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You QQ, Peng SY, Zhou ZY, Tan XL, Miao XS. Comparison of the Value of Conventional Ultrasound and Contrast-Enhanced Ultrasound-Guided Puncture Biopsy in Different Sizes of Peripheral Pulmonary Lesions. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:6425145. [PMID: 35615730 PMCID: PMC9110189 DOI: 10.1155/2022/6425145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/01/2022] [Accepted: 04/15/2022] [Indexed: 11/25/2022]
Abstract
Objective To compare the clinical value of contrast-enhanced ultrasound and conventional ultrasound-guided puncture biopsy in peripulmonary lesions of different sizes. Materials and Methods 110 patients with peripulmonary lesions were randomly divided into two groups: the conventional ultrasound-guided group and the contrast-enhanced ultrasound-guided group. The lesions in the two groups were further divided into two groups according to the size of the lesions, and the tissues taken after puncture biopsy were sent for pathological examination. The pathological results were compared with the postoperative pathological results and other examination results, and the complications were recorded at the same time. Results In the conventional ultrasound group, the success rate of single puncture was 72.7% and the success rate of puncture was 80.0%; in the contrast group, the success rate of single puncture was 90.9% and the success rate of puncture was 94.6%. The difference between the two groups was statistically significant. There was no significant difference in needle bleeding and pneumothorax between the two groups. In the <30 mm group, there was no significant difference in the success rate of single puncture and the success rate of puncture between the two groups according to the size of the lesions. In the ≥30 mm group, the success rate of single puncture (97.1%) and puncture success rate (97.1%) in the contrast guidance group were higher than those in the conventional ultrasound guidance group (70.3%, 78.4%) and the difference was statistically significant (p < 0.05). Conclusion Compared with conventional ultrasound, for peripheral pulmonary lesions guided by contrast-enhanced ultrasonography, especially when the maximum diameter of the lesion is ≥ 30 mm, needle biopsy has better guiding significance; for peripheral lung lesions with a maximum diameter of <30 mm, contrast-enhanced ultrasonography is compared with conventional ultrasound guidance. The puncture success rate was not significantly different.
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Affiliation(s)
- Qi-Qin You
- Department of Medical Ultrasound, Qingpu Brance of Zhongshan Hospital, Fudan University School of Medicine, No. 1158 East Park Road, Shanghai 201700, China
| | - Shi-Yi Peng
- Department of Medical Ultrasound, Qingpu Brance of Zhongshan Hospital, Fudan University School of Medicine, No. 1158 East Park Road, Shanghai 201700, China
| | - Zhi-Ying Zhou
- Department of Medical Ultrasound, Qingpu Brance of Zhongshan Hospital, Fudan University School of Medicine, No. 1158 East Park Road, Shanghai 201700, China
| | - Xing-Li Tan
- Department of Medical Ultrasound, Qingpu Brance of Zhongshan Hospital, Fudan University School of Medicine, No. 1158 East Park Road, Shanghai 201700, China
| | - Xian-Sheng Miao
- Department of Medical Ultrasound, Qingpu Brance of Zhongshan Hospital, Fudan University School of Medicine, No. 1158 East Park Road, Shanghai 201700, China
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Zhang G, Liu D. Comparative the clinical value of contrast-enhanced ultrasonography, enhancement CT and MRI for diagnosing of liver lesions. Clin Hemorheol Microcirc 2021; 80:241-251. [PMID: 34958008 DOI: 10.3233/ch-211142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND To investigate the accuracy of contrast-enhanced ultrasonography, CT-enhancement and MRI in the diagnosis of liver-occupying lesions. METHODS 176 patients with suspected liver lesions in our hospital were retrospectively studied from July 2014 to July 2016. All of the 176 patients were diagnosed by contrast-enhanced ultrasonography, enhanced CT and MRI, and the pathological examination was performed. The results of pathological examination were regarded as the results of the diagnosis. The diagnostic accuracywas then compared among contrast-enhanced ultrasound, enhanced CT and MRI of these patients. RESULTS The results of contrast-enhanced ultrasonography showed that 164 of the 176 patients had liver-occupying lesions, and the accuracy of the diagnosis was 95.35%, which was significantly higher than that of CT enhancement and MRI (80.23% 84.30%). The accuracy of contrast-enhanced ultrasonography, in the diagnosis of primary liver cancer was significantly higher than that of CT enhancement and MRI (P < 0.05), and the difference was significant difference (P < 0.05). CONCLUSIONS The examination of contrast-enhanced ultrasonography is relatively simple, and the patients can get duplicateexamination, so we should choose the contrast-enhanced ultrasonography as the preferred method of diagnosis in liver mass, especially primary liver cancer.
