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Lin M, Cao L, Wang J, Zhou J. Diagnosis of hepatic inflammatory pseudotumor by fine-needle biopsy. J Interv Med 2022; 5:166-170. [PMID: 36317142 PMCID: PMC9617152 DOI: 10.1016/j.jimed.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 04/09/2022] [Accepted: 04/15/2022] [Indexed: 11/26/2022] Open
Abstract
Hepatic inflammatory pseudotumor (IPT) is a benign lesion characterized by chronic infiltration of inflammatory cells and fibrosis that clinically, radiologically, and pathologically mimics malignancy. However, the epidemiology of IPTs remains unclear. IPTs are often misdiagnosed as malignant lesions because of the lack of characteristic features. We present the case of a 32-year-old man that was misdiagnosed as intrahepatic cholangiocarcinoma by CECT, CEMRI, and CEUS, which was finally confirmed as IPT by fine-needle liver biopsy. In this report, the key factor in the diagnosis of liver inflammatory masses was the presence of hepatic perfusion disorder.
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2
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Francica G. Pyogenic liver abscess: contrast-enhanced ultrasound allows morpho-evolutive classification and guides personalized management. EXPLORATION OF MEDICINE 2022. [DOI: 10.37349/emed.2022.00093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Aim: The aim of this study is to propose a contrast-enhanced ultrasound (CEUS)-based morphologic classification of pyogenic liver abscess (PLA) reflecting different evolutive stages and to assess the added value of CEUS in the management of PLA.
Methods: Forty-four PLAs of different etiologies in 44 patients (male/female = 24/20; mean age 66 ± 14.7 years) were evaluated with ultrasound (US) B-mode and CEUS (using SonoVue). PLAs were mainly located in the right lobe (n = 28, 63.6%) with a mean diameter of 6.8 cm [standard deviation (SD) ± 3.2, range 1.7–15 cm]. Conventional US findings were categorized as the presence and extension of liquified areas, echogenicity and echostructure of the index lesion. Peripheral hyperenhancing rim, transient segmental enhancement, hyperenhancing septa and “honeycomb” aspect were considered PLA hallmarks in the arterial phase after contrast agent injection. CEUS results were judged as clinically relevant if they modified the approach to percutaneous treatment in comparison with pre-operative US B-mode findings.
Results: CEUS was superior to US B-mode as to depiction of PLA internal echostructure and enabled identification of 4 evolutive stages of PLA: type I (tumor-like), type II (“honeycomb”), type III (multiloculated with incomplete septa), and type IV (cystic-like). In 22 cases (67.4%) out of 34 who underwent percutaneous treatment, the operator tailored percutaneous approach according to PLA internal echostructure observed during CEUS exam.
Conclusions: CEUS depicts the internal structure of PLA so allowing a morpho-evolutive classification of PLA and provides invaluable information for immediately tailoring the management to the single case. By showing the structure of PLA more precisely, CEUS allows a morpho-evolutive PLA classification and guides tailored management in the single case.
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Affiliation(s)
- Giampiero Francica
- Interventional Ultrasound Unit, Pineta Grande Hospital, 81030 Castel Volturno (CE), Italy
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Zhao ZH, Fan YC, Wang K. Pyogenic Liver Abscess Caused by Staphylococcus hominis: A Case Report. INFECTIOUS MICROBES AND DISEASES 2021; 4:79-81. [DOI: 10.1097/im9.0000000000000078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
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4
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Chaubal N, Thomsen T, Kabaalioglu A, Srivastava D, Rösch SS, Dietrich CF. Ultrasound and contrast-enhanced ultrasound (CEUS) in infective liver lesions. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2021; 59:1309-1321. [PMID: 34768289 DOI: 10.1055/a-1645-3138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Infektiöse fokale Leberläsionen (FLL) treten in der klinischen Praxis häufig auf, wobei bakterielle Leberabszesse die Hälfte ausmachen. Eine genaue Diagnose der FLL ist für die Auswahl der am besten geeigneten Therapie und zur Vorbeugung von Komplikationen unerlässlich. Ziel der aktuellen Arbeit ist es, den Nutzen von Ultraschall und kontrastmittelverstärktem Ultraschall (CEUS) zur Erkennung und Charakterisierung infektiöser Leberläsionen zu beschreiben.
