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Sample records for contrast-enhanced ultrasonography ceus

  1. International guidelines for contrast-enhanced ultrasonography

    DEFF Research Database (Denmark)

    Nolsøe, Christian Pállson; Lorentzen, Torben

    2016-01-01

    The intent of this review is to discuss and comment on common clinical scenarios in which contrast-enhanced ultrasonography (CEUS) may play a decisive role and to illustrate important points with typical cases. With the advent of CEUS, the scope of indications for ultrasonography has been dramati...

  2. Dynamic Contrast-Enhanced Magnetic Resonance Enterography and Dynamic Contrast-Enhanced Ultrasonography in Crohn's Disease

    DEFF Research Database (Denmark)

    Wilkens, Rune; Peters, David A; Nielsen, Agnete Hedemann

    2017-01-01

    Purpose e Cross-sectional imaging methods are important for objective evaluationof small intestinal inflammationinCrohn'sdisease(CD).The primary aim was to compare relative parameters of intestinal perfusion between contrast-enhanced ultrasonography (CEUS) and dynamic contrast-enhanced magnetic...

  3. Contrast-enhanced endoscopic ultrasonography

    DEFF Research Database (Denmark)

    Reddy, Nischita K; Ioncica, Ana Maria; Saftoiu, Adrian

    2011-01-01

    Contrast agents are increasingly being used to characterize the vasculature in an organ of interest, to better delineate benign from malignant pathology and to aid in staging and directing therapeutic procedures. We review the mechanisms of action of first, second and third generation contrast...... agents and their use in various endoscopic procedures in the gastrointestinal tract. Various applications of contrast-enhanced endoscopic ultrasonography include differentiating benign from malignant mediastinal lymphadenopathy, assessment of depth of invasion of esophageal, gastric and gall bladder...

  4. Contrast-enhanced endoscopic ultrasonography

    DEFF Research Database (Denmark)

    Reddy, Nischita K; Ioncică, Ana Maria; Săftoiu, Adrian

    2011-01-01

    Contrast agents are increasingly being used to characterize the vasculature in an organ of interest, to better delineate benign from malignant pathology and to aid in staging and directing therapeutic procedures. We review the mechanisms of action of first, second and third generation contrast...... agents and their use in various endoscopic procedures in the gastrointestinal tract. Various applications of contrast-enhanced endoscopic ultrasonography include differentiating benign from malignant mediastinal lymphadenopathy, assessment of depth of invasion of esophageal, gastric and gall bladder...... cancers and visualization of the portal venous system and esophageal varices. In addition, contrast agents can be used to differentiate pancreatic lesions. The use of color Doppler further increases the ability to diagnose and differentiate various pancreatic malignancies. The sensitivity of power Doppler...

  5. The role of contrast-enhanced ultrasonography in image-guided liver ablations

    International Nuclear Information System (INIS)

    Pescatori, Lorenzo Carlo; Sconfienza, Luca Maria; Mauri, Giovanni

    2016-01-01

    We read with great interest the paper by Kim et al. entitled “Local ablation therapy with contrast enhanced ultrasonography for hepatocellular carcinoma: a practical review,” recently published in Ultrasonography. We think that contrast-enhanced ultrasonography (CEUS), together with the development of reliable navigation systems, is likely to represent one of the most important advances in image-guided ablations in recent years. Thus, we offer some considerations on the topic

  6. Contrast-Enhanced Ultrasonography in Crohn's Disease Diagnostics.

    Science.gov (United States)

    Białecki, Marcin; Białecka, Agnieszka; Laskowska, Katarzyna; Liebert, Ariel; Kłopocka, Maria; Serafin, Zbigniew

    2015-06-01

    The chronic nature of Crohn's disease (CD) implicates necessity of multiple control assessments throughout patient's life. It is accepted that in patients with CD requiring disease monitoring, magnetic resonance enterography (MRE) and computed tomography enterography (CTE) are--apart from endoscopy--imaging studies of first choice. In practice, diagnostic imaging of patients with CD is troublesome, since MRE is an expensive and complicated study, and CTE exposes patients to high doses of ionizing radiation. Therefore, there is a need for new, both non-invasive and effective, methods of imaging in CD. Contrast-Enhanced Ultrasonography (CEUS) is a relatively new method using gas-filled microbubbles serving as contrast agent. It allows for detailed assessment of blood perfusion within intestine wall and peri-intestinal tissues, which enables detection and monitoring of inflammation and its qualitative assessment. The purpose of this paper is to describe CEUS examination technique and its clinical applications in patients with Crohn's disease.

  7. Differential diagnosis of gastric cancer and gastritis: the role of contrast-enhanced ultrasound (CEUS).

    Science.gov (United States)

    Xue, Heng; Ge, Hui-Yu; Miao, Li-Ying; Wang, Shu-Min; Zhao, Bo; Wang, Jin-Rui; Cui, Li-Gang

    2017-03-01

    To evaluate the diagnostic performance of contrast-enhanced ultrasound (CEUS) in differential diagnosis of gastric cancer and gastritis, with histological results as reference standard. From September 2011 to August 2014, 82 patients (50 males and 32 females; mean age ± SD, 59.5 ± 15.0 years; range 19-91 years) with gastric cancer or gastritis were included in this Ethics Committee-approved prospective study. Conventional ultrasonography (US) and CEUS were applied to distinguish the two lesions, and both qualitative and quantitative features were evaluated. Of the 82 histopathologic-proven lesions, 58 were cancer and 24 were gastritis. For US, the gastric wall stratification was not preserved in about one-third of cancer (21/58, 36.2%) compared with gastritis (0/24, 0%) (p gastritis (19/24, 79.2%, p gastritis. CEUS has the potential to make the diagnosis more accurate.

  8. Is CEUS (contrast enhanced ultrasonography a useful tool in a beginner’s hands? How much can CAD (computer assisted diagnosis prototype help us in the characterization of malignancy in focal lesions of the liver?

    Directory of Open Access Journals (Sweden)

    Tudor Voicu Moga1,

    2016-12-01

    Full Text Available OBJECTIVES CEUS improved the characterization of focal lesions of the liver (FLLs, but it remains an operator-dependent method. The goal of this scientific paper was to test a computer assisted diagnosis (CAD prototype. MATERIALS AND METHODS 97 CEUS videos [34% hepatocellular carcinomas (HCC, 12.3% hypervascular metastases (HiperM, 11.3% hypovascular metastases (HipoM, 24.7% hemangiomas (HMG, 17.5% focal nodular hyperplasia (FNH] were used to develop a CAD prototype based on an algorithm that tested a binary decision classifier. Two young MDs, two experts and the CAD prototype, reevaluated 50 CEUS videos (diagnosis of benign vs. malignant lesions, in order to evaluate the beginner vs. expert diagnostic gap, the first being blinded by clinical data. RESULTS I-Beginner misdiagnosed 4/10-FNH, 3/10-HCC, 2/10-HMG, 1/10-HiperM, 1/10-HipoM. After being informed about the clinical data 2/10-FNH, 1/10-HCC. II-beginner misdiagnosed: 3/10-FNH; 3/10-HCC, 2/10- HMG, 1/10-HiperM. Unblinded: 1/10-HCC, 1/10- HMG. I-Expert: only 1/10-FNH, 1/10-HCC, 1/10- HMG misdiagnosed. Unblinded: all lesions were correctly diagnosed. II-Expert: 1/10-FNH, 1/10-HCC misdiagnosed. Unblinded: only 1/10-FNH was misdiagnosed. The CAD classifier managed a 75.2% overall correct classification rate. The overall classification before and after the uncovering of clinical data was: I beginner 78 %; 94%, II 82%; 96%. I expert 94%; 100%. II 96%; 98%. CONCLUSIONS The CAD prototype can assist a beginner for a better CEUS diagnostic accuracy. The integration of clinical data in the CAD algorithm is essential. Graphical abstract: Average Intensity variation in Arterial and Late Phase with supra unitary (meaning wash in and sub unitary pattern (meaning washout. REFERENCES 1.Sugimoto K, Shiraishi J, Moriyasu F, Doi K. Computer-aided diagnosis for contrast-enhanced ultrasound in the liver. World J Gastroenterol. 2010;2:215-223. 2. Gatos I, Tsantis S, Spiliopoulos S, Skouroliakou A, Theotokas I

  9. Local ablation therapy with contrast-enhanced ultrasonography for hepatocellular carcinoma: a practical review

    Directory of Open Access Journals (Sweden)

    Tae Kyoung Kim

    2015-10-01

    Full Text Available A successful program for local ablation therapy for hepatocellular carcinoma (HCC requires extensive imaging support for diagnosis and localization of HCC, imaging guidance for the ablation procedures, and post-treatment monitoring. Contrast-enhanced ultrasonography (CEUS has several advantages over computed tomography/magnetic resonance imaging (CT/MRI, including real-time imaging capability, sensitive detection of arterial-phase hypervascularity and washout, no renal excretion, no ionizing radiation, repeatability, excellent patient compliance, and relatively low cost. CEUS is useful for image guidance for isoechoic lesions. While contrast-enhanced CT/MRI is the standard method for the diagnosis of HCC and post-ablation monitoring, CEUS is useful when CT/MRI findings are indeterminate or CT/MRI is contraindicated. This article provides a practical review of the role of CEUS in imaging algorithms for pre- and post-ablation therapy for HCC.

  10. International guidelines for contrast-enhanced ultrasonography: Ultrasound imaging in the new millennium

    International Nuclear Information System (INIS)

    Nolsoe, Christian Pallson; Lorentzen, Torben

    2016-01-01

    The intent of this review is to discuss and comment on common clinical scenarios in which contrast-enhanced ultrasonography (CEUS) may play a decisive role and to illustrate important points with typical cases. With the advent of CEUS, the scope of indications for ultrasonography has been dramatically extended, and now includes functional imaging and tissue characterization, which in many cases enable tumor diagnosis without a biopsy. It is virtually impossible to imagine the practice of modern medicine as we know it in high-income countries without the use of imaging, and yet, an estimated two thirds of the global population may receive no such care. Ultrasound imaging with CEUS has the potential to correct this inequity

  11. International guidelines for contrast-enhanced ultrasonography: Ultrasound imaging in the new millennium

    Energy Technology Data Exchange (ETDEWEB)

    Nolsoe, Christian Pallson; Lorentzen, Torben [Ultrasound Section, Dept. of Gastric Surgery, Herlev Hospital, University of Copenhagen, Herlev (Denmark)

    2016-03-15

    The intent of this review is to discuss and comment on common clinical scenarios in which contrast-enhanced ultrasonography (CEUS) may play a decisive role and to illustrate important points with typical cases. With the advent of CEUS, the scope of indications for ultrasonography has been dramatically extended, and now includes functional imaging and tissue characterization, which in many cases enable tumor diagnosis without a biopsy. It is virtually impossible to imagine the practice of modern medicine as we know it in high-income countries without the use of imaging, and yet, an estimated two thirds of the global population may receive no such care. Ultrasound imaging with CEUS has the potential to correct this inequity.