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Affiliation(s)
- Gang Zhang
- Department of Pediatric Surgery, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Dandan Liu
- Department of Ultrasound Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
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Guo Y, Qin X, Chen S, Liu X, Gu P. Diagnosis efficacy of CEUS for hepatic inflammatory lesions. J Clin Lab Anal 2020; 34:e23231. [PMID: 32017229 PMCID: PMC7307339 DOI: 10.1002/jcla.23231] [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] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 01/09/2020] [Accepted: 01/09/2020] [Indexed: 12/17/2022] Open
Abstract
Purpose In this study, the efficacy of US/CEUS and clinicopathologic parameters in differential diagnosis of hepatic inflammatory lesions were evaluated. Methods This was a retrospective study in which CEUS imaging was performed on 182 patients. Among these patients, 44 patients had hepatic inflammatory lesions and 138 patients had malignant lesions. The ultrasound (US), CEUS, and clinicopathologic parameters with respect to differential diagnosis of hepatic inflammatory lesions were analyzed. Results Irregular lesion shape and unclear margin were commonly seen in hepatic inflammatory lesions by US/CEUS examination. Hypoenhancement in arterial phase (AP) and portal venous phase (PVP), and isoenhancement in delayed phase (DP) were more commonly found in inflammatory lesions rather than malignant lesions [9% (4/44), 68% (30/44), and 16% (7/44) vs 2% (3/138), 11% (15/138), 1% (1/138), respectively; P < .05]. The enhancement coverage was also a significant indicator for the differentiation of inflammatory lesions and malignant lesions (P < .05). History of hepatitis or cirrhosis, and higher serum alpha‐fetoprotein (AFP) level were indicators for malignant lesions, while liver parasites and higher body temperature were indicators for inflammatory lesions. When the US/CEUS findings were combined with clinicopathologic parameters, the diagnostic accuracy of inflammatory lesions could reach 93.3%, with sensitivity, specificity, positive predictive value, and negative predictive value of 63.64%, 96.03%, 84.85%, and 88.32%, respectively. Conclusion The US/CEUS findings combined with clinical characteristics can accurately differentiate hepatic inflammatory lesions and malignant lesions. The results of study will improve the diagnostic confidence for hepatic inflammatory lesions.
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Affiliation(s)
- Yuanyuan Guo
- Department of Gynaecology and ObstetricsAffiliated Hospital of North Sichuan Medical CollegeNanchongChina
| | - Xiachuan Qin
- Department of UltrasoundNanchong Central HospitalSichuanChina
| | - Shaoxian Chen
- Radiology DepartmentGaoping District People Hospital of NanchongNanchongChina
| | - Xuebin Liu
- Department of UltrasoundNanchong Central HospitalSichuanChina
| | - Peng Gu
- Department of UltrasoundAffiliated Hospital of North Sichuan Medical CollegeNanchongChina
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Diagnostic Performance and Confidence of Contrast-Enhanced Ultrasound in the Differential Diagnosis of Cystic and Cysticlike Liver Lesions. AJR Am J Roentgenol 2017. [PMID: 28639831 DOI: 10.2214/ajr.16.17062] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aims of this study were to assess the diagnostic performance of contrast-enhanced ultrasound (CEUS) in the characterization of atypical cystic and cysticlike focal liver lesions in comparison with conventional US and to determine whether the use of CEUS can reduce the need for further diagnostic workup. SUBJECTS AND METHODS In a 3-year period 48 patients with 50 atypical cystic and cysticlike lesions found at conventional US underwent CEUS. Diagnostic confirmation was obtained in cytohistopathologic examinations, with other imaging modalities, and in follow-up. Overall, there were 24 cystic lesions and 26 cysticlike solid lesions, specifically 32 benign and 18 malignant lesions. The conventional US and CEUS images and cine loops were reviewed by two blinded readers independently. Sensitivity, specificity, area under the ROC curve (Az), and interobserver agreement were calculated. RESULTS Diagnostic performance improved after review of CEUS examinations by both readers (conventional US Az = 0.781 vs 0.972; CEUS Az = 0.734 vs 0.957). Interreader agreement increased, although slightly (conventional US weighted κ = 0.894; CEUS weighted κ = 0.953). In terms of differential diagnosis, the occurrence of correctly characterized lesions increased after CEUS for both readers (reader 1, 62% to 98%; reader 2, 56% to 96%). CONCLUSION The development of low-acoustic-power CEUS has made it possible to identify several imaging features of cystic and cysticlike focal liver lesions that, in association with history and clinical findings, may help to correctly characterize them. Our data indicate the usefulness of CEUS in the evaluation of patients with these lesions.