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Affiliation(s)
- Nitin Chaubal
- Thane Ultrasound Centre, Thane, India.,Jaslok Hospital and Research Centre, Mumbai, India
| | | | | | - David Srivastava
- Allgemeine Innere Medizin (DAIM) Kliniken Beau Site, Salem und Permanence, Bern, Switzerland
| | - Stephanie Simone Rösch
- Allgemeine Innere Medizin (DAIM) Kliniken Beau Site, Salem und Permanence, Bern, Switzerland
| | - Christoph F Dietrich
- Allgemeine Innere Medizin (DAIM) Kliniken Beau Site, Salem und Permanence, Bern, Switzerland
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5
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Lv K, Zhai H, Jiang Y, Liang P, Xu HX, Du L, Chou YH, Xie X, Luo Y, Lee YJ, Lee JY, Hu B, Luo B, Wang Y, Luan Y, Kalli C, Chen K, Wang W, Liang JD. Prospective assessment of diagnostic efficacy and safety of Sonazoid TM and SonoVue ® ultrasound contrast agents in patients with focal liver lesions. Abdom Radiol (NY) 2021; 46:4647-4659. [PMID: 34136936 PMCID: PMC8435522 DOI: 10.1007/s00261-021-03010-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 02/14/2021] [Accepted: 02/20/2021] [Indexed: 02/07/2023]
Abstract
Objectives To assess the respective diagnostic value of Sonazoid™ and SonoVue® for characterizing FLLs as benign or malignant and the corresponding safety. Methods This prospective Phase 3 study was conducted at 17 centres in China and Korea (May 2014 to April 2015); 424 patients (20 to 80 years) with at least 1 untreated focal liver lesion (FLL) (< 10 cm in diameter) underwent a contrast-enhanced ultrasound (CEUS) examination (218 received Sonazoid of 0.12 μL microbubbles/kg; 206 received SonoVue of 2.4 mL). Three independent blinded readers evaluated pre- and post-contrast images characterising the FLLs as benign or malignant. Results Sonazoid-enhanced and SonoVue-enhanced ultrasound provided a statistically significant improvement in specificity for all 3 readers comparing to unenhanced ultrasound (for Sonazoid: p = 0.0093, < 0.0001, 0.0011; for SonoVue: p = 0.002, 0.03, 0.12, respectively). Difference in accuracy improvement between the 2 groups was within the pre-specified non-inferiority margin of 20% for all 3 readers (6.1%, 95% CI: − 5.0 to 17.2; − 7.5%, 95% CI: − 18.4 to 3.5; − 0.3%, 95% CI: − 11.3 to 10.7). The diagnostic confidence level for all 3 readers increased with post-contrast images relative to pre-contrast images. Both contrast agents were well tolerated. Conclusion Results showed a similar efficacy for Sonazoid™ and SonoVue® in diagnosing FLLs as benign or malignant, and underlined the benefit of CEUS imaging over unenhanced ultrasound imaging in reaching a confident diagnosis without having to refer patients for additional imaging exams.
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Lu C, Tang S, Zhang X, Wang Y, Wang K, Shen P. Characteristics of hepatic solitary necrotic nodules on contrast-enhanced ultrasonography. BMC Gastroenterol 2021; 21:35. [PMID: 33494716 PMCID: PMC7836171 DOI: 10.1186/s12876-021-01608-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 01/12/2021] [Indexed: 11/20/2022] Open
Abstract
Background To summarize the characteristics of solitary necrotic nodules (SNN) in the liver observed under contrast-enhanced ultrasonography (CEUS). Methods Conventional ultrasonography (US) and CEUS were performed in 24 patients who were confirmed to have SNN by pathological assessment. The US data and dynamic enhancement patterns of CEUS were recorded and retrospectively analyzed. Results Ten of 24 patients underwent surgical resection, while the other 14 patients underwent a puncture biopsy to be confirmed as SNN. Among the 24 patients, 13 patients had a single lesion and 11 patients had multiple lesions. The largest lesion was selected for CEUS examination for patients with multiple lesions. Eleven patients presented no enhancement in all three phases, while the other 13 patients presented with a peripheral thin rim-like enhancement in the arterial phase, an iso-enhancement in the portal phase and delayed phase. However, no enhancement in the interior of the lesions was detected during three phases of CEUS. Conclusions SNN has characteristic findings on the CEUS, which play an important role in the differential diagnoses of liver focal lesions.
