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Contrast-enhanced ultrasonography: advance and current status in abdominal imaging.

Chung YE, Kim KW - Ultrasonography (2014)

Bottom Line: The use of second-generation contrast agents in a low-mechanical-index technique enables continuous scanning.Besides the detection and characterization of focal liver lesions, contrastenhanced US is helpful in the monitoring of radiofrequency ablation therapy and in the targeting step of an US-guided biopsy.In spite of the concerns related to its cost-effectiveness, contrast-enhanced US has the potential to be more widely used as a complimentary tool or to substitute the current imaging modalities in some occasions.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
In the field of contrast-enhanced ultrasonography (US), contrast agents are classified as either first- or second-generation agents depending on the gas within the microbubbles. In the case of first-generation contrast agents, a high-mechanical-index technique is used and only intermittent scanning is possible due to the early destruction of the microbubbles during the scanning. The use of second-generation contrast agents in a low-mechanical-index technique enables continuous scanning. Besides the detection and characterization of focal liver lesions, contrastenhanced US is helpful in the monitoring of radiofrequency ablation therapy and in the targeting step of an US-guided biopsy. Recently, there has been a demand for new criteria to evaluate the treatment response obtained using anti-angiogenic agents because morphologic criteria alone may not reflect the treatment response of the tumor and contrast-enhanced US can provide quantitative markers of tissue perfusion. In spite of the concerns related to its cost-effectiveness, contrast-enhanced US has the potential to be more widely used as a complimentary tool or to substitute the current imaging modalities in some occasions.

No MeSH data available.


Related in: MedlinePlus

A 64-year-old female with metastatic neuroendocrine carcinoma in the liver.A. The hepatobiliary phase of magnetic resonance showed a low signal intensity lesion in segment 4 (S4) of the liver (arrow). B. On conventional ultrasonography (US), the lesion was not clearly detected. C. After contrast enhancement, a low echoic lesion (arrow) was detected on S4 of the liver. US-guided biopsy was performed after lesion localization on contrast-enhanced US, and the lesion was confirmed as metastatic neuroendocrine carcinoma.
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f4-usg-14034: A 64-year-old female with metastatic neuroendocrine carcinoma in the liver.A. The hepatobiliary phase of magnetic resonance showed a low signal intensity lesion in segment 4 (S4) of the liver (arrow). B. On conventional ultrasonography (US), the lesion was not clearly detected. C. After contrast enhancement, a low echoic lesion (arrow) was detected on S4 of the liver. US-guided biopsy was performed after lesion localization on contrast-enhanced US, and the lesion was confirmed as metastatic neuroendocrine carcinoma.

Mentions: If the lesion was not clearly delineated on conventional US, but was well visualized on CT or MRI, a biopsy can be performed after the administration of a US contrast agent (Fig. 4). In lesions that have a large proportion of central necrosis, it may turn out that tissue is obtained only from the necrotic portion of the liver on a conventional grayscale US-guided biopsy, making a pathologic diagnosis impossible and requiring a re-biopsy. On CEUS, the viable portion of the tumor can be differentiated from the necrotic portion by the presence or absence of enhancement, and a targeted biopsy can be performed at the viable portion of the tumor (Fig. 5).


Contrast-enhanced ultrasonography: advance and current status in abdominal imaging.

Chung YE, Kim KW - Ultrasonography (2014)

A 64-year-old female with metastatic neuroendocrine carcinoma in the liver.A. The hepatobiliary phase of magnetic resonance showed a low signal intensity lesion in segment 4 (S4) of the liver (arrow). B. On conventional ultrasonography (US), the lesion was not clearly detected. C. After contrast enhancement, a low echoic lesion (arrow) was detected on S4 of the liver. US-guided biopsy was performed after lesion localization on contrast-enhanced US, and the lesion was confirmed as metastatic neuroendocrine carcinoma.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4282229&req=5

f4-usg-14034: A 64-year-old female with metastatic neuroendocrine carcinoma in the liver.A. The hepatobiliary phase of magnetic resonance showed a low signal intensity lesion in segment 4 (S4) of the liver (arrow). B. On conventional ultrasonography (US), the lesion was not clearly detected. C. After contrast enhancement, a low echoic lesion (arrow) was detected on S4 of the liver. US-guided biopsy was performed after lesion localization on contrast-enhanced US, and the lesion was confirmed as metastatic neuroendocrine carcinoma.
Mentions: If the lesion was not clearly delineated on conventional US, but was well visualized on CT or MRI, a biopsy can be performed after the administration of a US contrast agent (Fig. 4). In lesions that have a large proportion of central necrosis, it may turn out that tissue is obtained only from the necrotic portion of the liver on a conventional grayscale US-guided biopsy, making a pathologic diagnosis impossible and requiring a re-biopsy. On CEUS, the viable portion of the tumor can be differentiated from the necrotic portion by the presence or absence of enhancement, and a targeted biopsy can be performed at the viable portion of the tumor (Fig. 5).

Bottom Line: The use of second-generation contrast agents in a low-mechanical-index technique enables continuous scanning.Besides the detection and characterization of focal liver lesions, contrastenhanced US is helpful in the monitoring of radiofrequency ablation therapy and in the targeting step of an US-guided biopsy.In spite of the concerns related to its cost-effectiveness, contrast-enhanced US has the potential to be more widely used as a complimentary tool or to substitute the current imaging modalities in some occasions.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
In the field of contrast-enhanced ultrasonography (US), contrast agents are classified as either first- or second-generation agents depending on the gas within the microbubbles. In the case of first-generation contrast agents, a high-mechanical-index technique is used and only intermittent scanning is possible due to the early destruction of the microbubbles during the scanning. The use of second-generation contrast agents in a low-mechanical-index technique enables continuous scanning. Besides the detection and characterization of focal liver lesions, contrastenhanced US is helpful in the monitoring of radiofrequency ablation therapy and in the targeting step of an US-guided biopsy. Recently, there has been a demand for new criteria to evaluate the treatment response obtained using anti-angiogenic agents because morphologic criteria alone may not reflect the treatment response of the tumor and contrast-enhanced US can provide quantitative markers of tissue perfusion. In spite of the concerns related to its cost-effectiveness, contrast-enhanced US has the potential to be more widely used as a complimentary tool or to substitute the current imaging modalities in some occasions.

No MeSH data available.


Related in: MedlinePlus