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Dong Y, Zhang XL, Mao F, Huang BJ, Si Q, Wang WP. Contrast-enhanced ultrasound features of histologically proven small (≤20 mm) liver metastases. Scand J Gastroenterol 2017; 52:23-28. [PMID: 27577113 DOI: 10.1080/00365521.2016.1224380] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE We analyzed contrast-enhanced ultrasound (CEUS) features of histologically proved small (≤20 mm) liver metastases, in comparison to small (≤20 mm) hepatocellular carcinomas (HCC), to define the differentiate diagnoses value of CEUS in clinical practice. MATERIAL AND METHODS Eighty-two cases of small (≤20 mm) liver metastases and 84 cases of small (≤20 mm) HCC were retrospectively reviewed. All patients had CEUS images. Two radiologists assessed CEUS enhancement pattern and time of enhancement in consensus. Statistical analyses were performed using SPSS v.19.0 (SPSS Inc., Chicago, IL). The χ2 test and the independent sample t-test were used to compare the differences. RESULTS Comparing to small HCCs, rapid rim-like hyper-enhancement in arterial phase (56.1% in liver metastases vs. 2.3% in HCCs, p < .01), rapid wash-out and become hypo-enhancement in late arterial phase or early portal venous phase (96.4% in liver metastases vs. 22.6% in HCCs, p < .01) with central non-enhanced area in late phase were characteristic CEUS features of small metastases. CONCLUSIONS CEUS imaging enhancement findings reliably offer typical signs of small liver metastases, differentiate effectively with small HCCs. CEUS can help to improve the diagnostic confidence of small liver metastases.
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Affiliation(s)
- Yi Dong
- a Department of Ultrasound , Zhongshan Hospital, Fudan University , Shanghai , China
| | - Xiao-Long Zhang
- b Department of Ultrasound , Shanghai Institute of Imaging , Shanghai , China
| | - Feng Mao
- b Department of Ultrasound , Shanghai Institute of Imaging , Shanghai , China
| | - Bei-Jian Huang
- a Department of Ultrasound , Zhongshan Hospital, Fudan University , Shanghai , China
| | - Qin Si
- c Department of Ultrasound , 81st Hospital of Chinese PLA , Nanjing Jiangsu , China
| | - Wen-Ping Wang
- a Department of Ultrasound , Zhongshan Hospital, Fudan University , Shanghai , China
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Value of Contrast-Enhanced Ultrasound in Guidance of Percutaneous Biopsy in Peripheral Pulmonary Lesions. BIOMED RESEARCH INTERNATIONAL 2015; 2015:531507. [PMID: 26576426 PMCID: PMC4630371 DOI: 10.1155/2015/531507] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 10/05/2015] [Accepted: 10/07/2015] [Indexed: 12/27/2022]
Abstract
Objectives. To investigate the value of contrast-enhanced ultrasound (CEUS) in guidance of percutaneous biopsy in peripheral pulmonary lesions. Methods. This study focused on 53 patients (male: 38, female: 15, and mean age: 55.7 years ± 10.7) with 53 single peripheral pulmonary lesions. Before core needle (16-gauge) percutaneous biopsy, CEUS were performed in all lesions, with injection of 2.4 mL SonoVue (Bracco, Italy). The contrast-enhancement pattern, display rate of internal necrosis (nonenhanced) and active (obviously enhanced) areas, biopsy success rate, and pathological diagnosis rate were recorded. Results. All the peripheral pulmonary lesions were proved pathologically as benign lesions (n = 7), primary malignancies (n = 41), or metastasis (n = 5). Forty (86.9%) malignant lesions and 4 (57.1%) benign lesions showed internal necrosis areas on CEUS. The detection rate and average size of internal necrosis areas had been significantly improved compared to conventional ultrasound (P < 0.05). After CEUS, core needle percutaneous biopsies were performed successfully in the active areas of all lesions. The sampling success rate and pathological diagnosis rate were 100% and 98.1%. Conclusions. CEUS before biopsy provided useful diagnostic information about peripheral pulmonary lesions. By depicting internal necrotic and active areas, it is a promising technique for guaranteeing the accuracy, success, and safety of core needle biopsy.