  12. Contrast-enhanced ultrasonography for the determination of Crohn’s disease activity – preliminary experience

    Science.gov (United States)

    Białecki, Marcin; Białecka, Agnieszka; Laskowska, Katarzyna; Kłopocka, Maria; Liebert, Ariel; Lemanowicz, Adam; Serafin, Zbigniew

    2014-01-01

    Summary Background Contrast-enhanced ultrasound (CEUS) is a recent non-invasive modality, which may partially replace currently used techniques (endoscopy, CT enterography and MR enterography) in the diagnostics and assessment of Crohn’s disease (CD). The aim of the study was to analyze early experience in the use of CEUS for the measurement of activity and staging of CD. Material/Methods Eleven patients previously diagnosed with CD were included in the study. They underwent contrast-enhanced ultrasonography (SonoVue, Bracco), low-dose CT enterography (LDCTE), assessment of laboratory markers of inflammation and clinical CD activity index (CDAI). Contrast enhancement was evaluated using a semi-quantitative method and a quantitative method that included measurement of peak enhancement (PE), enhancement curve rise time (RT) and wash-in-rate (WiR). Results Ileal wall thickening was observed in all patients. Semi-quantitative method was used to observe CD activity in CEUS in 10 cases that perfectly matched LDCTE findings. There was a moderate positive correlation between PE and CDAI (r=0.65, p<0.001). There was no significant relationship between perfusion parameters and laboratory markers of inflammation. Conclusions CEUS is a promising modality for non-invasive assessment of pathologic ileal vascularization in the course of Crohn’s disease. Intensity of enhancement in CEUS reflects activity of the disease detected in LDCTE and correlates with CDAI. PMID:24723988

  13. Contrast-enhanced ultrasonography for the determination of Crohn's disease activity - preliminary experience.

    Science.gov (United States)

    Białecki, Marcin; Białecka, Agnieszka; Laskowska, Katarzyna; Kłopocka, Maria; Liebert, Ariel; Lemanowicz, Adam; Serafin, Zbigniew

    2014-01-01

    Contrast-enhanced ultrasound (CEUS) is a recent non-invasive modality, which may partially replace currently used techniques (endoscopy, CT enterography and MR enterography) in the diagnostics and assessment of Crohn's disease (CD). The aim of the study was to analyze early experience in the use of CEUS for the measurement of activity and staging of CD. Eleven patients previously diagnosed with CD were included in the study. They underwent contrast-enhanced ultrasonography (SonoVue, Bracco), low-dose CT enterography (LDCTE), assessment of laboratory markers of inflammation and clinical CD activity index (CDAI). Contrast enhancement was evaluated using a semi-quantitative method and a quantitative method that included measurement of peak enhancement (PE), enhancement curve rise time (RT) and wash-in-rate (WiR). Ileal wall thickening was observed in all patients. Semi-quantitative method was used to observe CD activity in CEUS in 10 cases that perfectly matched LDCTE findings. There was a moderate positive correlation between PE and CDAI (r=0.65, p<0.001). There was no significant relationship between perfusion parameters and laboratory markers of inflammation. CEUS is a promising modality for non-invasive assessment of pathologic ileal vascularization in the course of Crohn's disease. Intensity of enhancement in CEUS reflects activity of the disease detected in LDCTE and correlates with CDAI.

  14. Contrast-enhanced ultrasonography for the determination of Crohn’s disease activity – preliminary experience

    International Nuclear Information System (INIS)

    Białecki, Marcin; Białecka, Agnieszka; Laskowska, Katarzyna; Kłopocka, Maria; Liebert, Ariel; Lemanowicz, Adam; Serafin, Zbigniew

    2014-01-01

    Contrast-enhanced ultrasound (CEUS) is a recent non-invasive modality, which may partially replace currently used techniques (endoscopy, CT enterography and MR enterography) in the diagnostics and assessment of Crohn’s disease (CD). The aim of the study was to analyze early experience in the use of CEUS for the measurement of activity and staging of CD. Eleven patients previously diagnosed with CD were included in the study. They underwent contrast-enhanced ultrasonography (SonoVue, Bracco), low-dose CT enterography (LDCTE), assessment of laboratory markers of inflammation and clinical CD activity index (CDAI). Contrast enhancement was evaluated using a semi-quantitative method and a quantitative method that included measurement of peak enhancement (PE), enhancement curve rise time (RT) and wash-in-rate (WiR). Ileal wall thickening was observed in all patients. Semi-quantitative method was used to observe CD activity in CEUS in 10 cases that perfectly matched LDCTE findings. There was a moderate positive correlation between PE and CDAI (r=0.65, p<0.001). There was no significant relationship between perfusion parameters and laboratory markers of inflammation. CEUS is a promising modality for non-invasive assessment of pathologic ileal vascularization in the course of Crohn’s disease. Intensity of enhancement in CEUS reflects activity of the disease detected in LDCTE and correlates with CDAI

  15. Pretreatment Evaluation with Contrast-Enhanced Ultrasonography for Percutaneous Radiofrequency Ablation of Hepatocellular Carcinomas with Poor Conspicuity on Conventional Ultrasonography

    International Nuclear Information System (INIS)

    Kim, Ah Yeong; Lee, Min Woo; Rhim, Hyunchul; Cha, Dong Ik; Choi, Dongil; Kim, Young-sun; Lim, Hyo Keun; Cho, Seong Whi

    2013-01-01

    To determine whether pretreatment evaluation with contrast-enhanced ultrasonography (CEUS) is effective for percutaneous radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) with poor conspicuity on conventional ultrasonography (US). This retrospective study was approved by the institutional review board and informed consent was waived. From June 2008 to July 2011, 82 patients having HCCs (1.2 ± 0.4 cm) with poor conspicuity on planning US for RFA were evaluated with CEUS prior to percutaneous RFA. We analyzed our database, radiologic reports, and US images in order to determine whether the location of HCC candidates on planning US coincide with that on CEUS. To avoid incomplete ablation, percutaneous RFA was performed only when HCC nodules were identified on CEUS. The rate of technical success was assessed. The cumulative rate of local tumor progression was estimated with the use of the Kaplan-Meier method (mean follow-up: 24.0 ± 13.0 months). Among 82 patients, 73 (89%) HCCs were identified on CEUS, whereas 9 (11%) were not. Of 73 identifiable HCCs on CEUS, the location of HCC on planning US corresponded with that on CEUS in 64 (87.7%), whereas the location did not correspond in 9 (12.3%) HCCs. Technical success was achieved for all 73 identifiable HCCs on CEUS in a single (n = 72) or two (n = 1) RFA sessions. Cumulative rates of local tumor progression were estimated as 1.9% and 15.4% at 1 and 3 years, respectively. Pretreatment evaluation with CEUS is effective for percutaneous RFA of HCCs with poor conspicuity on conventional US

  16. Diagnostic value of contrast-enhanced ultrasonography in the characterization of ovarian tumors().

    Science.gov (United States)

    Sconfienza, L M; Perrone, N; Delnevo, A; Lacelli, F; Murolo, C; Gandolfo, N; Serafini, G

    2010-03-01

    Vascularity influences the characteristics of gynecologic tumors observed with direct imaging techniques that reveal the macrovascular component of these lesions (color and power Doppler) and with indirect imaging involving the administration of contrast agents to examine the microcirculation and interstitial perfusion (contrast-enhanced computed tomography [CT] and magnetic resonance [MR] imaging). The purpose of this study was to determine whether contrast-enhanced ultrasonography (CEUS) of ovarian lesions provides useful information that cannot be obtained with conventional US. We used CEUS to assess 72 nonspecific adnexal lesions in 61 patients. CEUS was performed with a 4.8-ml bolus of a second-generation ultrasonographic contrast agent and dedicated imaging algorithms. For each lesion, B-mode morphology, CEUS morphology, and time/intensity curves were evaluated. In 8/61 cases (13.1%) CEUS offered no additional morphovascular information. In 38/61 cases (62.3%), it provided additional information that did not modify the management of the lesion, and in 15/61 cases (24.6%) it gave additional information that modified the management of the lesion. Malignant lesions were characterized by significantly shorter times to peak enhancement (11.9 ± 3.1 s vs 19.8 ± 4.0 s p < 0.01) and significantly higher peak intensity (24.7 ± 4.2 dB vs 17.8 ± 3.3 dB p < 0.01) compared with benign lesions. CEUS improves diagnostic confidence in the characterization of liquid-corpuscular lesions where conventional US is inconclusive. CEUS can be proposed as a valid alternative to CT and MR. However, information obtained by CEUS influences the therapy in a limited percentage of cases (24.6%).

  17. Analysis of Achilles tendon vascularity with second generation Contrast-Enhanced Ultrasound (CEUS)

    OpenAIRE

    Genovese , Eugenio; Ronga , Mario; Recaldini , Chiara; Fontana , Federico; Callegari , Leonardo; Fugazzola , Carlo

    2011-01-01

    Abstract Purpose: To compare morphological and power Doppler features of the Achilles tendon and Contrast-Enhanced Ultrasound (CEUS) behaviour between asymptomatic athletes and athletes who had undergone surgery for repair of an Achilles tendon rupture. Materials and Methods: 24 athletes were divided in two groups (A and B). Group A included 14 patients with a median age of 32 years (range 27 to 47 years) who had undergone surgical repair for unilateral Achilles tendon ...

  18. Quantitative Assessment of Hepatic Fibrosis by Contrast-enhanced Ultrasonography

    Institute of Scientific and Technical Information of China (English)

    Ming-bo Zhang; En-ze Qu; Ji-Bin Liu; Jin-rui Wang

    2011-01-01

    Objective To explore the contrast-enhanced ultrasonographic features for quantitative assessment of hepatic fibrosis.Methods 86 patients with chronic viral hepatitis B were enrolled in this study from March 2007 to August 2009.The patients were classified into 5 groups (S0-S4) according to fibrosis stage evaluated with ultrasound guided liver biopsy.New contrast-enhanced ultrasonography (CEUS) features including area under the time-intensity curve (TIC) of portal venous phase/hepatic arterial phase (Qp/Qa) and intensity of portal venons phase/hepatic arterial phase (Ip/Ia) were used to detect the blood supply ratio (portal vein/hepatic artery) in each group.Arrival time of portal vein trunk (Tp) and decreasing rate of TIC (β) were also analyzed.Results Qp/Qa and Ip/Ia decreased from So to S4,while Tp and β increased These 4 features were significantly correlated with the degree of fibrosis (P<0.001) and were significantly different among the five groups (P<0.001).Sensitivity and specificity of Ip/Ia were 80% and 86% for groups ≥S1,75% and 86% for groups ≥ S2,71% and 84% for groups ≥ S3,and 76% and 80% for group S4,respectively.Sensitivity and specificity of Qp/Qa were 70% and 88% for groups ≥ S1,80% and 76% for groups ≥ S2,74% and 70% for groups ≥ S3,and 81% and 95% for group S4,respectively.Conclusion Ip/Ia and Qp/Qa could be adopted as reliable,non-invasive features for quantitative assessment of hepatic fibrosis.

  19. Guidelines and good clinical practice recommendations for Contrast Enhanced Ultrasound (CEUS) in the liver - update 2012

    DEFF Research Database (Denmark)

    Claudon, Michel; Dietrich, Christoph F; Choi, Byung Ihn

    2013-01-01

    Initially, a set of guidelines for the use of ultrasound contrast agents was published in 2004 dealing only with liver applications. A 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...... Medizin/European Journal of Ultrasound for EFSUMB). These guidelines and recommendations provide general advice on the use of all currently clinically available ultrasound contrast agents (UCA). They are intended to create standard protocols for the use and administration of UCA in liver applications...... non-liver applications. Time has moved on, and the need for international guidelines on the use of CEUS in the liver has become apparent. The present document describes the third iteration of recommendations for the hepatic use of contrast enhanced ultrasound (CEUS) using contrast specific imaging...

  20. Comparison of gray-scale contrast-enhanced ultrasonography with contrast-enhanced computed tomography in different grading of blunt hepatic and splenic trauma: an animal experiment.

    Science.gov (United States)

    Tang, Jie; Li, Wenxiu; Lv, Faqin; Zhang, Huiqin; Zhang, Lihai; Wang, Yuexiang; Li, Junlai; Yang, Li

    2009-04-01

    To compare the diagnostic value of contrast-enhanced ultrasonography (CEUS) with contrast-enhanced computed tomography (CECT) for the detection of different grading of solid organ injuries in blunt abdominal trauma in animals. A self-made miniature tools were used as models to simulate a blunt hepatic or splenic trauma in 16 and 14 anesthetized dogs, respectively. Baseline ultrasound, CEUS and CECT were used to detect traumatic injuries of livers and spleens. The degree of injuries was determined by CEUS according to the American Association for the Surgery of Trauma (AAST) scale and the results compared with injury scale based on CECT evaluation. CEUS showed 22 hepatic injury sites in 16 animals and 17 splenic injury sites in other 14 animals. According to AAST scale, 2 grade I, 4 grade II, 3 grade III, 5 grade IV and 2 grade V hepatic lesions were present in 16 animals; 2 grade I, 4 grade II, 6 grade III and 2 grade IV splenic lesions in 14 animals. On CECT scan, 21 hepatic and 17 splenic injuries were demonstrated. According to Becker CT scaling for hepatic injury, 1 grade I, 2 grade II, 4 grade III, 5 grade IV and 2 grade V hepatic injuries were present. On the basis of Buntain spleen scaling, 2 grade I, 5 grade II, 5 grade III, 2 grade IV splenic injuries were showed. After Spearman rank correlation analysis, the agreement of CEUS with CECT on the degree of hepatic and splenic injury is 93.3% and 92.9%, respectively. CT is currently considered as the reference method for grading blunt abdominal trauma, according to experiment results, CEUS grading showed high levels of concordance with CECT. CEUS can accurately determine the degree of injury and will play an important role in clinical application.