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Affiliation(s)
- Chunyu Lu
- Department of Ultrasound, Shengjing Hospital of China Medical University, 36 Sanhao St, Heping District, Shenyang, 110004, Liaoning Province, China
| | - Shaoshan Tang
- Department of Ultrasound, Shengjing Hospital of China Medical University, 36 Sanhao St, Heping District, Shenyang, 110004, Liaoning Province, China.
| | - Xiaoyue Zhang
- Department of Ultrasound, Shengjing Hospital of China Medical University, 36 Sanhao St, Heping District, Shenyang, 110004, Liaoning Province, China
| | - Yang Wang
- Department of Ultrasound, Shengjing Hospital of China Medical University, 36 Sanhao St, Heping District, Shenyang, 110004, Liaoning Province, China
| | - Kaiming Wang
- Department of Ultrasound, Shengjing Hospital of China Medical University, 36 Sanhao St, Heping District, Shenyang, 110004, Liaoning Province, China
| | - Peng Shen
- Department of Ultrasound, Shengjing Hospital of China Medical University, 36 Sanhao St, Heping District, Shenyang, 110004, Liaoning Province, China
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7
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Lee JY, Minami Y, Choi BI, Lee WJ, Chou YH, Jeong WK, Park MS, Kudo N, Lee MW, Kamata K, Iijima H, Kim SY, Numata K, Sugimoto K, Maruyama H, Sumino Y, Ogawa C, Kitano M, Joo I, Arita J, Liang JD, Lin HM, Nolsoe C, Gilja OH, Kudo M. The AFSUMB Consensus Statements and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound using Sonazoid. Ultrasonography 2020; 39:191-220. [PMID: 32447876 PMCID: PMC7315291 DOI: 10.14366/usg.20057] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 04/27/2020] [Indexed: 12/11/2022] Open
Abstract
The first edition of the guidelines for the use of ultrasound contrast agents was published in 2004, dealing with liver applications. The second edition of the guidelines in 2008 reflected changes in the available contrast agents and updated the guidelines for the liver, as well as implementing some nonliver applications. The third edition of the contrast-enhanced ultrasound (CEUS) guidelines was the joint World Federation for Ultrasound in Medicine and Biology-European Federation of Societies for Ultrasound in Medicine and Biology (WFUMB-EFSUMB) venture in conjunction with other regional US societies such as Asian Federation of Societies for Ultrasound in Medicine and Biology, resulting in a simultaneous duplicate on liver CEUS in the official journals of both WFUMB and EFSUMB in 2013. However, no guidelines were described mainly for Sonazoid due to limited clinical experience only in Japan and Korea. The new proposed consensus statements and recommendations provide general advice on the use of Sonazoid and are intended to create standard protocols for the use and administration of Sonazoid in hepatic and pancreatobiliary applications in Asian patients and to improve patient management.