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Abstract
OBJECTIVE The purpose of this article is to discuss the use of contrast-enhanced ultra-sound (CEUS) in focal liver lesions. CONCLUSION Focal liver lesions are usually detected incidentally during abdominal ultrasound. The injection of microbubble ultrasound contrast agents improves the characterization of focal liver lesions that are indeterminate on conventional ultrasound. The use of CEUS is recommended in official guidelines and suggested as a second diagnostic step after ultrasound detection of indeterminate focal liver lesions to immediately establish the diagnosis, especially for benign liver lesions, such as hemangiomas, avoiding further and more expensive examinations.
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Hepatic inflammatory pseudotumor: educational value of an incorrect diagnosis at contrast-enhanced ultrasound. J Med Ultrason (2001) 2015; 42:547-52. [PMID: 26576980 DOI: 10.1007/s10396-015-0624-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 03/06/2015] [Indexed: 12/16/2022]
Abstract
Hepatic inflammatory pseudotumor (IPT) is a rare lesion that is frequently confused with malignant tumors. According to the latest guidelines on contrast-enhanced ultrasound, hypoenhancement of solid lesions in the portal and late phases corresponds to the wash-out phenomenon that characterizes malignancies. IPT may show rapid arterial enhancement and portal or late phase hypoenhancement, falsely suggesting malignancy. We report a case of a diagnostic error in which a multifocal IPT was misdiagnosed as hepatic metastases. The IPT developed after an endoscopic retrograde cholangiography was investigated by close follow-up with CEUS and contrast-enhanced CT.
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Crippa S, Salgarello M, Laiti S, Partelli S, Castelli P, Spinelli AE, Tamburrino D, Zamboni G, Falconi M. The role of (18)fluoro-deoxyglucose positron emission tomography/computed tomography in resectable pancreatic cancer. Dig Liver Dis 2014; 46:744-9. [PMID: 24721105 DOI: 10.1016/j.dld.2014.03.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Revised: 03/03/2014] [Accepted: 03/16/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND The role of (18)fluoro-deoxyglucose positron emission tomography/computed tomography in pancreatic ductal adenocarcinoma is debated. We retrospectively assessed the value of (18)fluoro-deoxyglucose positron emission tomography/computed tomography in addition to conventional imaging as a staging modality in pancreatic cancer. METHODS (18)Fluoro-deoxyglucose positron emission tomography/computed tomography was performed in 72 patients with resectable pancreatic carcinoma after multi-detector computed tomography positron emission tomography was considered positive for a maximum standardized uptake value >3. RESULTS Overall, 21% of patients had a maximum standardized uptake value ≤ 3, and 60% of those had undergone neoadjuvant treatment (P=0.0001). Furthermore, 11% of patients were spared unwarranted surgery since positron emission tomography/computed tomography detected metastatic disease. All liver metastases were subsequently identified with contrast-enhanced ultrasound. Sensitivity and specificity of positron emission tomography/computed tomography for distant metastases were 78% and 100%. The median CA19.9 concentration was 48.8 U/mL for the entire cohort and 292 U/mL for metastatic patients (P=0.112). CONCLUSIONS The widespread application of (18)fluoro-deoxyglucose positron emission tomography/computed tomography in patients with resectable pancreatic carcinoma seems not justified. It should be considered in selected patients at higher risk of metastatic disease (i.e. CA19.9>200 U/mL) after undergoing other imaging tests. Neoadjuvant treatment is significantly associated with low metabolic activity, limiting the value of positron emission tomography in this setting.
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Affiliation(s)
- Stefano Crippa
- Division of Pancreatic Surgery, Department of Surgery, Università Politecnica delle Marche, Ospedali Riuniti, Ancona, Italy
| | | | - Silvia Laiti
- Residency Programme in Surgery, University of Verona, Italy
| | - Stefano Partelli
- Division of Pancreatic Surgery, Department of Surgery, Università Politecnica delle Marche, Ospedali Riuniti, Ancona, Italy
| | - Paola Castelli
- Department of Pathology, Ospedale Sacro Cuore-Don Calabria, Negrar, Italy
| | - Antonello E Spinelli
- Department of Medical Physics and Experimental Imaging, San Raffaele Scientific Institute, Milan, Italy
| | | | - Giuseppe Zamboni
- Department of Pathology, Ospedale Sacro Cuore-Don Calabria, Negrar, Italy
| | - Massimo Falconi
- Division of Pancreatic Surgery, Department of Surgery, Università Politecnica delle Marche, Ospedali Riuniti, Ancona, Italy.