  1. Post-operative monitoring of tissue transfers: advantages using contrast enhanced ultrasound (CEUS) and contrast enhanced MRI (ceMRI) with dynamic perfusion analysis?

    Science.gov (United States)

    Lamby, P; Prantl, L; Fellner, C; Geis, S; Jung, E M

    2011-01-01

    The immediate evaluation of microvascular tissue flaps with respect to microcirculation after transplantation is crucial for optimal monitoring and outcome. The purpose of our investigation was to evaluate the clinical value of contrast-enhanced ultrasound (CEUS) and contrast-enhanced MRI (ceMRI) for monitoring the integrity of tissue flaps in plastic surgery. To this end, we investigated 10 patients (47 ± 16 a) between postoperative day 7 and 14 who underwent flap surgery in order to cover tissue defects in various body regions. For CEUS we utilized the GE LOGIQ E9 equipped with a linear transducer (6-9 MHz). After application of 2.4 ml SonoVue, the tissue perfusion was detected in Low MI-Technique (MI present, both technologies provide an optimal assessment of perfusion in cutaneous, subcutaneous and muscle tissue layers, whereby the detection of fatty tissue perfusion is currently more easily detected using CEUS compared to ceMRI.

  2. Diagnostic accuracy of contrast-enhanced ultrasound for the differential diagnosis of hepatocellular carcinoma: ESCULAP versus CEUS-LI-RADS.

    Science.gov (United States)

    Schellhaas, Barbara; Görtz, Ruediger S; Pfeifer, Lukas; Kielisch, Christian; Neurath, Markus F; Strobel, Deike

    2017-09-01

    A comparison is made of two contrast-enhanced ultrasound (CEUS) algorithms for the diagnosis of hepatocellular carcinoma (HCC) in high-risk patients: Erlanger Synopsis of Contrast-enhanced Ultrasound for Liver lesion Assessment in Patients at Risk (ESCULAP) and American College of Radiology Contrast-Enhanced Ultrasound-Liver Imaging Reporting and Data System (ACR-CEUS-LI-RADSv.2016). Focal liver lesions in 100 high-risk patients were assessed using both CEUS algorithms (ESCULAP and CEUS-LI-RADSv.2016) for a direct comparison. Lesions were categorized according to size and contrast enhancement in the arterial, portal venous and late phases.For the definite diagnosis of HCC, categories ESCULAP-4, ESCULAP-Tr and ESCULAP-V and CEUS-LI-RADS-LR-5, LR-Tr and LR-5-V were compared. In addition, CEUS-LI-RADS-category LR-M (definitely/probably malignant, but not specific for HCC) and ESCULAP-category C [intrahepatic cholangiocellular carcinoma (ICC)] were compared.Histology, CE-computed tomography and CE-MRI served as reference standards. The reference standard among 100 lesions included 87 HCCs, six ICCs and seven non-HCC-non-ICC-lesions. For the diagnosis of HCC, the diagnostic accuracy of CEUS was significantly higher with ESCULAP versus CEUS-LI-RADS (94.3%/72.4%; pdiagnostic accuracy for ICC (LR-M/ESCULAP-C) was identical with both algorithms (50%), with higher PPV for ESCULAP-C versus LR-M (75 vs. 50%). CEUS-based algorithms contribute toward standardized assessment and reporting of HCC-suspect lesions in high-risk patients. ESCULAP shows significantly higher diagnostic accuracy, sensitivity and negative predictive value with no loss of specificity compared with CEUS-LI-RADS. Both algorithms have an excellent PPV. Arterial hyperenhancement is the key feature for the diagnosis of HCC with CEUS. Washout should not be a necessary prerequisite for the diagnosis of definite HCC. CEUS-LI-RADS in its current version is inferior to ESCULAP for the noninvasive diagnosis of HCC

  3. Contrast-Enhanced Ultrasonography in Differential Diagnosis of Benign and Malignant Ovarian Tumors

    Science.gov (United States)

    Qiao, Jing-Jing; Yu, Jing; Yu, Zhe; Li, Na; Song, Chen; Li, Man

    2015-01-01

    Objective To evaluate the accuracy of contrast-enhanced ultrasonography (CEUS) in differential diagnosis of benign and malignant ovarian tumors. Methods The scientific literature databases PubMed, Cochrane Library and CNKI were comprehensively searched for studies relevant to the use of CEUS technique for differential diagnosis of benign and malignant ovarian cancer. Pooled summary statistics for specificity (Spe), sensitivity (Sen), positive and negative likelihood ratios (LR+/LR−), and diagnostic odds ratio (DOR) and their 95%CIs were calculated. Software for statistical analysis included STATA version 12.0 (Stata Corp, College Station, TX, USA) and Meta-Disc version 1.4 (Universidad Complutense, Madrid, Spain). Results Following a stringent selection process, seven high quality clinical trials were found suitable for inclusion in the present meta-analysis. The 7 studies contained a combined total of 375 ovarian cancer patients (198 malignant and 177 benign). Statistical analysis revealed that CEUS was associated with the following performance measures in differential diagnosis of ovarian tumors: pooled Sen was 0.96 (95%CI = 0.92∼0.98); the summary Spe was 0.91 (95%CI = 0.86∼0.94); the pooled LR+ was 10.63 (95%CI = 6.59∼17.17); the pooled LR− was 0.04 (95%CI = 0.02∼0.09); and the pooled DOR was 241.04 (95% CI = 92.61∼627.37). The area under the SROC curve was 0.98 (95% CI = 0.20∼1.00). Lastly, publication bias was not detected (t = −0.52, P = 0.626) in the meta-analysis. Conclusions Our results revealed the high clinical value of CEUS in differential diagnosis of benign and malignant ovarian tumors. Further, CEUS may also prove to be useful in differential diagnosis at early stages of this disease. PMID:25764442

  4. Severe portal hypertension in cirrhosis: evaluation of perfusion parameters with contrast-enhanced ultrasonography.

    Directory of Open Access Journals (Sweden)

    Woo Kyoung Jeong

    Full Text Available To investigate the role of contrast-enhanced ultrasonography (CEUS and Doppler ultrasonography (DUS in the diagnosis of severe portal hypertension (PH in patients with liver cirrhosis (LC.Patients with PH scheduled to receive hepatic venous pressure gradient (HVPG measurement were recruited for this study. Hepatic DUS and CEUS were performed successively. Several Doppler and CEUS parameters were explored for correlation with HVPG values and their association with severe PH (≥ 12 mmHg of HVPG. Comparison of the parameters between the severe and non-severe PH groups and their correlation with HVPG values was evaluated. A receiver operating characteristic (ROC curve analysis was also performed to investigate the performance in order to diagnose severe PH.Fifty-three consecutive patients were enrolled in this study. Among them, 43 patients did not have significant ascites. Compared with the non-severe PH group, portal venous velocity and intrahepatic transit time (ITT were significantly reduced in the severe PH group (all p<0.05. Difference between inspiratory and expiratory hepatic venous damping indices (ΔHVDI, hepatic venous arrival time (HVAT and ITT moderately correlated with HVPG (r = -0.358, -0.338, and -0.613, respectively. Areas under the curves for severe PH were 0.94 of ITT and 0.72 of HVAT, respectively (all p<0.05. ITT under 6 seconds indicated severe PH with a sensitivity of 92% and a specificity of 89%.Hepatic CEUS may be more useful in estimating the HVPG value and determining the presence of severe PH compared to DUS, and ITT was the most accurate parameter to diagnose severe PH.

  5. Imaging of the acute scrotum: is there a place for contrast-enhanced ultrasonography?

    Directory of Open Access Journals (Sweden)

    H. Moschouris

    2009-12-01

    Full Text Available Purpose: To present and evaluate the findings of contrast-enhanced ultrasonography (CEUS in typical cases of acute painful scrotum. Materials and methods: Nineteen patients aged from 19 to 61 years old were included in the study. All patients underwent grey-scale and color Doppler ultrasonography (US of the scrotum, followed by imaging after i.v. administration of 2.4 mL of a second generation ultrasound contrast agent (microbubbles of sulphur hexafluoride. A dedicated, contrast-sensitive technique was used (Contrast Tissue Imaging - CnTI. The diagnosis was confirmed surgically in 6 cases while in the remaining 8 cases it was based on the combination of clinical, imaging and laboratory findings. Results: The final diagnosis was testicular torsion (n = 4, epididymitis (n = 2, one of the cases complicated by abscess, testicular abscess (n = 1, scrotal abscess (n = 1, testicular trauma of varying severity (n = 6. Five out of 19 cases were true negatives: neither clinical examination nor laboratory tests revealed any pathology. CEUS showed complete lack of enhancement in all cases of torsion, permitting a rapid and definitive diagnosis. In the cases of infection complicated by abscesses, CEUS delineated the lesions much better than the combination of B-mode/Color Doppler US. The severely traumatized testicles showed minimal, inhomogeneous or patchy enhancement, while cases of minor trauma showed no significant enhancement defects. Hematomas were presented as non-enhancing lesions. Conclusion: Generally, there was no advantage over Doppler US as has been previously shown. However, CEUS can be used supplementary to traditional Doppler US in the investigation of blunt testicular trauma especially when there is uncertainty in diagnosis after appropriate clinical and radiographic evaluations occurs. Further studies are required to clearly define the indications of this method.

  6. Evaluation of pathological features of hepatocellular carcinoma by contrast-enhanced ultrasonography: Comparison with pathology on resected specimen

    International Nuclear Information System (INIS)

    Ogawa, Sadanobu; Kumada, Takashi; Toyoda, Hidenori; Ichikawa, Hideo; Kawachi, Toshiaki; Otobe, Katsuhiko; Hibi, Toshio; Takeshima, Kenji; Kiriyama, Seiki; Sone, Yasuhiro; Tanikawa, Makoto; Hisanaga, Yasuhiro; Yamaguchi, Akihiro; Isogai, Masatoshi; Kaneoka, Yuji; Washizu, Junji

    2006-01-01

    Features of hepatocellular carcinoma (HCC) observed by contrast-enhanced ultrasonography (CEUS) were compared to pathological features of corresponding resected HCC specimens, to evaluate the ability of CEUS to depict the pathological features of HCC. We investigated 50 HCC nodules that were treated by surgical resection. All nodules had been examined by CEUS with intravenous contrast agent (Levovist) before surgery. CEUS findings were divided into three phases for evaluation and classification of enhancement patterns: two vascular phases (arterial phase and portal venous phase) and the delayed phase. Pathological examination focused on differentiation and on the presence or absence of a tumor capsule, intratumoral septum, and intratumoral necrosis. All 21 nodules that showed a linear or annular vessel around the tumor margin in the arterial phase had capsular formation. Of the 27 nodules that showed heterogeneous perfusion in the portal venous phase, 21 (77.8%) had an intratumoral septum and 23 (85.2%) showed intratumoral necrosis. All nodules that were depicted as a defect with an unclear margin in the delayed phase were well-differentiated HCCs, whereas all nodules that were depicted as a defect with a clear margin were moderately or poorly differentiated HCCs. From our observations, the arterial, portal venous, and delayed phases of CEUS could reflect different pathological aspects of HCC. Some pathological characteristics of HCC might be evaluated preoperatively and non-invasively, by means of combined analysis of three phases of CEUS findings

  7. Can quantitative contrast-enhanced ultrasonography predict cervical tumor response to neoadjuvant chemotherapy?

    Energy Technology Data Exchange (ETDEWEB)