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Affiliation(s)
- Jae Young Lee
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Yasunori Minami
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Higashi-Osaka, Japan
| | - Byung Ihn Choi
- Department of Radiology, Chung Ang University Hospital, Seoul, Korea
| | - Won Jae Lee
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yi-Hong Chou
- Department of Medical Imaging and Radiological Technology, Yuanpei University of Medical Technology, Hsinchu, Taiwan.,Department of Radiology, National Yang Ming University, Taipei, Taiwan
| | - Woo Kyoung Jeong
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mi-Suk Park
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Nobuki Kudo
- Laboratory of Biomedical Engineering, Graduate School of Information Science and Technology, Hokkaido University, Sapporo, Japan
| | - Min Woo Lee
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ken Kamata
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Higashi-Osaka, Japan
| | - Hiroko Iijima
- Department of Ultrasound, Hepatobiliary and Pancreatic Disease, Hyogo College of Medicine, Nishinomiya, Japan
| | - So Yeon Kim
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Kazushi Numata
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Katsutoshi Sugimoto
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Hitoshi Maruyama
- Department of Gastroenterology, Juntendo University, Tokyo, Japan
| | - Yasukiyo Sumino
- Department of Gastroenterology and Hepatology, Toho University Medical Center, Tokyo, Japan
| | - Chikara Ogawa
- Department of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, Takamatsu, Japan
| | - Masayuki Kitano
- Department of Gastroenterology and Hepatology, Wakayama Medical University Hospital, Wakayama, Japan
| | - Ijin Joo
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Junichi Arita
- Hepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ja-Der Liang
- Department of Gastroenterology and Hepatology, National Taiwan University, Taipei, Taiwan
| | - Hsi-Ming Lin
- Department of Gastroenterology and Hepatology, Chang Gung University, Taipei, Taiwan
| | - Christian Nolsoe
- Ultrasound Section, Division of Surgery, Department of Gastroenterology, Herlev Hospital, Copenhagen Academy for Medical Education and Simulation, University of Copenhagen, Copenhagen, Denmark
| | - Odd Helge Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Higashi-Osaka, Japan
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8
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Lee JY, Minami Y, Choi BI, Lee WJ, Chou YH, Jeong WK, Park MS, Kudo N, Lee MW, Kamata K, Iijima H, Kim SY, Numata K, Sugimoto K, Maruyama H, Sumino Y, Ogawa C, Kitano M, Joo I, Arita J, Liang JD, Lin HM, Nolsoe C, Gilja OH, Kudo M. The AFSUMB Consensus Statements and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound using Sonazoid. J Med Ultrasound 2020; 28:59-82. [PMID: 32874864 PMCID: PMC7446696 DOI: 10.4103/jmu.jmu_124_19] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/09/2020] [Accepted: 02/17/2020] [Indexed: 12/13/2022] Open
Abstract
The first edition of the guidelines for the use of ultrasound contrast agents was published in 2004, dealing with liver applications. The second edition of the guidelines in 2008 reflected changes in the available contrast agents and updated the guidelines for the liver, as well as implementing some nonliver applications. The third edition of the contrast-enhanced ultrasound (CEUS) guidelines was the joint World Federation for Ultrasound in Medicine and Biology-European Federation of Societies for Ultrasound in Medicine and Biology (WFUMB-EFSUMB) venture in conjunction with other regional US societies such as Asian Federation of Societies for Ultrasound in Medicine and Biology, resulting in a simultaneous duplicate on liver CEUS in the official journals of both WFUMB and EFSUMB in 2013. However, no guidelines were described mainly for Sonazoid due to limited clinical experience only in Japan and Korea. The new proposed consensus statements and recommendations provide general advice on the use of Sonazoid and are intended to create standard protocols for the use and administration of Sonazoid in hepatic and pancreatobiliary applications in Asian patients and to improve patient management.
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Affiliation(s)
- Jae Young Lee
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Yasunori Minami
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Higashi-Osaka, Japan
| | - Byung Ihn Choi
- Department of Radiology, Chung Ang University Hospital, Seoul, Korea
| | - Won Jae Lee
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yi-Hong Chou
- Department of Medical Imaging and Radiological Technology, Yuanpei University of Medical Technology, Hsinchu, Taiwan
- Department of Radiology, National Yang Ming University, Taipei, Taiwan
| | - Woo Kyoung Jeong
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mi-Suk Park
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Nobuki Kudo
- Laboratory of Biomedical Engineering, Graduate School of Information Science and Technology, Hokkaido University, Sapporo, Japan
| | - Min Woo Lee
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ken Kamata
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Higashi-Osaka, Japan