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Cao BS, Li L, Li YX, Liang YM. Assessment of abnormal bowel perfusion using contrast-enhanced ultrasonography after small bowel transplantation: a case report. JOURNAL OF CLINICAL ULTRASOUND : JCU 2013; 41:370-372. [PMID: 22811315 DOI: 10.1002/jcu.21965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Accepted: 05/30/2012] [Indexed: 06/01/2023]
Abstract
A 59-year-old man with short-bowel syndrome received a small bowel transplantation. Because the recipient complained of severe abdominal pain 40 hours after the surgery and was highly suspected of having mesenteric vascular thrombosis, contrast-enhanced sonography (CEUS) was performed at his bedside. CEUS demonstrated that the superior mesenteric artery was patent, but the bowel graft showed hypoenhancement, indicating severely inadequate perfusion of the graft. Due to this complication, the patient underwent an exploratory laporatomy, and the bowel graft was removed. The pathologic findings support the diagnosis of acute vascular rejection after intestinal transplantation. This case suggests that CEUS can be used to assess perfusion and vascular complications after intestinal transplantation, as it is noninvasive and easily performed at bedside.
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Affiliation(s)
- Bing-Sheng Cao
- Department of Ultrasound, 309th Hospital of Chinese PLA, 17 Heishanhu Road, Haidian, Beijing, 100091, China
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Jung EM, Friedrich C, Hoffstetter P, Dendl LM, Klebl F, Agha A, Wiggermann P, Stroszcynski C, Schreyer AG. Volume navigation with contrast enhanced ultrasound and image fusion for percutaneous interventions: first results. PLoS One 2012; 7:e33956. [PMID: 22448281 PMCID: PMC3309014 DOI: 10.1371/journal.pone.0033956] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2011] [Accepted: 02/22/2012] [Indexed: 12/13/2022] Open
Abstract
Objective Assessing the feasibility and efficiency of interventions using ultrasound (US) volume navigation (V Nav) with real time needle tracking and image fusion with contrast enhanced (ce) CT, MRI or US. Methods First an in vitro study on a liver phantom with CT data image fusion was performed, involving the puncture of a 10 mm lesion in a depth of 5 cm performed by 15 examiners with US guided freehand technique vs. V Nav for the purpose of time optimization. Then 23 patients underwent ultrasound-navigated biopsies or interventions using V Nav image fusion of live ultrasound with ceCT, ceMRI or CEUS, which were acquired before the intervention. A CEUS data set was acquired in all patients. Image fusion was established for CEUS and CT or CEUS and MRI using anatomical landmarks in the area of the targeted lesion. The definition of a virtual biopsy line with navigational axes targeting the lesion was achieved by the usage of sterile trocar with a magnetic sensor embedded in its distal tip employing a dedicated navigation software for real time needle tracking. Results The in vitro study showed significantly less time needed for the simulated interventions in all examiners when V Nav was used (p<0.05). In the study involving patients, in all 10 biopsies of suspect lesions of the liver a histological confirmation was achieved. We also used V Nav for a breast biopsy (intraductal carcinoma), for a biopsy of the abdominal wall (metastasis of ovarial carcinoma) and for radiofrequency ablations (4 ablations). In 8 cases of inflammatory abdominal lesions 9 percutaneous drainages were successfully inserted. Conclusion Percutaneous biopsies and drainages, even of small lesions involving complex access pathways, can be accomplished with a high success rate by using 3D real time image fusion together with real time needle tracking.