    Peng, Chuan; Liu, Long-Zhong; Zheng, Wei [Department of Ultrasound, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060 (China); Xie, Yan-Jun [Department of Gynecology and Obstetrics, Zhongcun Town hospital, 140 Renmin Road, Zhongcun Town, Panyu District, Guangzhou, 511400 (China); Xiong, Yong-Hong; Li, An-Hua [Department of Ultrasound, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060 (China); Pei, Xiao-Qing, E-mail: peixq@sysucc.org.cn [Department of Ultrasound, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060 (China)

    2016-11-15

    Highlights: • We assessed the clinical value of quantitative CEUS for prediction of cervical tumor perfusion response to NACT. • IMAX, RT, and TTP changed significantly after one NACT cycle. • Pre-treatment IMAX positively correlated with the absolute and percentage changes in all cervical tumor IMAX after NACT. • Pre-treatment IMAX may be predictive of NACT perfusion response in cervical tumor. - Abstract: Objective: To evaluate the feasibility of quantitative contrast-enhanced ultrasonography (CEUS) for predicting and assessing cervical tumor response to neoadjuvant chemotherapy (NACT). Methods: Thirty-eight cases with stage IB2 or IIA cervical cancer were studied using CEUS before and after one cycle of NACT. The quantitative CEUS parameters maximum intensity (IMAX), rise time (RT), time to peak (TTP), and mean transit time (MTT) were compared between cervical tumors and myometrium (reference zone) using Sonoliver software. Absolute and relative changes in quantitative CEUS parameters were also compared among complete response, partial response, and non-responsive groups. Correlations between pre-treatment IMAX and changes in quantitative parameters were assessed after one cycle of NACT. Results: There were significant changes in cervical tumor IMAX (P < 0.001), RT (P < 0.05), and TTP (P < 0.05) after one cycle of NACT. According to the Response Evaluation Criteria In Solid Tumors guidelines, the enrollments were divided into complete response, partial response, stable disease and progressive disease groups. There were no significant differences in quantitative CEUS parameters among complete response, partial response, and non-responsive groups (P > 0.05). In the stable disease group (n = 17), cervical tumor IMAX, RT, and TTP decreased significantly after NACT (P < 0.001). The absolute and percentage changes in IMAX were positively correlated with pre-treatment IMAX in all 38 patients (r = 0.576, P < 0.001 and r = 0.429, P < 0.001). Conclusion

  8. Therapeutic response assessment of high intensity focused ultrasound therapy for uterine fibroid: Utility of contrast-enhanced ultrasonography

    International Nuclear Information System (INIS)

    Zhou Xiaodong; Ren Xiaolong; Zhang Jun; He Guangbin; Zheng Minjuan; Tian Xue; Li Li; Zhu Ting; Zhang Min; Wang Lei; Luo Wen

    2007-01-01

    Purpose: To assess the utility of contrast-enhanced ultrasonography (ceUS) in the assessment of the therapeutic response to high intensity focused ultrasound (HIFU) ablation in patients with uterine fibroid. Materials and methods: Sixty-four patients with a total of 64 uterine fibroids (mean: 5.3 ± 1.2 cm; range: 3.2-8.9 cm) treated with HIFU ablation under the ultrasound guidance were evaluated with ceUS after receiving an intravenous bolus injection of a microbubble contrast agent (SonoVue) within 1 week after intervention. We obtained serial ceUS images during the time period from beginning to 5 min after the initiation of the bolus contrast injection. All of the patients underwent a contrast enhanced MRI (ceMRI) and ultrasound guided needle puncture biopsy within 1 week after HIFU ablation. And as a follow-up, all of the patients underwent US at 1, 3, 6 and 12 months after HIFU treatment. The volume change was observed and compared to pre- and post-HIFU ablation. The results of the ceUS were compared with those of the ceMRI in terms of the presence or absence of residual unablated tumor and pathologic change in the treated lesions. Results: On ceUS, diagnostic accuracy was 100%, while residual unablated tumors were found in three uterine fibroids (4.7%) and failed treatment was found in eight uterine fibroids (12.5%). All the 11 fibroids were subjected to additional HIFU ablation. Of the 58 ablated fibroids without residual tumors on both the ceUS and ceMRI after the HIFU ablation, the volumes of all the fibroids decreased in different degrees during the 1 year follow-up USs. And histologic examinations confirmed findings of necrotic and viable tumor tissue, respectively. Conclusion: CEUS is potentially useful for evaluating the early therapeutic effect of percutaneous HIFU ablation for uterine fibroids

  9. Evaluation of hepatocellular carcinoma tumor vascularity using contrast-enhanced ultrasonography as a predictor for local recurrence following radiofrequency ablation

    Energy Technology Data Exchange (ETDEWEB)

    Ishii, Tomohiro [Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa 232-0024 (Japan); Numata, Kazushi, E-mail: kz-numa@urahp.yokohama-cu.ac.jp [Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa 232-0024 (Japan); Hao, Yoshiteru; Doba, Nobutaka; Hara, Koji [Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa 232-0024 (Japan); Kondo, Masaaki [Division of Gastroenterology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004 (Japan); Tanaka, Katsuaki [Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa 232-0024 (Japan); Maeda, Shin [Division of Gastroenterology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004 (Japan)

    2017-04-15

    Purpose: The purpose of this study was to evaluate whether the hypervascularity of hepatocellular carcinomas (HCCs) on contrast-enhanced ultrasonography (CEUS) prior to radiofrequency ablation (RFA) is a significant risk factor for local recurrence after RFA. Materials and methods: Institutional review board approval and informed consent were obtained. Overall, 208 patients (mean age, 71.7 years; range, 50–87 years; 137 men, 71 women) with 282 HCCs treated with RFA were analyzed retrospectively. The mean maximum tumor diameter was 15.7 mm. We compared the abilities of CEUS and contrast-enhanced computed tomography (CECT) to detect hypervascularity in HCCs. We then classified the HCCs into two groups according to the arterial-phase CEUS findings: a “hypervascular group” with whole or partial hypervascular areas within the lesions compared with the surrounding liver parenchyma, and a “non-hypervascular group” with isovascular or hypovascular areas within the lesions. We assessed the cumulative rate of local recurrence after RFA, and we also evaluated the risk factors for local recurrence using a univariate analysis. Results: The detection rate for hypervascular HCCs was significantly higher using CEUS (78%, 221/282) than that using CECT (66%, 186/282) (P < 0.001). Using the CEUS findings, the cumulative rate of local recurrence was significantly higher in the hypervascular group (41.2%, 56/221) than in the non-hypervascular group (18.4%, 6/61) (P = 0.007). A univariate analysis revealed that hypervascularity on CEUS was an independent risk factor for local recurrence (P = 0.010). Conclusion: Hypervascularity in HCCs as observed using CEUS is a significant risk factor for local recurrence after RFA.

  10. Unenhanced and Contrast-Enhanced Ultrasonography During Hepatic Transarterial Embolization and Chemoembolization With Drug-Eluting Beads

    International Nuclear Information System (INIS)

    Moschouris, Hippocrates; Malagari, Katerina; Kornezos, Ioannis; Papadaki, Marina Georgiou; Gkoutzios, Panagiotis; Matsaidonis, Dimitrios

    2010-01-01

    The purpose of this study was to describe and evaluate the findings of unenhanced ultrasonography (US) and contrast-enhanced ultrasonography (CEUS) when these modalities are applied during transarterial embolization (TAE) or transarterial chemoembolization (TACE) of liver tumors. Sixteen tumors (9 hepatocellular carcinomas, 5 metastases from colorectal cancer, and 2 hemangiomas) were treated with TAE with microspheres and/or TACE with drug-eluting beads. All of these lesions were studied with intraprocedural unenhanced US and 12 were studied with intraprocedural CEUS. For the latter, a second-generation echo-enhancer (SonoVue; Bracco, Milan, Italy) and a low mechanical index technique were used. Intraprocedural findings were classified according to an arbitrary scale and were compared with pretreatment imaging (CEUS and computed tomography or CEUS and magnetic resonance imaging), with postembolization angiography, and with follow-up results. On unenhanced intraprocedural US, 13 of 16 tumors demonstrated intralesional high-level echoes of varying extent. These feature correlated poorly (r = 0.33, p = 0.097) with and generally underestimated the actual extent of necrosis. Exceptionally, high-level echoes that occupied the largest part of the treated lesions were associated with >50% tumor necrosis. Intraprocedural CEUS clearly depicted immediate partial or complete disappearance of tumor enhancement as a result of TAE/TACE. Three of 6 tumors with complete devascularization on postembolization angiogram showed residual enhancement on intraprocedural CEUS. Intraprocedural CEUS findings correlated closely (r = 0.91, p = 0.002) with follow-up findings. Intraprocedural sonography, particularly with echo-enhancers, could be used for intraprocedural monitoring in selected cases of liver tumors that undergo TAE or TACE.

  11. Detection of parenchymal abnormalities in experimentally induced acute pyelonephritis in rabbits using contrast-enhanced ultrasonography, CT, and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Jeong Ah; Kim, Bo Hyun; Kim, Seung Kwon; Seo, Jin Won [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Jong Sung [Laboratory Animal Research Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2016-12-15

    We evaluated the efficacy of contrast-enhanced ultrasonography (CEUS) in detecting acute pyelonephritis (APN) using the rabbit kidney model and compared it with CT and MRI. This study was approved by the Institutional Review Board. In a total of 20 New Zealand White rabbits, APN was induced experimentally. CEUS, CT, and MRI were performed on the first, third, and seventh postoperative days. After imaging studies, the subjects were sacrificed and the pathological diagnosis of APN was confirmed in each animal by a pathologist. Imaging studies were obtained in eight animals, including eight CEUS, four computed tomography (CT), and four magnetic resonance imaging (MRI) images. CEUS depicted diffuse renal enlargement (7), diffuse heterogeneous parenchymal enhancement (6), and focal areas of decreased parenchymal enhancement (6). These findings were well correlated with the CT and MRI findings in five cases in which these studies were available. CT and MRI showed diffuse renal enlargement, diffuse heterogeneous parenchymal enhancement, focal areas of decreased parenchymal enhancement, focal contour bulging, and the finding of perinephric spread of infection. In a rabbit model, CEUS could depict the parenchymal lesions of APN similar to CT or MRI; however, it was limited in depicting the perinephric extension of inflammation.

  12. Contrast-enhanced ultrasonography of hepatocellular carcinoma: Correlation between quantitative parameters and arteries in neoangiogenesis or sinusoidal capillarization

    International Nuclear Information System (INIS)

    Pei Xiaoqing; Liu Longzhong; Zheng Wei; Cai Muyan; Han Feng; He Jiehua; Li Anhua; Chen Minshan

    2012-01-01

    Objective: The quantitative parameters in contrast-enhanced ultrasonography-time–intensity curve of hepatocellular carcinoma (HCC) were studied to explore their potential importance in monitoring the effects of anti-angiogenic therapy for HCC. Methods: 115 HCC patients were studied with contrast-enhanced ultrasonography-time–intensity curve (CEUS-TIC) and with immunohistochemical analysis of tissue sections. The CEUS images were analyzed off-line to obtained quantitative parameters including maximum of intensity (IMAX), rise time (RT), time to peak (TTP), mean transit time (mTT), rise slope (RS), and washout time (WT). Monoclonal antibodies specific for smooth muscle actin and anti-CD34 were used to observe unpaired arteries (UAs) and microvessel area (MVA) of sinusoidal capillarization, respectively. The UAs and MVA of 82 HCC cases were successfully stained. Results: The number of UAs had moderate correlation with RT (r = −0.446), TTP (r = −0.432), and RS (r = 0.431) (P < 0.05), and it had mild correlation with IMAX (r = 0.303) and WT (r = 0.285) (P < 0.05). MVA of sinusoidal capillarization had no correlation with perfusion parameters. Conclusion: Quantitative CEUS-TIC parameters reflecting hemodynamics of tumors are correlated with UAs, but not with MVA, and they might be used to monitor the effects of anti-angiogenic therapy on HCC.

