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Cruz J, McGillen K, Pryor W, Esslinger D, Shin B. Novel use of contrast-enhanced ultrasound in the pretreatment planning prior to endovascular repair of endoleak after endovascular aortic aneurysm repair in a patient with chronic renal insufficiency: A case report and literature review. J Med Ultrasound 2022; 30:54-58. [PMID: 35465604 PMCID: PMC9030361 DOI: 10.4103/jmu.jmu_173_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/17/2021] [Accepted: 03/02/2021] [Indexed: 11/04/2022] Open
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2
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Na F, Wang L, Wu C, Ding Y. Contrast‐enhanced
ultrasound combined with augmented reality medical technology in the treatment of rabbit liver cancer with
high‐energy
focused knife. Comput Intell 2021. [DOI: 10.1111/coin.12450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Fengyu Na
- Department of Ultrasound The Third Affiliated Hospital of Qiqihar Medical University Qiqihaer China
| | - Li Wang
- Radiation Imaging Centre The Third Affiliated Hospital of Qiqihar Medical University Qiqihaer China
| | - Cuicui Wu
- Master Degree Candidate Qiqihar Medical University Qiqihar China
| | - Yan Ding
- Department of Ultrasound The Third Affiliated Hospital of Qiqihar Medical University Qiqihaer China
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3
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Frenzel F, Kubale R, Massmann A, Raczeck P, Jagoda P, Schlueter C, Stroeder J, Buecker A, Minko P. Artifacts in Contrast-Enhanced Ultrasound during Follow-up after Endovascular Aortic Repair: Impact on Endoleak Detection in Comparison with Computed Tomography Angiography. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:488-498. [PMID: 33358051 DOI: 10.1016/j.ultrasmedbio.2020.11.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/21/2020] [Accepted: 11/25/2020] [Indexed: 06/12/2023]
Abstract
The study described here systematically analyzed how specific artifacts in contrast-enhanced ultrasound (CEUS) can affect the detection of endoleaks during follow-up after endovascular aortic repair (EVAR). Patients undergoing EVAR of atherosclerotic or mycotic abdominal aortic aneurysms using various standard and branched stent-graft material for visceral and iliac preservation were enrolled over 5 y and followed up with computed tomography angiography (CTA) and CEUS simultaneously. CEUS artifacts were frequently identified after EVAR procedures (59% of examinations) and were caused mainly by contrast agent, different prosthesis or embolization material and postinterventional changes in the aneurysm sac. This article describes how to identify important artifacts and how to avoid false-negative or false-positive interpretations of endoleaks. Despite artifacts, CEUS had higher sensitivity for endoleak detection after EVAR than CTA. CEUS was superior to CTA in the identification of late endoleaks type II and in follow-up examinations after embolization procedures, where beam-hardening artifacts limited CTA.
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Affiliation(s)
- Felix Frenzel
- Clinic for Diagnostic and Interventional Radiology, Saarland University Medical Centre, Homburg/Saar, Germany.