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Affiliation(s)
- Ernst Michael Jung
- Department of Radiology, University Medical Center Regensburg, Regensburg, Germany
- Interdisciplinary Ultrasound Center, University Medical Center Regensburg, Regensburg, Germany
| | - Chris Friedrich
- Department of Radiology, University Medical Center Regensburg, Regensburg, Germany
| | - Patrick Hoffstetter
- Department of Radiology, University Medical Center Regensburg, Regensburg, Germany
| | - Lena Marie Dendl
- Department of Radiology, University Medical Center Regensburg, Regensburg, Germany
| | - Frank Klebl
- Interdisciplinary Ultrasound Center, University Medical Center Regensburg, Regensburg, Germany
| | - Ayman Agha
- Department of Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Phillipp Wiggermann
- Department of Radiology, University Medical Center Regensburg, Regensburg, Germany
| | | | - Andreas Georg Schreyer
- Department of Radiology, University Medical Center Regensburg, Regensburg, Germany
- * E-mail:
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Cao BS, Wu JH, Li XL, Deng J, Liao GQ. Sonographically guided transthoracic biopsy of peripheral lung and mediastinal lesions: role of contrast-enhanced sonography. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2011; 30:1479-1490. [PMID: 22039020 DOI: 10.7863/jum.2011.30.11.1479] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVES The purpose of this study was to assess the impact of contrast-enhanced sonography on sonographically guided transthoracic needle biopsy of lung lesions. METHODS A total of 121 patients underwent sonographically guided transthoracic needle cutting biopsy. Of the 121 patients, 62 (contrast-enhanced sonography group) underwent contrast-enhanced sonography before biopsy, and the information from contrast-enhanced sonography was used to optimize the biopsy procedure. The remaining 59 patients constituted the non-contrast-enhanced sonography group. The enhancement patterns and echogenicity were evaluated by the consensus of 2 sonographers. The diagnostic efficacy was compared between the contrast-enhanced and non-contrast-enhanced sonography groups. RESULTS The enhancement intensity and extent varied greatly among different thoracic lesions, and an anechoic area (necrosis) was revealed in 26 of 62 lesions (41.9%) lesions after administration of the contrast agent. The overall diagnostic accuracy of sonographically guided transthoracic biopsy in this study was 85.9% (104 of 121). In the contrast-enhanced sonography group, the initial biopsy led to correct diagnosis in 58 of 62 lesions (93.6%). In the non-contrast-enhanced sonography group, the initial biopsy led to correct diagnosis in 46 of 59 lesions (78.0%). The difference in the diagnostic accuracy between the contrast-enhanced and non-contrast-enhanced sonography groups was statistically significant (P < .05). CONCLUSIONS Contrast-enhanced sonography enables differentiation of viable from necrotic portions of thoracic lesions and has a positive impact on the diagnostic efficacy of sonographically guided transthoracic needle biopsy.
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Affiliation(s)
- Bing-Sheng Cao
- Department of Ultrasound, 309th Hospital of the Chinese PLA, 17 Heishanhu Rd, 100091 Beijing, China.
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Diagnosis value of focal liver lesions with SonoVue®-enhanced ultrasound compared with contrast-enhanced computed tomography and contrast-enhanced MRI: a meta-analysis. J Cancer Res Clin Oncol 2011; 137:1595-605. [PMID: 21850382 DOI: 10.1007/s00432-011-1035-8] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Accepted: 08/04/2011] [Indexed: 12/14/2022]
Abstract
PURPOSES This study is aimed at evaluating diagnostic value of focal liver lesions (FLLs) with SonoVue(®)-enhanced ultrasound compared with contrast-enhanced computed tomography (CECT) and contrast-enhanced magnetic resonance imaging (CEMRI). METHODS PubMed, EMBASE, and the Cochrane Central Register were searched for English language articles published from January 2000 to May 2011. Histopathologic analysis and/or close clinical and imaging follow-up (except CECT or CEMRI) for at least 6 months were used as golden reference. Sensitivity, specificity, summary receiver operating characteristic (SROC) curves, and area under the curve (AUC) were extracted to test heterogeneity. RESULTS In 21 included studies, for the SonoVue(®)-enhanced ultrasound studies, sensitivity was 88% (95% CI 87-90), specificity was 81% (95% CI 79-84), and 38.62 (95% CI 13.64-109.35) for diagnostic odds ratio (DOR); for the CECT studies, sensitivity was 90% (95% CI 88-92), specificity was 77% (95% CI 71-82), and 30.84 (95% CI 11.11-85.61) for DOR; for the CEMRI studies, sensitivity was 86% (95% CI 83-88), specificity was 81% (95% CI 76-85), and 27.63 (95% CI 11.28-67.70) for DOR. CONCLUSIONS In comparison, SonoVue(®)-enhanced ultrasound had high pooled sensitivity and pooled specificity. SROC analysis showed the diagnostic value of FLLs with SonoVue(®)-enhanced ultrasound has no significant difference compared with CECT and CEMRI. SonoVue(®)-enhanced ultrasound is highly sensitive and specific in the characterization of FLLs to support an effective diagnostic method.
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