  13. Quantitative analysis of contrast-enhanced ultrasonography of the bowel wall can predict disease activity in inflammatory bowel disease

    Energy Technology Data Exchange (ETDEWEB)

    Romanini, Laura, E-mail: laura.romanini@libero.it [Department of Radiology, Spedali Civili di Brescia, P.le Spedali Civili, 1, 25123 Brescia (Italy); Passamonti, Matteo, E-mail: matteopassamonti@gmail.com [Department of Radiology-AO Provincia di Lodi, Via Fissiraga, 15, 26900 Lodi (Italy); Navarria, Mario, E-mail: navarria.mario@tiscali.it [Department of Radiology-ASL Vallecamonica-Sebino, Via Manzoni 142, 25040 Esine, BS (Italy); Lanzarotto, Francesco, E-mail: francesco.lanzarotto@spedalicivili.brescia.it [Department of Gastroenterology, Spedali Civili di Brescia, P.le Spedali Civili, 1, 25123 Brescia (Italy); Villanacci, Vincenzo, E-mail: villanac@alice.it [Department of Pathology, Spedali Civili di Brescia, P.le Spedali Civili, 1, 25123 Brescia (Italy); Grazioli, Luigi, E-mail: radiologia1@spedalicivili.brescia.it [Department of Radiology, Spedali Civili di Brescia, P.le Spedali Civili, 1, 25123 Brescia (Italy); Calliada, Fabrizio, E-mail: fabrizio.calliada@gmail.com [Department of Radiology, University of Pavia, Viale Camillo Golgi 19, 27100 Pavia (Italy); Maroldi, Roberto, E-mail: rmaroldi@gmail.com [Department of Radiology, University of Brescia, P.le Spedali Civili, 1, 25123 Brescia (Italy)

    2014-08-15

    Purpose: To evaluate the accuracy of quantitative analysis of bowel wall enhancement in inflammatory bowel disease (IBD) with contrast enhanced ultrasound (CEUS) by comparing the results with vascular density in a biopsy sample from the same area of the intestinal tract, and to determine the usefulness of this analysis for the prediction of disease activity. Materials and methods: This prospective study was approved by our institute's ethics committee and all patients gave written informed consent. We enrolled 33 consecutive adult patients undergoing colonoscopy and biopsy for IBD. All patients underwent CEUS and the results were quantitatively analyzed. Vessel count per high-power field on biopsy specimens was compared with colonoscopy, baseline ultrasonography, and CEUS findings, and with analysis of peak intensity, time to peak, regional blood volume, mean transit time, and regional blood flow. Results in patients with high and low vascular density were compared using Fisher's test, t-test, Pearson's correlation test, and receiver operating characteristic curve (ROC) analysis. Cutoff values were determined using ROC analysis, and sensitivity and specificity were calculated. Results: High vascular density (>265 vessels per field) on histological examination was significantly correlated with active disease on colonoscopy, baseline ultrasonography, and CEUS (p < .0001). Quantitative analysis showed a higher enhancement peak, a shorter time to peak enhancement, a higher regional blood flow and regional blood volume in patients with high vascular density than in those with low vascular density. Cutoff values to distinguish between active and inactive disease were identified for peak enhancement (>40.5%), and regional blood flow (>54.8 ml/min). Conclusion: Quantitative analysis of CEUS data correlates with disease activity as determined by vascular density. Quantitative parameters of CEUS can be used to predict active disease with high sensitivity and

  14. Quantitative analysis of contrast-enhanced ultrasonography of the bowel wall can predict disease activity in inflammatory bowel disease

    International Nuclear Information System (INIS)

    Romanini, Laura; Passamonti, Matteo; Navarria, Mario; Lanzarotto, Francesco; Villanacci, Vincenzo; Grazioli, Luigi; Calliada, Fabrizio; Maroldi, Roberto

    2014-01-01

    Purpose: To evaluate the accuracy of quantitative analysis of bowel wall enhancement in inflammatory bowel disease (IBD) with contrast enhanced ultrasound (CEUS) by comparing the results with vascular density in a biopsy sample from the same area of the intestinal tract, and to determine the usefulness of this analysis for the prediction of disease activity. Materials and methods: This prospective study was approved by our institute's ethics committee and all patients gave written informed consent. We enrolled 33 consecutive adult patients undergoing colonoscopy and biopsy for IBD. All patients underwent CEUS and the results were quantitatively analyzed. Vessel count per high-power field on biopsy specimens was compared with colonoscopy, baseline ultrasonography, and CEUS findings, and with analysis of peak intensity, time to peak, regional blood volume, mean transit time, and regional blood flow. Results in patients with high and low vascular density were compared using Fisher's test, t-test, Pearson's correlation test, and receiver operating characteristic curve (ROC) analysis. Cutoff values were determined using ROC analysis, and sensitivity and specificity were calculated. Results: High vascular density (>265 vessels per field) on histological examination was significantly correlated with active disease on colonoscopy, baseline ultrasonography, and CEUS (p < .0001). Quantitative analysis showed a higher enhancement peak, a shorter time to peak enhancement, a higher regional blood flow and regional blood volume in patients with high vascular density than in those with low vascular density. Cutoff values to distinguish between active and inactive disease were identified for peak enhancement (>40.5%), and regional blood flow (>54.8 ml/min). Conclusion: Quantitative analysis of CEUS data correlates with disease activity as determined by vascular density. Quantitative parameters of CEUS can be used to predict active disease with high sensitivity and

  15. Vascular patterns in nodules of intraductal papillary mucinous neoplasms depicted under contrast-enhanced ultrasonography are helpful for evaluating malignant potential

    International Nuclear Information System (INIS)

    Kurihara, Naoko; Kawamoto, Hirofumi; Kobayashi, Yoshiyuki; Okamoto, Yuko; Yamamoto, Naoki; Tsutsumi, Koichiro; Fujii, Masakuni; Kato, Hironari; Yamamoto, Kazuhide

    2012-01-01

    Objectives: The purpose of this study is to evaluate the feasibility of contrast-enhanced ultrasonography (CE-US) to differentiate between benign and malignant intraductal papillary mucinous neoplasms (IPMN). Patients and methods: Contrast-enhanced ultrasonography with a contrast agent was performed on 22 consecutive patients with IPMN suspected of being malignant. This revealed 10 carcinomas, 1 borderline lesion and 11 adenomas. All patients underwent surgery, and the histological diagnosis was confirmed by examination of resected specimens. CE-US was performed using a contrast agent. The detection rates of mural nodules were compared between CE-US and contrast-enhanced computed tomography (CE-CT), and the imaging of mural nodules depicted under CE-US was analyzed. Results: Seventeen of 22 resected specimens (77.3%) had mural nodules. There was no significant difference in the detection rate between CE-US (n = 15; 88.2%) and CE-CT (n = 12; 70.6%). In 12 (80.0%) of these patients, CE-US revealed small vessels in the mural nodule. The spotty or linear-shaped pattern was detected in 4 patients and the branch-shaped pattern in 8. The branch-shaped pattern lesion was associated with carcinoma. These mural nodules were 10 mm or more in height. In the perfusion image phase, cystic walls and mural nodules were also enhanced in all cases. Conclusion: The vessel shapes of the mural nodules depicted under CE-US were associated with size and pathological findings. These results suggested that CE-US with a contrast agent is a powerful modality with which to evaluate the malignant potential of IPMN.

  16. Therapeutic evaluation of sorafenib for hepatocellular carcinoma using contrast-enhanced ultrasonography: Preliminary result.

    Science.gov (United States)

    Shiozawa, Kazue; Watanabe, Manabu; Ikehara, Takashi; Kogame, Michio; Kikuchi, Yoshinori; Igarashi, Yoshinori; Sumino, Yasukiyo

    2016-07-01

    The present study aimed to determine the usefulness of contrast-enhanced ultrasonography (CEUS) with Sonazoid in evaluating the therapeutic response to sorafenib for hepatocellular carcinoma (HCC). In total, 26 patients with advanced HCC who received sorafenib and were followed up by CEUS were enrolled in the present study. CEUS was performed prior to and within 2-4 weeks of treatment, and the images of the target lesion in the post-vascular phase with a re-injection method were analyzed. The presence (+) or absence (-) of intratumoral necrosis and the intratumoral vascular architecture on micro-flow imaging (MFI) were compared prior to and subsequent to treatment. Target lesions that exhibited non-enhancement after re-injection were considered to indicate intratumoral necrosis. The intratumoral vascular architecture was classified into three groups, as follows: Vd, the intratumoral vessels visually narrowed or decreased; Vnc, the vessels remained unchanged; and Vi, the vessels were thickened or increased. Survival curves were estimated using the Kaplan-Meier method and compared using the log rank test between the intratumoral necrosis (+) and (-) groups, and among the Vd, Vnc and Vi groups. PVnc group and 5 patients in the Vi group. The MSTs in the Vd, Vnc and Vi groups were 15.6 months (95% CI, 5.0-23.3), 11.0 months (95% CI, 3.5-17.6) and 3.6 months (95% CI: 1.2-6.0), respectively. The P-value for the differences between the Vd and Vnc groups, Vd and Vi groups, and Vnc and Vi groups were 0.78, 0.016 and 0.047, respectively, which indicated that the survival time decreased significantly in the Vi group. Evaluation of intratumoral vascular architecture using MFI demonstrates promise for assessing the therapeutic response to sorafenib in patients with HCC.

  17. Transrectal contrast-enhanced ultrasonography, transrectal ultrasonography and retrograde cystography for the detection of vesicourethral anastomosis leakage after radical retropubic prostatectomy: a prospective comparative evaluation.

    Science.gov (United States)

    Cantiello, Francesco; Cicione, Antonio; Autorino, Riccardo; De Nunzio, Cosimo; Tubaro, Andrea; Damiano, Rocco

    2013-01-01

    To evaluate the diagnostic accuracy of cystography (CG), transrectal ultrasonography (TRUS) and transrectal contrast-enhanced ultrasonography (CEUS) for the detection of vesicourethral extravasation (VE) after radical retropubic prostatectomy (RRP). In 80 consecutive patients who underwent RRP, the strength of the vesicourethral anastomosis (VUA) was assessed by CG, TRUS and transrectal CEUS. The investigation started with a conventional CG evaluated by an experienced uroradiologist. Following this, patients underwent TRUS which was performed by an experienced urologist who was blinded to the CG findings. The examination started with a conventional B-scan and, subsequently, a CEUS was performed by emptying and refilling the bladder with 90 ml of NaCl 0.9% + 10 ml suspension of 1:10 SonoVue and NaCl 0.9%. 26 patients (32.5%) presented urinary VE and 54 (67.5%) a watertight VUA. In 16 patients (61%) we observed a small leakage, 9 patients (35%) presented a moderate VE, and a large VE was detected in 1 patient (4%). No statistically significant difference in detection of VE was found among the three tests (p = 0.472). TRUS and CEUS are able to provide information about the integrity of the VUA that is comparable with that of CG. Copyright © 2013 S. Karger AG, Basel.

  18. The role of contrast-enhanced ultrasound (CEUS) in visualizing atherosclerotic carotid plaque vulnerability: Which injection protocol? Which scanning technique?