| | - Hiroko Iijima
- Department of Ultrasound, Hepatobiliary and Pancreatic Disease, Hyogo College of Medicine, Nishinomiya, Japan
| | - So Yeon Kim
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Kazushi Numata
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Katsutoshi Sugimoto
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Hitoshi Maruyama
- Department of Gastroenterology, Juntendo University, Tokyo, Japan
| | - Yasukiyo Sumino
- Department of Gastroenterology and Hepatology, Toho University Medical Center, Tokyo, Japan
| | - Chikara Ogawa
- Department of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, Takamatsu, Japan
| | - Masayuki Kitano
- Department of Gastroenterology and Hepatology, Wakayama Medical University Hospital, Wakayama, Japan
| | - Ijin Joo
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Junichi Arita
- Hepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ja-Der Liang
- Department of Gastroenterology and Hepatology, National Taiwan University, Taipei, Taiwan
| | - Hsi-Ming Lin
- Department of Gastroenterology and Hepatology, Chang Gung University, Taipei, Taiwan
| | - Christian Nolsoe
- Ultrasound Section, Division of Surgery, Department of Gastroenterology, Herlev Hospital, Copenhagen Academy for Medical Education and Simulation, University of Copenhagen, Copenhagen, Denmark
| | - Odd Helge Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Higashi-Osaka, Japan
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9
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Morita M, Ogawa C, Omura A, Noda T, Kubo A, Matsunaka T, Tamaki H, Shibatoge M, Seno H, Minami Y, Ueshima K, Sakurai T, Nishida N, Kudo M. The Efficacy of Sonazoid-enhanced Ultrasonography in Decision-making for Liver Abscess Treatment. Intern Med 2020; 59:471-477. [PMID: 32062622 PMCID: PMC7056389 DOI: 10.2169/internalmedicine.2510-18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Objective The usefulness of contrast-enhanced ultrasonography (CEUS) for making decisions in the treatment of liver abscess is unknown. Methods We evaluated the internal blood flow in the arterial-predominant phase by CEUS using Sonazoid® in 21 patients. The stain area rate was evaluated in maximum parting plane of abscess in CEUS. Patients were divided into two groups: the vascular phase enhancement (VE) group, in which ≥50% of the abscess cavity was enhanced (12 patients), and the vascular phase non-enhancement (VNE) group, in which <50% of the abscess cavity was enhanced (9 patients). The rate of patients who were cured by conservative treatment alone was examined in both groups. The defect rate of all liver abscesses in the post-vascular phase was also evaluated. Results In the VE group, improvement by conservative treatment alone was obtained in 11 out of 12 patients (91.7%), while in the VNE group, improvement by conservative treatment alone was obtained in only 1 out of 9 patients (11.1%), a significant difference (p<0.001). In the VE group, one patient did not improve with conservative treatment alone because the abscess ruptured near the liver surface. In the VE group, the abscess size was smaller than in the VNE group. By examining the defect rate in the post-vascular phase, it was found that 16 out of 21 patients (76.2%) showed 71% or more defects. Conclusion The enhancement rate in the arterial-predominant phase of CEUS was considered useful for determining the treatment approach for liver abscess.
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Affiliation(s)
- Masahiro Morita
- Department of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, Japan
| | - Chikara Ogawa
- Department of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, Japan
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
| | - Akina Omura
- Department of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, Japan
| | - Teruyo Noda
- Department of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, Japan
| | - Atsushi Kubo
- Department of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, Japan
| | - Toshihiro Matsunaka
- Department of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, Japan
| | - Hiroyuki Tamaki
- Department of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, Japan
| | - Mitsushige Shibatoge
- Department of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, Japan
| | - Hiroshi Seno
- Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Japan
| | - Yasunori Minami
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
| | - Kazuomi Ueshima
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
| | - Toshiharu Sakurai
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
| | - Naoshi Nishida
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
| | - Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
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10
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Boccatonda A, D'Ardes D, Cocco G, Cipollone F, Schiavone C. Ultrasound and hepatic abscess: A successful alliance for the internist. Eur J Intern Med 2019; 68:e19-e21. [PMID: 31399328 DOI: 10.1016/j.ejim.2019.07.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 07/28/2019] [Accepted: 07/30/2019] [Indexed: 02/07/2023]
Affiliation(s)
- A Boccatonda
- Unit of Internistic Ultrasound, Department of Medicine and Science of Aging, G. d'Annunzio University, Chieti, Italy.
