosis, followed by the construction of receiver operating characteristic curves (ROCs). Result. Among 57 thyroid nodules, there were statistically significant differences between benign and malignant thyroid nodules in terms of echogenicity, margin characteristics, aspect ratio, and calcification ( P < 0.01 ). In the case of CEUS, there was no statistically significant difference among contrast agent perfusion patterns in distinguishing between benign and malignant thyroid nodules ( P > 0.05 ). However, there were statistically significant differences among different enhancement degrees, enhanced borders, and enhancement patterns. By comparing the CEUS results of TI-RADS 4-5 thyroid nodules with the results of pathology report, the malignancy rate was found to pathology report results, the malignancy rate was 53.85% in TI-RADS class 4 thyroid nodules and 100.00% in TI-RADS class 5 thyroid nodules. Among thyroid nodules diagnosed using US, 6 benign nodules were misdiagnosed as malignant and 7 malignant nodules were misdiagnosed as benign. Among those diagnosed using US + CEUS, 2 benign nodules were misdiagnosed as malignant and 2 malignant nodules were misdiagnosed as benign. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of UN + CEUS significantly outperformed those of UN alone in diagnosing thyroid nodules ( P < 0.05 ). The ROC curve analysis showed that the area under the curve (AUC) derived from US + CEUS was 0.849, while the AUC from US was only 0.726. Conclusion. Using US + CEUS to diagnose thyroid nodules classified as TI-RADS category 4 or 5 can further improve distinguishing between benign and malignant nodules. The CEUS is of important value to clinical applications as it can provide effective supplementary information and quantitative analysis for the differentiation between benign and malignant thyroid nodules.
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De Majo, Massimo, Giulia Donato, Marisa Masucci, Cyndi Mangano, Maria Flaminia Persichetti, Luigi Liotta, Giuseppe Mazzullo, et al. "Bidimensional and Contrast-Enhanced Ultrasonography of the Spleen in Dogs Affected by Leishmaniosis." Animals 11, no. 5 (May 17, 2021): 1437. http://dx.doi.org/10.3390/ani11051437.
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Canine leishmaniosis (CanL) is responsible for splenic pathological changes. The main features detectable from ultrasound examination are splenomegaly and diffuse alterations of the echostructure. The study aimed to highlight whether these ultrasound changes are related to the severity of the disease or to a modification of splenic microvascularization that can be detected in vivo through contrast-enhanced ultrasonography (CEUS). Twenty-five adult dogs tested for CanL were enrolled in this prospective, controlled study and staged according to LeishVet guidelines. Bidimensional ultrasonography revealed that splenomegaly was seen in 50% of the affected dogs, and diffuse parenchymal changes were seen in more than 60% of dogs with splenomegaly, showing a positive correlation with severity of the disease; therefore, splenomegaly could be of prognostic significance. CEUS showed that a persistent heterogeneous distribution pattern appeared only in spleens with diffuse echostructure alterations. The evaluation of quantitative CEUS parameters regarding the volume and velocity of flow in three regions of interest did not show differences between affected and control dogs. Diffuse spleen microvascular modifications evidenced by CEUS were reported for the first time in dogs with CanL. In endemic areas, CanL could be included in the differential diagnoses list when detecting splenic alterations in dogs.
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Li, Yezhao, Caihong Zhao, Minpei Qin, Xia Zhang, Haizhen Liao, and Haiqing Su. "Values of Contrast-Enhanced Ultrasound in Classification and Diagnosis of Common Bile Duct and Superficial Organ Lesions under Compression Algorithm." Journal of Healthcare Engineering 2021 (September 29, 2021): 1–10. http://dx.doi.org/10.1155/2021/9577440.