    Energy Technology Data Exchange (ETDEWEB)

    Iezzi, Roberto, E-mail: roberto.iezzi@rm.unicatt.it [Department of Bioimaging and Radiological Sciences, Institute of Radiology, “A. Gemelli” Hospital—Catholic University, L.go A Gemelli 8, 00168 Rome (Italy); Petrone, Gianluigi [Institute of Pathology, “A. Gemelli” Hospital—Catholic University, L.go A Gemelli 8, 00168, Rome (Italy); Ferrante, Angela [Department of Vascular Surgery, “A. Gemelli” Hospital—Catholic University, L.go A Gemelli 8, 00168 Rome (Italy); Lauriola, Libero [Institute of Pathology, “A. Gemelli” Hospital—Catholic University, L.go A Gemelli 8, 00168, Rome (Italy); Vincenzoni, Claudio [Department of Vascular Surgery, “A. Gemelli” Hospital—Catholic University, L.go A Gemelli 8, 00168 Rome (Italy); Torre, Michele Fabio la [Department of Bioimaging and Radiological Sciences, Institute of Radiology, “A. Gemelli” Hospital—Catholic University, L.go A Gemelli 8, 00168 Rome (Italy); Snider, Francesco [Department of Vascular Surgery, “A. Gemelli” Hospital—Catholic University, L.go A Gemelli 8, 00168 Rome (Italy); Rindi, Guido [Institute of Pathology, “A. Gemelli” Hospital—Catholic University, L.go A Gemelli 8, 00168, Rome (Italy); Bonomo, Lorenzo [Department of Bioimaging and Radiological Sciences, Institute of Radiology, “A. Gemelli” Hospital—Catholic University, L.go A Gemelli 8, 00168 Rome (Italy)

    2015-05-15

    Highlights: • CEUS is a safe and efficacious technique for the identification and characterization of carotid plaque. • CEUS represents a diagnostic tool for the management of patients with carotid plaque, particularly in asymptomatic patients. • Improved diagnostic performance is achieved with the injection of 4 mL bolus of contrast-medium. • Improved diagnostic performance is achieved with the use of Dynamic Imaging rather than late-phase imaging. - Abstract: Purpose: To correlate the degree of plaque vulnerability as determined by contrast-enhanced ultrasound (CEUS) with histological findings. Secondary objectives were to optimize the CEUS acquisition technique and image evaluation methods. Materials and methods: Fifty consecutive patients, either symptomatic and asymptomatic referring to our department in order to perform carotid endarterectomy (TEA), were enrolled. Each patient provided informed consent before undergoing CEUS. Ultrasound examination was performed using high-frequency (8–14 MHz) linear probe and a non-linear pulse inversion technique (mechanical index: 0.09–1.3). A double contrast media injection (Sonovue, 2 mL and 4 mL; Bracco, Italy) was performed. Two videotapes were recorded for every injection: early “dynamic” phase and late “flash” phase, performed with 6 high mechanical index impulses. Movies were quantitatively and qualitatively evaluated. Qualitative and quantitative evaluation were statistically compared to immunohistological diagnosis of vulnerable plaque, considered as gold standard. Results: Qualitative CEUS evaluation obtained high statistical results when compared to immunohistological results, with values of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of 94%, 68%, 87%, 85% and 86%, respectively, which became higher if considering only asymptomatic patient, with a NPV of 91%. Nevertheless, quantitative software evaluation proved less

  19. Improved outcome of percutaneous radiofrequency ablation in renal cell carcinoma: a retrospective study of intraoperative contrast-enhanced ultrasonography in 73 patients.

    Science.gov (United States)

    Zhao, Xiaozhi; Wang, Wei; Zhang, Shiwei; Liu, Jun; Zhang, Fan; Ji, Changwei; Li, Xiaogong; Gan, Weidong; Zhang, Gutian; Guo, Hongqian

    2012-10-01

    To evaluate the impact of contrast-enhanced ultrasonography (CEUS) during percutaneous radiofrequency ablation (PRFA) procedure in renal cell carcinoma (RCC). From January 2008 to July 2010, 73 patients with sporadic unilateral RCC were enrolled to our study (57 men and 16 women, age range: 37-78 years, mean age 57.9 years). The diameter of the tumor was 1.7-5.8, 3.4 cm on average. The patients were divided into two groups depending on the intraoperative ultrasonography type: CEUS group and conventional ultrasound group. Patients in CEUS group received CEUS before insertion of the electrode, and the second CEUS was performed right after the initial ablation to dynamically evaluate the images. If there was highly suspicious residue, additional ablation and repeated CEUS were applied. Patients in the conventional ultrasound group received PRFA guided by gray-scale ultrasound. All of these patients received contrast-enhanced computed tomography (CT) examination 7 days after the procedure (patients in CEUS group received CEUS conducted with each CT scan), with subsequent CT and CEUS assessment at 3, 6, and every 6 months thereafter. The mean follow-up period was 22 months (range: 12-42 months). All tumors were biopsied before RFA. The local tumor control rate was 94.6% (35/37) in the CEUS group and 86.1% (31/36) in the conventional ultrasound group (P 73 m(2) (P > 0.05, compared with pre-GFR: 86.4 ± 26.2 mL/min/1.73 m(2)) in the CEUS group and 81.9 ± 22.8 mL/min/1.73 m(2) (P > 0.05, compared with pre-GFR: 83.5 ± 23.7 mL/min/1.73 m(2)) in the conventional ultrasound group. Intraoperative CEUS can "real-time" monitor the ablated area during PRFA procedure. This technique can help to achieve a higher success rate compared with conventional ultrasound. No impact of intraoperative CEUS has been found on GFR level.

  20. [Value of contrast-enhanced ultrasound (CEUS) in the differential diagnosis between benign and malignant renal neoplasms].

    Science.gov (United States)

    Zhang, Sheng; Wang, Xiao-qing; Xin, Xiao-jie; Xu, Yong

    2013-05-01

    To investigate the value of contrast enhanced ultrasound (CEUS) imaging in the differential diagnosis between benign and malignant renal neoplasms. Two hundred and forty-five cases of renal space-occupying lesions confirmed by biopsy or surgical pathology were included in this study. The CEUS features of the renal space-occupying lesions, i.e., the enhancement degree, homogeneity of enhancement, washing-in and washing-out time and enhancement pattern, were retrospectively analyzed. There were 210 cases of malignant renal tumors and 35 cases of benign lesions. The CEUS modes of the malignant renal tumors included "quick in and quick out" 82 cases, "quick in and slow out" 64 cases, "slow in and quick out" 18 cases and "slow in and slow out" 46 cases; good enhancement 150 cases (71.4%) and inhomogeneous enhancement 180 cases (85.7%).Both the contrast agent filling defect area and solid component enhancement of solid-cystic tumors were important features of malignant renal tumors. In the 35 cases of benign lesions,the CEUS modes included "quick in and quick out" 4 cases, "quick in and slow out" 8 cases, "slow in and quick out" 10 cases and "slow in and slow out" 13 cases. Most of the benign tumors showed low enhancement 51.4% (18/35) and inhomogeneous enhancement 54.3% (19/35). There were significant differences between the malignant and benign renal neoplasms in CEUS mode, degree of enhancement and homogeneity of enhancement (P benign and malignant tumors were 77.1% and 83.8%, respectively, while the two-dimensional ultrasound diagnosis of benign and malignant tumors were 68.6% and 76.7%, respectively, with a significant difference (P benign and malignant renal lesions.

  1. Characterisation of focal liver lesions with contrast enhanced ultrasonography

    International Nuclear Information System (INIS)

    Dietrich, Christoph F.

    2004-01-01

    Ultrasound contrast agents (USCA) have improved the detection rate of liver tumours in recent years. Conventional ultrasound has been reported to be relatively unreliable in the characterisation of liver tumours. SonoVue [reg] (Bracco Imaging Spa) has been shown to be particularly advantageous in the differentiation of benign and malignant liver tumours and, therefore, possibly represents a new cost-effective competitive alternative to other liver imaging modalities (e.g. computed tomography and magnetic resonance imaging), thus allowing these important technologies to be available for other indications (e.g. brain, thorax). More detailed and specific liver tumour characterisation is possible in about 80% of liver tumours due to typical vascularity and perfusion patterns. The role of USCA for better characterisation, which is possible through the analysis of flow characteristics in real time, places a particular emphasis on agent use. Contrast enhanced real-time imaging techniques with SonoVue [reg] allow real-time analysis of tumour perfusion in patients with liver lesions. Liver tumours known to be hyperperfused in the arterial phase (e.g. focal nodular hyperplasia, hepatocellular adenoma and carcinoma, and hyperperfused metastases) can be better detected and characterised. Hypoperfused tumours (e.g. liver metastases of the gastrointestinal tract) can be recognised in the portal venous phase as less perfused 'black spots'. In this article we discuss liver tumour characterisation by contrast enhanced ultrasonography

  2. Contrast-enhanced ultrasonography and spiral computed tomography in the detection and characterization of portal vein thrombosis complicating hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Rossi, Sandro; Ghittoni, Giorgia; Ravetta, Valentina; Torello Viera, Francesca; Rosa, Laura [Policlinico ' S. Matteo' Foundation, IRCCS, VI Department of Internal Medicine and Interventional Ultrasonography, Pavia (Italy); Serassi, Martina; Scabini, Mara; Vercelli, Alessandro; Calliada, Fabrizio [IRCCS Policlinico ' S. Matteo' , Department of Radiology, P.le Golgi n. 19, Pavia (Italy); Tinelli, Carmine [Biometrics Unit, IRCCS Policlinico ' S. Matteo' , Pavia (Italy); Dal Bello, Barbara [IRCCS Policlinico ' S. Matteo' , Department of Human Pathology, Pavia (Italy); Burns, Peter N. [University of Toronto, Department of Medical Biophysics, Toronto, ON (Canada); Imaging Research S660, Sunnybrook Health Science Centre, Toronto, ON (Canada)

    2008-08-15

    The aim was to compare the performances of contrast-enhanced (CE) ultrasonography (US) and spiral computed tomography (CT) in the detection and characterization of portal vein thrombosis complicating hepatocellular carcinoma (HCC). We studied 50 patients with HCC who had biopsy-proven portal vein thrombi that had been detected with US and color Doppler US. Thirteen of the thrombi involved the main portal trunk and 37 the segmental branches. CEUS and CT were performed within a week of thrombus biopsies. For each imaging technique, diagnoses of thrombosis (present/absent) and thrombus nature (malignancy/benignancy) were made by experienced readers under blinded conditions and compared with pathological findings to determine accuracy rates for thrombus detection and characterization. Forty-four of the 50 thrombi were pathologically diagnosed as malignant and the remaining six were benign. CEUS detected 50/50 (100%) thrombi and correctly characterized 49/50 (98%). CT detected 34/50 (68%) thrombi and correctly characterized 23 of these 34 (68%). CEUS outperformed CT in terms of both thrombus detection (P < 0.0001) and characterization (P = 0.0001). CEUS appears to be significantly superior to CT for detection and characterization of portal vein thrombosis complicating HCC, and it should be considered in the staging of these tumors. (orig.)

  3. Evaluation of Hemodynamics in Focal Steatosis and Focal Spared Lesion of the Liver Using Contrast-Enhanced Ultrasonography with Sonazoid

    International Nuclear Information System (INIS)

    Shiozawa, K.; Watanabe, M.; Ikehara, T.; Kogame, M.; Shinohara, M.; Shinohara, M.; Ishii, K.; Igarashi, Y.; Sumino, Y.; Shiozawa, K.; Makino, H.

    2014-01-01

    We aim to investigate the hemodynamics in focal steatosis and focal spared lesion of the liver using contrast-enhanced ultrasonography (CEUS) with Sonazoid. The subjects were 47 patients with focal steatosis and focal spared lesion. We evaluated enhancement patterns (hyper enhancement, iso enhancement, and hypo enhancement) in the vascular phase and the presence or absence of a hypoechoic area in the post vascular phase for these lesions using CEUS. Of the 24 patients with focal steatosis, the enhancement pattern was iso enhancement in 19 and hypo enhancement in 5. Hypoechoic areas were noted in the post vascular phase in 3 patients. Of the 23 patients with focal spared lesions, the enhancement pattern was iso enhancement in 18 and hyper enhancement in 5. No hypoechoic areas were noted in the post vascular phase in any patient. The hemodynamics in focal steatosis and focal spared lesions in non diffuse fatty liver can be observed using low-invasive procedures in real-time by CEUS. It was suggested that differences in the dynamics of enhancement in the vascular phase of CEUS were influenced by the fat deposits in the target lesion, the surrounding liver parenchyma, and the third inflow.