| | - D D'Ardes
- Unit of Internistic Ultrasound, Department of Medicine and Science of Aging, G. d'Annunzio University, Chieti, Italy
| | - G Cocco
- Unit of Internistic Ultrasound, Department of Medicine and Science of Aging, G. d'Annunzio University, Chieti, Italy
| | - F Cipollone
- European Center of Excellence on Hypertension, Dyslipidemia and Atherosclerosis, Department of Medicine and Science of Aging, "G. d'Annunzio" University, Chieti, Italy
| | - C Schiavone
- Unit of Internistic Ultrasound, Department of Medicine and Science of Aging, G. d'Annunzio University, Chieti, Italy
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11
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Kessner R, Nakamoto DA, Kondray V, Partovi S, Ahmed Y, Azar N. Contrast-Enhanced Ultrasound Guidance for Interventional Procedures. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:2541-2557. [PMID: 30714653 DOI: 10.1002/jum.14955] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 01/03/2019] [Indexed: 06/09/2023]
Abstract
Since its introduction, contrast-enhanced ultrasound (CEUS) has gained an important role in the diagnosis and management of abdominal and pelvic diseases. Contrast-enhanced ultrasound can improve lesion detection rates as well as success rates of interventional procedures when compared to conventional ultrasound alone. Additionally, CEUS enables the interventionalist to assess the dynamic enhancement of different tissues and lesions, without the adverse effects of contrast-enhanced computed tomography, such as exposure to ionizing radiation and nephrotoxicity from iodinated contrast material. This review article describes the various applications and advantages of the use of CEUS to enhance performance of ultrasound-guided interventions in the abdomen and pelvis.
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Affiliation(s)
- Rivka Kessner
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Dean A Nakamoto
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Victor Kondray
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Sasan Partovi
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Yasmine Ahmed
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Nami Azar
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
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12
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Abstract
The introduction of ultrasound contrast agents has rendered contrast-enhanced ultrasound (CEUS) a valuable complementary technique to address clinically significant problems. This pictorial review describes the use of CEUS guidance in abdominal intervention and illustrates such application for a range of clinical indications. Clinical application of CEUS discussed include commonly performed abdominal interventional procedures, such as biopsy, drainage, nephrostomy, biliary intervention, abdominal tumor ablation and its subsequent monitoring, and imaging of vascular complications following abdominal intervention. The purpose of this article is to further familiarize readers with the application of CEUS, particularly its specific strength over alternative imaging modalities, in abdominal intervention.
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Huang DY, Yusuf GT, Daneshi M, Husainy MA, Ramnarine R, Sellars MEK, Sidhu PS. Contrast-enhanced US-guided Interventions: Improving Success Rate and Avoiding Complications Using US Contrast Agents. Radiographics 2017; 37:652-664. [PMID: 27860550 DOI: 10.1148/rg.2017160123] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Ultrasonography (US) is an established modality for intervention. The introduction of microbubble US contrast agents (UCAs) has the potential to further improve US imaging for intervention. According to licensing, UCAs are currently approved for clinical use in restricted situations, but many additional indications have become accepted as having clinical value. The use of UCAs has been shown to be safe, and there is no risk of renal toxic effects, unlike with iodinated or gadolinium contrast medium. Broadly speaking, UCAs can be injected into the bloodstream (intravascular use) or instilled into almost any accessible body cavity (endocavitary use), either in isolation or synchronously. In microvascular applications, contrast-enhanced US (CEUS) enhances delineation of necrotic areas and the vascularized target to improve real-time targeting. The ability of CEUS to allow true assessment of vascularity has also been used in follow-up of devascularizing intervention. In macrovascular applications, real-time angiographic images can be obtained with CEUS without nephrotoxic effects or radiation. In endocavitary applications, CEUS can achieve imaging similar to that of iodinated contrast medium-based fluoroscopy; follow-up to intervention (eg, tubography and nephrostography) can be performed at the bedside, which may be advantageous. The use of UCAs is a natural progression in US-guided intervention. The aim of this article is to describe the indications, contraindications, and techniques of using UCAs as an adjunctive tool for US-guided interventional procedures to facilitate effective treatment, improve complication management, and increase the overall success of interventional procedures. Online supplemental material is available for this article. ©RSNA, 2016.