| | - Reinhard Kubale
- Clinic for Diagnostic and Interventional Radiology, Saarland University Medical Centre, Homburg/Saar, Germany
| | - Alexander Massmann
- Clinic for Diagnostic and Interventional Radiology, Saarland University Medical Centre, Homburg/Saar, Germany
| | - Paul Raczeck
- Clinic for Diagnostic and Interventional Radiology, Saarland University Medical Centre, Homburg/Saar, Germany
| | - Philippe Jagoda
- Clinic for Diagnostic and Interventional Radiology, Saarland University Medical Centre, Homburg/Saar, Germany
| | - Christian Schlueter
- Clinic for General, Abdominal and Vascular Surgery, Saarland University Medical Centre, Homburg/Saar, Germany
| | - Jonas Stroeder
- Clinic for Diagnostic and Interventional Radiology, Saarland University Medical Centre, Homburg/Saar, Germany
| | - Arno Buecker
- Clinic for Diagnostic and Interventional Radiology, Saarland University Medical Centre, Homburg/Saar, Germany
| | - Peter Minko
- Clinic for Diagnostic and Interventional Radiology, Saarland University Medical Centre, Homburg/Saar, Germany
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Therapeutic response monitoring after targeted therapy in an orthotopic rat model of hepatocellular carcinoma using contrast-enhanced ultrasound: Focusing on inter-scanner, and inter-operator reproducibility. PLoS One 2020; 15:e0244304. [PMID: 33362203 PMCID: PMC7757904 DOI: 10.1371/journal.pone.0244304] [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: 06/23/2020] [Accepted: 12/03/2020] [Indexed: 11/30/2022] Open
Abstract
Purpose To assess therapeutic response monitoring after targeted therapy in an orthotopic rat model of hepatocellular carcinoma (HCC) using CEUS with focusing on inter-scanner and inter-operator reproducibility. Materials and methods For reproducibility, CEUS was performed using two different US scanners by two operators in sixteen rat models of HCC. Using perfusion analysis software (VueBox ®), eleven parameters were collected, and intra-class correlation coefficient (ICC) was used to analyze reproducibility. Then seventeen rat models of HCC were divided into treatment group (n = 8, 30 mg/kg/day sorafenib for five days) and control group (n = 9). CEUS was performed at baseline and 14 days after first treatment, and changes of perfusion parameters were analyzed. Results In treatment group, CEUS perfusion parameters showed a significant change. The peak enhancement (PE, 2.50 x103±1.68 x103 vs 5.55x102±4.65x102, p = 0.010) and wash-in and wash out AUC (WiWoAUC, 1.07x105±6.48 x104 vs 2.65x104±2.25x104, p = 0.009) had significantly decreased two weeks after treatment. On the contrary, control group did not show a significant change, including PE (1.15 x103±7.53x102 vs 9.43x102± 7.81 x102, p = 0.632) and WiWoAUC (5.09 x104±3.25x104 vs 5.92 x104±3.20x104, p = 0.646). For reproducibility, the various degrees of inter-scanner reproducibility were from poor to good (ICC: <0.01–0.63). However, inter-operator reproducibility of important perfusion parameters, including WiAUC, WoAUC, and WiWoAUC, ranged from fair to excellent (ICC: 0.59–0.93) in a different scanner. Conclusion Our results suggest that CEUS is useful for assessment of the treatment response after targeted therapy and with fair to excellent inter-operator reproducibility.
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Kloth C, Kratzer W, Schmidberger J, Beer M, Clevert DA, Graeter T. Ultrasound 2020 - Diagnostics & Therapy: On the Way to Multimodal Ultrasound: Contrast-Enhanced Ultrasound (CEUS), Microvascular Doppler Techniques, Fusion Imaging, Sonoelastography, Interventional Sonography. ROFO-FORTSCHR RONTG 2020; 193:23-32. [PMID: 32731265 DOI: 10.1055/a-1217-7400] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Ultrasound as a non-ionizing imaging procedure is one of the most important diagnostic procedures in everyday clinical practice. The technology is widely used. Due to constant technical innovations, sonographic procedures, such as contrast-enhanced ultrasound (CEUS), sonoelastography, new microvascular Doppler modalities and, as an example of interventional procedures, sonographically controlled microwave ablation (MWA), are becoming increasingly important in diagnostic imaging and interventional medicine alongside CT and MRI. However, this also requires greater expertise, specialization and qualification on the part of users. METHOD This review article provides information about the range of technical innovations in ultrasound in recent years and describes the underlying technology, the clinical applications, and their diagnostic value. These are presented in the context of the current literature, explaining their advantages and disadvantages and their clinical value. RESULTS AND CONCLUSION Contrast-enhanced ultrasound (CEUS), microvascular Doppler modalities, fusion imaging and elastography complement B-scan ultrasound and conventional Doppler procedures for various problems. Microwave ablation (MWA) has a firm place as an ablative procedure for local tumor therapy in different organ systems and can be performed under ultrasound guidance. Thanks to new developments, the possibilities of ultrasound are now greater than ever. Knowledge of the technology, indications, and possible applications of newer procedures is essential for adequate patient care. KEY POINTS · Contrast-enhanced ultrasound (CEUS) allows an increase in sensitivity and specificity in the assessment of parenchymal lesions.. · CEUS allows the microperfusion to be visualized and quantified. For larger vessels, CEUS is an important instrument in diagnosing endoleak after stenting.. · Microvascular Doppler techniques with clutter suppression algorithms allow a more accurate representation of the smallest vessels than regular color or power Doppler.. · Elastography of the liver in diffuse hepatopathies is a noninvasive diagnostic tool to exclude higher grade fibrosis/cirrhosis.. · Microwave ablation (MWA) also offers sonographically controlled ablation of tumors.. CITATION FORMAT · Kloth C, Kratzer W, Schmidberger J et al. Ultrasound 2020 - Diagnostics & Therapy: On the Way to Multimodal Ultrasound: Contrast-Enhanced Ultrasound (CEUS), Microvascular Doppler Techniques, Fusion Imaging, Sonoelastography, Interventional Sonography . Fortschr Röntgenstr 2021; 193: 23 - 32.