  4. Contrast-enhanced endoscopic ultrasonography in digestive diseases.

    Science.gov (United States)

    Hirooka, Yoshiki; Itoh, Akihiro; Kawashima, Hiroki; Ohno, Eizaburo; Itoh, Yuya; Nakamura, Yosuke; Hiramatsu, Takeshi; Sugimoto, Hiroyuki; Sumi, Hajime; Hayashi, Daijiro; Ohmiya, Naoki; Miyahara, Ryoji; Nakamura, Masanao; Funasaka, Kohei; Ishigami, Masatoshi; Katano, Yoshiaki; Goto, Hidemi

    2012-10-01

    Contrast-enhanced endoscopic ultrasonography (CE-EUS) was introduced in the early 1990s. The concept of the injection of carbon dioxide microbubbles into the hepatic artery as a contrast material (enhanced ultrasonography) led to "endoscopic ultrasonographic angiography". After the arrival of the first-generation contrast agent, high-frequency (12 MHz) EUS brought about the enhancement of EUS images in the diagnosis of pancreatico-biliary diseases, upper gastrointestinal (GI) cancer, and submucosal tumors. The electronic scanning endosonoscope with both radial and linear probes enabled the use of high-end ultrasound machines and depicted the enhancement of both color/power Doppler flow-based imaging and harmonic-based imaging using second-generation contrast agents. Many reports have described the usefulness of the differential diagnosis of pancreatic diseases and other abdominal lesions. Quantitative evaluation of CE-EUS images was an objective method of diagnosis using the time-intensity curve (TIC), but it was limited to the region of interest. Recently developed Inflow Time Mapping™ can be generated from stored clips and used to display the pattern of signal enhancement with time after injection, offering temporal difference of contrast agents and improved tumor characterization. On the other hand, three-dimensional CE-EUS images added new information to the literature, but lacked positional information. Three-dimensional CE-EUS with accurate positional information is awaited. To date, most reports have been related to pancreatic lesions or lymph nodes. Hemodynamic analysis might be of use for diseases in other organs: upper GI cancer diagnosis, submucosal tumors, and biliary disorders, and it might also provide functional information. Studies of CE-EUS in diseases in many other organs will increase in the near future.

  5. Contrast-Enhanced Endoscopic Ultrasonography for Pancreatic Tumors

    Directory of Open Access Journals (Sweden)

    Yasunobu Yamashita

    2015-01-01

    Full Text Available Objectives. To investigate the usefulness of contrast-enhanced endoscopic ultrasonography (CE-EUS for histological differentiation of pancreatic tumors. Methods. CE-EUS was performed for consecutive patients having a pancreatic solid lesion, and tumors were classified into three vascular patterns (hypervascular, isovascular, and hypovascular at two time phases (early-phase and late-phase. Correlation between vascular patterns and histopathology of resected pancreatic cancer (PC tissues was ascertained. Results. The final diagnoses of 147 examined tumors were PC (n=109, inflammatory mass (n=11, autoimmune pancreatitis (n=9, neuroendocrine tumor (n=8, and others (n=10. In late-phase images, 104 of 109 PCs had the hypovascular pattern, for a diagnostic sensitivity and specificity of 94% and 71%, respectively. Of 28 resected PCs, 10 had isovascular, and 18 hypovascular, patterns on the early-phase image. Early-phase isovascular PCs were more likely to be differentiated than were early-phase hypovascular PCs (6 well and 4 moderately differentiated versus 3 well, 14 moderately, and 1 poorly differentiated, P=0.028. Immunostaining revealed that hypovascular areas of early-phase images reflected heterogeneous tumor cells with fibrous tissue, necrosis, and few vessels. Conclusion. CE-EUS could be useful for distinguishing PC from other solid pancreatic lesions and for histological differentiation of PCs.

  6. Perfusion quantification in contrast-enhanced ultrasound (CEUS)--ready for research projects and routine clinical use.

    Science.gov (United States)

    Tranquart, F; Mercier, L; Frinking, P; Gaud, E; Arditi, M

    2012-07-01

    With contrast-enhanced ultrasound (CEUS) now established as a valuable imaging modality for many applications, a more specific demand has recently emerged for quantifying perfusion and using measured parameters as objective indicators for various disease states. However, CEUS perfusion quantification remains challenging and is not well integrated in daily clinical practice. The development of VueBox™ alleviates existing limitations and enables quantification in a standardized way. VueBox™ operates as an off-line software application, after dynamic contrast-enhanced ultrasound (DCE-US) is performed. It enables linearization of DICOM clips, assessment of perfusion using patented curve-fitting models, and generation of parametric images by synthesizing perfusion information at the pixel level using color coding. VueBox™ is compatible with most of the available ultrasound platforms (nonlinear contrast-enabled), has the ability to process both bolus and disruption-replenishment kinetics loops, allows analysis results and their context to be saved, and generates analysis reports automatically. Specific features have been added to VueBox™, such as fully automatic in-plane motion compensation and an easy-to-use clip editor. Processing time has been reduced as a result of parallel programming optimized for multi-core processors. A long list of perfusion parameters is available for each of the two administration modes to address all possible demands currently reported in the literature for diagnosis or treatment monitoring. In conclusion, VueBox™ is a valid and robust quantification tool to be used for standardizing perfusion quantification and to improve the reproducibility of results across centers. © Georg Thieme Verlag KG Stuttgart · New York.

  7. Age-related differences in skeletal muscle microvascular response to exercise as detected by contrast-enhanced ultrasound (CEUS).

    Science.gov (United States)

    Hildebrandt, Wulf; Schwarzbach, Hans; Pardun, Anita; Hannemann, Lena; Bogs, Björn; König, Alexander M; Mahnken, Andreas H; Hildebrandt, Olaf; Koehler, Ulrich; Kinscherf, Ralf

    2017-01-01

    Aging involves reductions in exercise total limb blood flow and exercise capacity. We hypothesized that this may involve early age-related impairments of skeletal muscle microvascular responsiveness as previously reported for insulin but not for exercise stimuli in humans. Using an isometric exercise model, we studied the effect of age on contrast-enhanced ultrasound (CEUS) parameters, i.e. microvascular blood volume (MBV), flow velocity (MFV) and blood flow (MBF) calculated from replenishment of Sonovue contrast-agent microbubbles after their destruction. CEUS was applied to the vastus lateralis (VLat) and intermedius (VInt) muscle in 15 middle-aged (MA, 43.6±1.5 years) and 11 young (YG, 24.1±0.6 years) healthy males before, during, and after 2 min of isometric knee extension at 15% of peak torque (PT). In addition, total leg blood flow as recorded by femoral artery Doppler-flow. Moreover, fiber-type-specific and overall capillarisation as well as fiber composition were additionally assessed in Vlat biopsies obtained from CEUS site. MA and YG had similar quadriceps muscle MRT-volume or PT and maximal oxygen uptake as well as a normal cardiovascular risk factors and intima-media-thickness. During isometric exercise MA compared to YG reached significantly lower levels in MFV (0.123±0.016 vs. 0.208±0.036 a.u.) and MBF (0.007±0.001 vs. 0.012±0.002 a.u.). In the VInt the (post-occlusive hyperemia) post-exercise peaks in MBV and MBF were significantly lower in MA vs. YG. Capillary density, capillary fiber contacts and femoral artery Doppler were similar between MA and YG. In the absence of significant age-related reductions in capillarisation, total leg blood flow or muscle mass, healthy middle-aged males reveal impaired skeletal muscle microcirculatory responses to isometric exercise. Whether this limits isometric muscle performance remains to be assessed.

  8. Age-related differences in skeletal muscle microvascular response to exercise as detected by contrast-enhanced ultrasound (CEUS.

    Directory of Open Access Journals (Sweden)

    Wulf Hildebrandt

    Full Text Available Aging involves reductions in exercise total limb blood flow and exercise capacity. We hypothesized that this may involve early age-related impairments of skeletal muscle microvascular responsiveness as previously reported for insulin but not for exercise stimuli in humans.Using an isometric exercise model, we studied the effect of age on contrast-enhanced ultrasound (CEUS parameters, i.e. microvascular blood volume (MBV, flow velocity (MFV and blood flow (MBF calculated from replenishment of Sonovue contrast-agent microbubbles after their destruction. CEUS was applied to the vastus lateralis (VLat and intermedius (VInt muscle in 15 middle-aged (MA, 43.6±1.5 years and 11 young (YG, 24.1±0.6 years healthy males before, during, and after 2 min of isometric knee extension at 15% of peak torque (PT. In addition, total leg blood flow as recorded by femoral artery Doppler-flow. Moreover, fiber-type-specific and overall capillarisation as well as fiber composition were additionally assessed in Vlat biopsies obtained from CEUS site. MA and YG had similar quadriceps muscle MRT-volume or PT and maximal oxygen uptake as well as a normal cardiovascular risk factors and intima-media-thickness.During isometric exercise MA compared to YG reached significantly lower levels in MFV (0.123±0.016 vs. 0.208±0.036 a.u. and MBF (0.007±0.001 vs. 0.012±0.002 a.u.. In the VInt the (post-occlusive hyperemia post-exercise peaks in MBV and MBF were significantly lower in MA vs. YG. Capillary density, capillary fiber contacts and femoral artery Doppler were similar between MA and YG.In the absence of significant age-related reductions in capillarisation, total leg blood flow or muscle mass, healthy middle-aged males reveal impaired skeletal muscle microcirculatory responses to isometric exercise. Whether this limits isometric muscle performance remains to be assessed.

  9. Contrast-enhanced ultrasonography depicts small tumor vessels for the evaluation of pancreatic tumors

    International Nuclear Information System (INIS)

    Okamoto, Yuko; Kawamoto, Hirofumi; Takaki, Akinobu; Ishida, Etsuji; Ogawa, Tsuneyoshi; Kuwaki, Kenji; Kobayashi, Yoshiyuki; Sakaguchi, Kohsaku; Shiratori, Yasushi

    2007-01-01

    Objective: The aim of this study is to evaluate the efficacy of contrast-enhanced ultrasonography for the diagnosis of pancreatic tumors. Materials and methods: Contrast-enhanced ultrasonography with Levovist was performed on 62 consecutive patients (53 with pancreatic cancer, 4 with islet cell tumor, 3 with inflammatory pancreatic tumor, and 2 with metastatic tumor). The vascular and perfusion image phases of the tumors were evaluated and compared with the findings of contrast-enhanced computed tomography. Results: Contrast-enhanced ultrasonography showed tumor vessels around and/or in the tumor at the vascular image phase in 79% of pancreatic cancer patients (42/53). At the perfusion image phase, 96% of pancreatic cancers (51/53) were classified as hypo-enhancement type. However, tiny spotty or irregular heterogeneous enhanced lesions were found in 84% of hypo-enhanced pancreatic cancer patients (43/51). The presence of small vessels at the vascular image phase was closely correlated with the presence of these intratumor regional enhanced lesions at the perfusion image phase (κ coefficient = 0.42). The sensitivity of contrast-enhanced ultrasonography (100%) for pancreatic cancer was superior to that of contrast-enhanced computed tomography (91%), but no significant difference was observed between the two (McNemar test: p = 0.063). Conclusion: Contrast-enhanced ultrasonography with Levovist successfully visualizes fine vessels and enhancement in pancreatic tumors, and is useful for evaluating pancreatic tumors

  10. Assessment of contrast-enhanced ultrasonography of the hepatic vein for detection of hemodynamic changes associated with experimentally induced portal hypertension in dogs.

    Science.gov (United States)

    Morishita, Keitaro; Hiramoto, Akira; Michishita, Asuka; Takagi, Satoshi; Hoshino, Yuki; Itami, Takaharu; Lim, Sue Yee; Osuga, Tatsuyuki; Nakamura, Sayuri; Ochiai, Kenji; Nakamura, Kensuke; Ohta, Hiroshi; Yamasaki, Masahiro; Takiguchi, Mitsuyoshi

    2017-04-01

    OBJECTIVE To assess the use of contrast-enhanced ultrasonography (CEUS) of the hepatic vein for the detection of hemodynamic changes associated with experimentally induced portal hypertension in dogs. ANIMALS 6 healthy Beagles. PROCEDURES A prospective study was conducted. A catheter was surgically placed in the portal vein of each dog. Hypertension was induced by intraportal injection of microspheres (10 to 15 mg/kg) at 5-day intervals via the catheter. Microsphere injections were continued until multiple acquired portosystemic shunts were created. Portal vein pressure (PVP) was measured through the catheter. Contrast-enhanced ultrasonography was performed before and after establishment of hypertension. Time-intensity curves were generated from the region of interest in the hepatic vein. Perfusion variables measured for statistical analysis were hepatic vein arrival time, time to peak, time to peak phase (TTPP), and washout ratio. The correlation between CEUS variables and PVP was assessed by use of simple regression analysis. RESULTS Time to peak and TTPP were significantly less after induction of portal hypertension. Simple regression analysis revealed a significant negative correlation between TTPP and PVP. CONCLUSIONS AND CLINICAL RELEVANCE CEUS was useful for detecting hemodynamic changes associated with experimentally induced portal hypertension in dogs, which was characterized by a rapid increase in the intensity of the hepatic vein. Furthermore, TTPP, a time-dependent variable, provided useful complementary information for predicting portal hypertension. IMPACT FOR HUMAN MEDICINE Because the method described here induced presinusoidal portal hypertension, these results can be applied to idiopathic portal hypertension in humans.