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This work aimed to investigate values of contrast-enhanced ultrasound (CEUS) under DEFLATE in the classification and diagnosis of the common bile duct and superficial lymphoid lesions. 88 patients with lower common bile duct lesions and 126 patients with superficial lymphoid lesions were selected as the subjects investigated and examined by CEUS under DEFLATE to compare characteristics and diagnostic efficiency of CEUS in different types of lesions. The time-intensity curve (TIC) was for quantitative analysis on CEUS results. The results showed that there were statistically significant differences in the comparison of time to peak (TTP), area under the curve (AUC), and gradient (Grad) of common bile duct walls in patients from the malignant group ( P < 0.05), while the comparison of three indicators of patients in the benign group was not statistically remarkable ( P > 0.05). In addition, there were statistically great differences in TTP, AUC, and Grad among patients in the benign and malignant groups ( P < 0.05). The sensitivity, specificity, accuracy, and positive/negative predictive value of CEUS + ultrasound (US) in the diagnosis of benign and malignant lymph nodes were 92.83%, 87.14%, 89.54%, 91.23%, and 86.43%, respectively. The values of maximal intensity (Imax) in the reactive hyperplasia group (group A), lymphoma group (group B), and metastatic lymph nodes group (group C) were compared, showing statistical differences ( P < 0.05). The TTP and AUC of group B were higher than those of groups A and C, respectively ( P < 0.05), and the base-to-peak ascending slope (KUP) and the absolute value of the semidescending slope (KDOWN) in group C increased hugely compared to group A ( P < 0.05). It indicated that CEUS examination under DEFLATE could be applied in the qualitative diagnosis of lower common bile duct lesions and superficial lymphoid lesions, which was worthy of clinical application.
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Wang, Ling, Jia-Fen Cheng, Li-Ping Sun, Ya-Xiang Song, Le-Hang Guo, Jun-Mei Xu, Tian-Fu Wu, et al. "Use of Contrast-Enhanced Ultrasound to Study Relationship between Serum Uric Acid and Renal Microvascular Perfusion in Diabetic Kidney Disease." BioMed Research International 2015 (2015): 1–10. http://dx.doi.org/10.1155/2015/732317.
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Purpose.To investigate the relationship between uric acid and renal microvascular perfusion in diabetic kidney disease (DKD) using contrast-enhanced ultrasound (CEUS) method.Materials and Methods.79 DKD patients and 26 healthy volunteers were enrolled. Renal function and urine protein markers were tested. DKD patients were subdivided into two groups including a normal serum uric acid (SUA) group and a high SUA group. Contrast-enhanced ultrasound (CEUS) was performed, and low acoustic power contrast-specific imaging was used for quantitative analysis.Results.Normal controls (NCs) had the highest levels of AUC, AUC1, and AUC2. Compared to the normal SUA DKD group, high SUA DKD patients had significantly higher IMAX, AUC, and AUC1 (P<0.05). DKD patients with low urinary uric acid (UUA) excretion had significantly higher AUC2 compared to DKD patients with normal UUA (P<0.05).Conclusion.Hyperuricemia in DKD patients was associated with a renal ultrasound image suggestive of microvascular hyperperfusion. The CEUS parameter AUC1 holds promise as an indicator for renal microvascular hyperperfusion, while AUC2 might be a useful indicator of declining glomerular filtration rate in DKD patients with decreased excretion of uric acid.
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Wiesinger, Isabel, Friedrich Jung, and Ernst Michael Jung. "Contrast-enhanced ultrasound (CEUS) and perfusion imaging using VueBox®." Clinical Hemorheology and Microcirculation 78, no. 1 (June 2, 2021): 29–40. http://dx.doi.org/10.3233/ch-201040.
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The external perfusion software (VueBox™) for contrast-enhanced ultrasound (CEUS), enables the quantitative analysis of micro-vascularization within non-cystic lesions in terms of characterization and detection. This review summarizes our work about parathyroid gland, thyroid gland, liver, prostate and other tissues as well as original studies in the use of parametric perfusion imaging. Useful perfusion parameters are introduced.