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Affiliation(s)
- Christopher Kloth
- Department of Interventional and Diagnostic Radiology, University Hospital Ulm, Germany
| | - Wolfgang Kratzer
- Department of Internal Medicine I, University Hospital Ulm, Germany
| | | | - Meinrad Beer
- Department of Interventional and Diagnostic Radiology, University Hospital Ulm, Germany
| | - Dirk Andre Clevert
- Department of Clinical Radiology, University Hospital Munich Campus Großhadern, München, Germany
| | - Tilmann Graeter
- Department of Interventional and Diagnostic Radiology, University Hospital Ulm, Germany
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Kalender G, Lisy M, Stock UA, Endisch A, Kornberger A. Long-term radiation exposure in patients undergoing EVAR: Reflecting clinical day-to-day practice to assess realistic radiation burden. Clin Hemorheol Microcirc 2019; 71:451-461. [PMID: 30248048 DOI: 10.3233/ch-170344] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Endovascular repair of aortic aneurysms (EVAR) has become an established treatment option currently applied in an increasing numbers of patients with aortic aneurysms. Advantages include reduced surgical trauma, procedural time, intensive care unit and hospital lengths of stay, blood loss as well as morbidity and mortality.The optimal imaging modalities in EVAR follow-up as well as the appropriate intervals between these follow-ups remain subject of controversial discussion. Objective of this study was the evaluation of the realistic radiation exposure and risk estimate postop EVAR treatment.Of the follow-ups required according to the surveillance schedule during the first year post-EVAR, only 68.3% were actually implemented. Of those required from the second year onwards, an average of 70% was actually performed. During the observation period, each patient underwent a mean of 4.3 CTAs. The median ED calculated from all CTAs was 24. 5 mSv. The minimum and maximum cumulative EDs for the entire observation period were 55 mSv and 310 mSv, respectively.
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Affiliation(s)
- G Kalender
- Department of Vascular and Endovascular Surgery, DRK Hospital Berlin Köpenick, Berlin, Germany
| | - M Lisy
- Department of Vascular and Endovascular Surgery, Krankenhaus Nordwest Frankfurt, Germany
| | - U A Stock
- Department of Cardiac and Transplant Surgery, Royal Brompton and Harefield NHS Trust, Harefield, UK
| | - A Endisch
- Department of Vascular and Endovascular Surgery, Asklepios Hospital Bad Tölz, Germany
| | - A Kornberger
- Department of Vascular, Thoracic and Cardiovascular Surgery, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Germany
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Schwarze V, Mueller-Peltzer K, Negrão de Figueiredo G, Lindner F, Rübenthaler J, Clevert DA. The use of contrast-enhanced ultrasound (CEUS) for the diagnostic evaluation of hepatic echinococcosis. Clin Hemorheol Microcirc 2019; 70:449-455. [DOI: 10.3233/ch-189310] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- V. Schwarze
- Department of Radiology, Interdisciplinary Ultrasound Center, Ludwig-Maximilians-University Munich - Grosshadern Campus, Munich, Germany
| | - K. Mueller-Peltzer
- Department of Radiology, Interdisciplinary Ultrasound Center, Ludwig-Maximilians-University Munich - Grosshadern Campus, Munich, Germany
| | - G. Negrão de Figueiredo
- Department of Radiology, Interdisciplinary Ultrasound Center, Ludwig-Maximilians-University Munich - Grosshadern Campus, Munich, Germany
| | - F. Lindner
- Department of Radiology, Interdisciplinary Ultrasound Center, Ludwig-Maximilians-University Munich - Grosshadern Campus, Munich, Germany
| | - J. Rübenthaler
- Department of Radiology, Interdisciplinary Ultrasound Center, Ludwig-Maximilians-University Munich - Grosshadern Campus, Munich, Germany
| | - D.-A. Clevert