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Affiliation(s)
- Dean Y Huang
- From the Department of Radiology, King's College Hospital, Denmark Hill, London SE5 9RS, England
| | - Gibran T Yusuf
- From the Department of Radiology, King's College Hospital, Denmark Hill, London SE5 9RS, England
| | - Mohammad Daneshi
- From the Department of Radiology, King's College Hospital, Denmark Hill, London SE5 9RS, England
| | - Mohammad Ali Husainy
- From the Department of Radiology, King's College Hospital, Denmark Hill, London SE5 9RS, England
| | - Raymond Ramnarine
- From the Department of Radiology, King's College Hospital, Denmark Hill, London SE5 9RS, England
| | - Maria E K Sellars
- From the Department of Radiology, King's College Hospital, Denmark Hill, London SE5 9RS, England
| | - Paul S Sidhu
- From the Department of Radiology, King's College Hospital, Denmark Hill, London SE5 9RS, England
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Tomizawa M, Togashi M, Shinozaki F, Hasegawa R, Shirai Y, Noritake M, Matsuoka Y, Kainuma H, Iwasaki Y, Fugo K, Motoyoshi Y, Sugiyama T, Yamamoto S, Kishimoto T, Ishige N. Unenhanced areas revealed by contrast-enhanced abdominal ultrasonography with Sonazoid™ potentially correspond to colorectal cancer. Exp Ther Med 2017; 12:4012-4016. [PMID: 28105132 DOI: 10.3892/etm.2016.3868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 09/22/2016] [Indexed: 11/06/2022] Open
Abstract
The present study investigated the potential utility of contrast-enhanced abdominal ultrasonography (CEUS), using Sonazoid™, in colorectal cancer (CRC). Three patients were subjected to CEUS with Sonazoid™. Surgical specimens were immunostained for CD31. Numbers of blood vessels positive for CD31 were analyzed in each of five fields at ×400 magnification and averaged to determine blood vessel density. Blood vessel density was compared between non-tumorous and tumorous areas. Prior to the administration of Sonazoid™, CRC was illustrated as irregular-shaped wall thickening. One minute after the administration of Sonazoid™, the majority of the thickened wall was enhanced, while some parts of the thickened wall remained unenhanced. Blood vessel densities of non-tumorous and tumorous areas in patient two were 25.2±2.5 and 5.2±1.1 (P<0.0001). Blood vessel densities of non-tumorous and tumorous areas in patient three were 19.0±3.1 and 2.2±0.8 (P<0.0001). Tumorous areas of CRC were not enhanced 1 min after the administration of Sonazoid™. Blood vessel density was lower in tumorous areas compared with non-tumorous areas, as evidenced by immunohistochemistry for CD31. These findings suggest that CEUS may be useful for the determination of the extent of CRC.
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Affiliation(s)
- Minoru Tomizawa
- Department of Gastroenterology, National Hospital Organization, Shimoshizu Hospital, Yotsukaido City, Chiba, 284-0003, Japan
| | - Mizuki Togashi
- Department of Clinical Laboratory, National Hospital Organization, Shimoshizu Hospital, Yotsukaido City, Chiba, 284-0003, Japan
| | - Fuminobu Shinozaki
- Department of Radiology, National Hospital Organization, Shimoshizu Hospital, Yotsukaido City, Chiba, 284-0003, Japan
| | - Rumiko Hasegawa
- Department of Surgery, National Hospital Organization, Shimoshizu Hospital, Yotsukaido City, Chiba, 284-0003, Japan
| | - Yoshinori Shirai
- Department of Surgery, National Hospital Organization, Shimoshizu Hospital, Yotsukaido City, Chiba, 284-0003, Japan
| | - Midori Noritake
- Department of Clinical Laboratory, National Hospital Organization, Shimoshizu Hospital, Yotsukaido City, Chiba, 284-0003, Japan
| | - Yukie Matsuoka
- Department of Clinical Laboratory, National Hospital Organization, Shimoshizu Hospital, Yotsukaido City, Chiba, 284-0003, Japan
| | - Hiroaki Kainuma
- Department of Clinical Laboratory, National Hospital Organization, Shimoshizu Hospital, Yotsukaido City, Chiba, 284-0003, Japan
| | - Yasuji Iwasaki
- Department of Clinical Laboratory, National Hospital Organization, Shimoshizu Hospital, Yotsukaido City, Chiba, 284-0003, Japan
| | - Kazunori Fugo
- Department of Molecular Pathology, Chiba University Graduate School of Medicine, Chiba City, Chiba 260-8670, Japan
| | - Yasufumi Motoyoshi
- Department of Neurology, National Hospital Organization, Shimoshizu Hospital, Yotsukaido, Yotsukaido City, Chiba 284-0003, Japan
| | - Takao Sugiyama