- Department of Radiology, Interdisciplinary Ultrasound Center, Ludwig-Maximilians-University Munich - Grosshadern Campus, Munich, Germany
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Negrão de Figueiredo G, Müller-Peltzer K, Schwarze V, Rübenthaler J, Clevert DA. Ultrasound and contrast enhanced ultrasound imaging in the diagnosis of acute aortic pathologies. VASA 2018; 48:17-22. [PMID: 30403367 DOI: 10.1024/0301-1526/a000758] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Conventional ultrasound is worldwide the first-line imaging modality for the prompt diagnosis in the daily practice because it is a cost-effective and easy to perform technique. The additional application of contrast media has been used to enhance the intravascular contrast and to improve the imaging diagnostic accuracy in the detection, classification and follow-up of vascular pathologies. Contrast-enhanced ultrasound has the advantage of being a safe, fast and dynamic non-invasive imaging tool with excellent results in the diagnosis of acute aortic pathologies, especially the detection of endoleaks after endovascular aneurysm repair. This review describes the diagnostic and therapeutic roles of ultrasound and contrast-enhanced ultrasound imaging in the most common vascular pathologies such as aortic dissections, aneurysms and endoleaks. Keywords: Endoleak, contrast media, ultrasonography, aorta.
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Affiliation(s)
- Giovanna Negrão de Figueiredo
- 1 Department of Radiology, Interdisciplinary Ultrasound-Center Ludwig-Maximilians-University of Munich - Grosshadern Campus, Munich, Germany
| | - Katharina Müller-Peltzer
- 1 Department of Radiology, Interdisciplinary Ultrasound-Center Ludwig-Maximilians-University of Munich - Grosshadern Campus, Munich, Germany
| | - Vincent Schwarze
- 1 Department of Radiology, Interdisciplinary Ultrasound-Center Ludwig-Maximilians-University of Munich - Grosshadern Campus, Munich, Germany
| | - Johannes Rübenthaler
- 1 Department of Radiology, Interdisciplinary Ultrasound-Center Ludwig-Maximilians-University of Munich - Grosshadern Campus, Munich, Germany
| | - Dirk-André Clevert
- 1 Department of Radiology, Interdisciplinary Ultrasound-Center Ludwig-Maximilians-University of Munich - Grosshadern Campus, Munich, Germany
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Abstract
Non-invasive imaging of the aorta has undergone considerable advancements in recent times; largely driven by the technological advances in computed tomography (CT) and magnetic resonance imaging (MRI). This review article highlights these recent advancements and discusses the current role of different imaging tools in the management of aortic diseases.
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Affiliation(s)
- Vinit Baliyan
- Division of Cardiovascular Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Daniel Verdini
- Division of Cardiovascular Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Nandini M Meyersohn
- Division of Cardiovascular Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
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10
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Jung EM, Jung F, Xu HX. Developments in the application of high resolution ultrasound in clinical diagnostics. Clin Hemorheol Microcirc 2017; 66:273-275. [PMID: 28527197 DOI: 10.3233/ch-179100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Ernst-Michael Jung
- Department of Radiology, Interdisciplinary Ultrasound Department, University Hospital Regensburg, Regensburg, Germany
| | - Friedrich Jung
- Institute of Biomaterial Science and Berlin-Brandenburg Centre for Regenerative Therapies, Helmholtz-Zentrum Geesthacht, Teltow, Germany
| | - Hui-Xiong Xu
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University, School of Medicine, Shanghai, China
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