- Department of Rheumatology, National Hospital Organization, Shimoshizu Hospital, Yotsukaido, Yotsukaido City, Chiba 284-0003, Japan
| | - Shigenori Yamamoto
- Department of Pediatrics, National Hospital Organization, Shimoshizu Hospital, Yotsukaido, Yotsukaido City, Chiba 284-0003, Japan
| | - Takashi Kishimoto
- Department of Molecular Pathology, Chiba University Graduate School of Medicine, Chiba City, Chiba 260-8670, Japan
| | - Naoki Ishige
- Department of Neurosurgery, National Hospital Organization, Shimoshizu Hospital, Yotsukaido, Yotsukaido City, Chiba 284-0003, Japan
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15
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Modern role of clinical ultrasound in liver abscess and echinococcosis. J Med Ultrason (2001) 2016; 44:239-245. [DOI: 10.1007/s10396-016-0765-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 11/09/2016] [Indexed: 12/13/2022]
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16
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Bartolotta TV, Vernuccio F, Taibbi A, Lagalla R. Contrast-Enhanced Ultrasound in Focal Liver Lesions: Where Do We Stand? Semin Ultrasound CT MR 2016; 37:573-586. [PMID: 27986175 DOI: 10.1053/j.sult.2016.10.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Contrast-enhanced ultrasound (CEUS) represents a significant breakthrough in sonography, and it is being increasingly used for the evaluation of focal liver lesions (FLLs). Currently, CEUS is included as a part of the suggested diagnostic workup of FLLs, resulting in a better patient management and delivering cost-effective therapy. After a brief technical note, contrast-enhancement patterns of different types of benign and malignant FLLs, along with hepatic pseudolesions, are described and discussed based on our experience and literature data. At the same time, the most recent concepts and the use of CEUS in different clinical settings are presented.
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Affiliation(s)
| | - Federica Vernuccio
- Section of Radiology, DIBIMED, University Hospital "Paolo Giaccone", Palermo, Italy
| | - Adele Taibbi
- Section of Radiology, DIBIMED, University Hospital "Paolo Giaccone", Palermo, Italy
| | - Roberto Lagalla
- Section of Radiology, DIBIMED, University Hospital "Paolo Giaccone", Palermo, Italy
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Mavilia MG, Molina M, Wu GY. The Evolving Nature of Hepatic Abscess: A Review. J Clin Transl Hepatol 2016; 4:158-68. [PMID: 27350946 PMCID: PMC4913073 DOI: 10.14218/jcth.2016.00004] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 02/25/2016] [Accepted: 03/09/2016] [Indexed: 12/19/2022] Open
Abstract
Hepatic abscess (HA) remains a serious and often difficult to diagnose problem. HAs can be divided into three main categories based on the underlying conditions: infectious, malignant, and iatrogenic. Infectious abscesses include those secondary to direct extension from local infection, systemic bacteremia, and intra-abdominal infections that seed the portal system. However, over the years, the etiologies and risks factors for HA have continued to evolve. Prompt recognition is important for instituting effective management and obtaining good outcomes.
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Affiliation(s)
- Marianna G. Mavilia
- University of New England College of Osteopathic Medicine, Biddeford, ME, USA
- *Correspondence to: Marianna G. Mavilia, University of New England College of Osteopathic Medicine, 11 Hills Beach Road, Biddeford, ME 04005, USA. Tel: +1-617-435-1185, Fax: +1-860-679-6582,
| | - Marco Molina
- Department of Radiology, UCONN Health, Farmington, CT, USA
| | - George Y. Wu
- Department of Medicine, Division of Gastroenterology-Hepatology, UCONN Health, Farmington, CT, USA
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Chaubal N, Joshi M, Bam A, Chaubal R. Contrast-Enhanced Ultrasound of Focal Liver Lesions. Semin Roentgenol 2016; 51:334-357. [PMID: 27743569 DOI: 10.1053/j.ro.2016.05.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Nitin Chaubal
- Thane Ultrasound Center, Thane (W), MS, India; Jaslok Hospital & Research Centre, Mumbai.
| | - Mukund Joshi
- Thane Ultrasound Center, Thane (W), MS, India; Jaslok Hospital & Research Centre, Mumbai
| | - Anupam Bam
- Thane Ultrasound Center, Thane (W), MS, India
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