  11. Sonographic patterns of renal lymphoma in B-mode imaging and in contrast-enhanced ultrasound (CEUS)—A retrospective evaluation

    International Nuclear Information System (INIS)

    Trenker, C.; Neesse, A.; Görg, C.

    2015-01-01

    Introduction: Retrospective analysis of sonographic patterns of renal lymphoma in B-mode imaging and contrast-enhanced ultrasound (CEUS). Patients/methods: From January 2000 to June 2014, 27 patients with clinical or histologically confirmed renal lymphoma were examined with B-mode imaging, followed by CEUS in 8 cases. Results: In B-mode imaging renal lymphoma were hypoechoic in all 27 cases (100%). 9 patients (33.3%) had a bilateral, 18 (66.7%) patients had an unilateral lymphoma infiltration of the kidneys. 8 (29.6%) cases of small nodular, 5 (18.5%) cases of large nodular and 6 (22.2%) cases of perirenal lymphoma infiltration of the kidney were observed in B-mode imaging. Bulky-formation of renal lymphoma was detected in 6 (22.2%) patients and 2 (7.4%) patients had a diffuse lymphoma infiltration of the kidneys. In CEUS an arterial isoechoic enhancement was observed in 5 (62.5%)- and, an arterial hypoechoic enhancement was observed in 3 (37.5%) cases of renal lymphoma. A hypoechoic enhancement in the parenchymal phase was observed in 8 (100%) cases of renal lymphoma infiltration. Conclusion: In B-mode-imaging, nodular lymphoma infiltration of the kidneys is the most common of all renal lymphoma patterns in B-mode imaging. In CEUS, renal lymphoma presented an arterial iso- or hypoechoic enhancement, followed by a hypoechoic enhancement in the parenchymal phase. In regard to the differentiation of renal lymphoma to benign lesions of the kidney, CEUS may be helpful. However, the differentiation of renal lymphoma from other malignant lesions of the kidney like renal cell carcinoma is not feasible by CEUS

  12. Intraoperative contrast-enhanced ultrasonography for microcirculatory evaluation in rhesus monkey with spinal cord injury.

    Science.gov (United States)

    Huang, Lin; Chen, Keng; Chen, Fu-Chao; Shen, Hui-Yong; Ye, Ji-Chao; Cai, Zhao-Peng; Lin, Xi

    2017-06-20

    This study tried to quantify spinal cord perfusion by using contrast-enhanced ultrasound (CEUS) in rhesus monkey models with acute spinal cord injury. Acute spinal cord perfusion after injury was detected by CEUS, coupling with conventional ultrasound (US) and Color Doppler US (CDFI). Time-intensity curves and perfusion parameters were obtained by autotracking contrast quantification (ACQ) software in the epicenter and adjacent regions of injury, respectively. Neurological and histological examinations were performed to confirm the severity of injury. US revealed spinal cords were hypoechoic and homogeneous, whereas dura maters, pia maters, and cerebral aqueducts were hyperechoic. After spinal cord contusion, the injured spinal cord was hyperechoic on US, and intramedullary vessels of adjacent region of injury were increased and dilated on CDFI. On CEUS hypoperfusion were found in the epicenter of injury, while hyperperfusion in its adjacent region. Quantitative analysis showed that peak intensity (PI) decreased in epicenters of injury but significantly increased in adjacent regions at all time points (p spinal cord injury in overall views and real-time.

  13. Use of contrast-enhanced ultrasonography in hepatosplenic sarcoidosis: Report of 2 cases

    International Nuclear Information System (INIS)

    Grzelak, Piotr; Augsburg, Lukasz; Majos, Agata; Stefanczyk, Ludomir; Gorski, Paweł; Piotrowski, Wojciech; Antczak, Adam

    2012-01-01

    Sarcoidosis is a multisystemic granulomatous disease of unknown etiology that predominantly affects lungs and intrathoracic lymph nodes; in rare cases (approx. 10%), infiltration of the spleen and liver may be observed. In order to identify hepatosplenic infiltration, MRI/CT of the abdomen and different ultrasound techniques (PD US, US D) are usually performed. Contrast enhanced ultrasound (CEUS) is a new technique in this diagnostic algorithm, but the fact that this is a safe, accurate, and widely available method opens a new perspective for the detection of abdominal lesions in sarcoidosis. We report 2 cases of hepatosplenic sarcoidosis – a 41-year-old woman with splenic lesions and a 46-year-old man with liver infiltration. On the basis of these 2 cases we intended to show the diagnostic potential of contrast enhanced ultrasound for the recognition of focal lesions of the spleen and liver in patients suffering from sarcoidosis

  14. Features of time–intensity curve parameters of colorectal adenocarcinomas evaluated by double-contrast enhanced ultrasonography: Initial observation

    International Nuclear Information System (INIS)

    Zhuang Hua; Yang Zhigang; Wang Ziqiang; Wang Xiaodong; Chen Huijiao; Zhang Yuanchuan; Luo Yan

    2012-01-01

    Purpose: This study is to investigate the value of double contrast-enhanced ultrasonography (DCEU) in assessing microcirculation of colorectal adenocarcinomas and to describe the perfusion features of the tumours. Material and methods: DCEUS was performed in 42 patients with adenocarcinoma. The time–intensity curve parameters (arrival time (AT), time-to-peak (TTP), peak intensity (PI) and area under the curve (AUC)) within the tumours were extracted. The parameters were compared among the tumours with different CEUS features and stages. Results: The mean values of AT, TTP, PI and AUC of the colorectal adenocarcinomas were 13.68 ± 13.36 s, 32.61 ± 19.56 s, 19.82 ± 16.54 dB and 271.10 ± 159.19 dB s, respectively. In the adenocarcinomas with necrosis, the mean values of AUC was significantly lower than that of the adenocarcinomas without (231.10 ± 219.27 dB s, 278.10 ± 123.20 dB s, p = 0.004). In the adenocarcinomas with necrosis, the AUC and PI of the non-necrotic part were significantly higher than that of the necrotic part (p = 0.007, 0.0025, respectively). AUC increased progressively in the subgroups of T2, T3 and T4 and the difference of AUC between T2 and T4 subgroup was significant (p = 0.008). Conclusions: Double contrast-enhanced ultrasonography is a valuable technique for quantifying tumour vascularity of colorectal adenocarcinomas. AUC was significantly different in the subgroups of different T stage. AUC and PI could reflect the different perfusion status of tumours with or without necrosis.

  15. Evaluation of liver parenchyma and perfusion using dynamic contrast-enhanced computed tomography and contrast-enhanced ultrasonography in captive green iguanas (Iguana iguana) under general anesthesia.

    Science.gov (United States)

    Nardini, Giordano; Di Girolamo, Nicola; Leopardi, Stefania; Paganelli, Irene; Zaghini, Anna; Origgi, Francesco C; Vignoli, Massimo

    2014-05-13

    Contrast-enhanced diagnostic imaging techniques are considered useful in veterinary and human medicine to evaluate liver perfusion and focal hepatic lesions. Although hepatic diseases are a common occurrence in reptile medicine, there is no reference to the use of contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT) to evaluate the liver in lizards. Therefore, the aim of this study was to evaluate the pattern of change in echogenicity and attenuation of the liver in green iguanas (Iguana iguana) after administration of specific contrast media. An increase in liver echogenicity and density was evident during CEUS and CECT, respectively. In CEUS, the mean ± SD (median; range) peak enhancement was 19.9% ± 7.5 (18.3; 11.7-34.6). Time to peak enhancement was 134.0 ± 125.1 (68.4; 59.6-364.5) seconds. During CECT, first visualization of the contrast medium was at 3.6 ± 0.5 (4; 3-4) seconds in the aorta, 10.7 ± 2.2 (10.5; 7-14) seconds in the hepatic arteries, and 15 ± 4.5 (14.5; 10-24) seconds in the liver parenchyma. Time to peak was 14.1 ± 3.4 (13; 11-21) and 31 ± 9.6 (29; 23-45) seconds in the aorta and the liver parenchyma, respectively. CEUS and dynamic CECT are practical means to determine liver hemodynamics in green iguanas. Distribution of contrast medium in iguana differed from mammals. Specific reference ranges of hepatic perfusion for diagnostic evaluation of the liver in iguanas are necessary since the use of mammalian references may lead the clinician to formulate incorrect diagnostic suspicions.

  16. Contrast-enhanced power Doppler ultrasonography of the metacarpophalangeal joints in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Szkudlarek, Marcin; Court-Payen, Michel; Strandberg, Charlotte

    2003-01-01

    The aim of this study was to examine, with dynamic contrast-enhanced MRI as the reference, if contrast-enhanced power Doppler ultrasonography (CE PDUS) of rheumatoid arthritis (RA) metacarpophalangeal (MCP) joints provides additional information for evaluation of synovial inflammation compared...... with PDUS. One MCP joint in each of 15 RA patients and 3 healthy control persons were examined with PDUS before and after intravenous bolus Levovist contrast injection. Corresponding rates of early synovial enhancement (RESE), previously shown to be closely related to histopathological synovitis, were...... calculated from dynamic contrast-enhanced MR images obtained the same day. Prior to ultrasonography, the joint was evaluated clinically. Levovist increased the flow signal in 7 of 9 joints with pre-contrast flow-signal and in 0 of 9 without pre-contrast signal. No healthy controls showed CE PDUS signal...

  17. Evaluation of residual hepatocellular carcinoma after transcatheter arterial chemoembolization: Comparison between contrast-enhanced helical CT and contrast-enhanced power doppler ultrasonography

    International Nuclear Information System (INIS)

    Kim, Seung Hoon; Lim, Hyo Keun; Lee, Won Jae

    2001-01-01

    To evaluate the effectiveness of contrast-enhanced helical CT and contrast-enhanced power doppler ultrasonography (PDUS) in assessing the therapeutic effect of transcatheter arterial chemoembolization (TACE) in hepatocellular carcinomas (HCCs). The follow-up contrast-enhanced helical CT and contrast-enhanced PDUS were performed for twenty-nine nodular HCCs from twelve patients previously treated with TACE. We defined the residual HCCs as intratumoral enhancing area on contrast-enhanced helical CT and color signal on contrast-enhanced PDUS. The interval between two examinations was less than 2 weeks (mean, 9 days). Two radiologists evaluated two examinations by consensus, and the results of these two examination were compared with the findings of other examinations including CT, angiography, and/or pathology to calculate the sensitivity, specificity and accuracy of two examinations. Of the 29 HCCs, 20 had residual HCCs whereas no residual HCCs in 9 HCCs on pathologic examination and/or follow-up radiologic study. The sensitivity, sensitivity and accuracy of contrast-enhanced helical CT were 65 (13/20), 89 (8/9), and 72% (21/29) while those of contrast-enhanced PDUS were 100 (20/20), 89 (8/9) and 97% (28/29), respectively. A microbubble contrast-enhanced PDUS was more effective in the detection of residual tumor in HCCs following TACE than contrast-enhanced helical CT.

  18. Radiofrequency ablation of liver cancer: early evaluation of therapeutic response with contrast-enhanced ultrasonography

    International Nuclear Information System (INIS)

    Choi, Dong Gil; Lim, Hyo K.; Lee, Won Jae; Kim, Seung Hoon; Kim, Min Ju; Kim, Seung Kwon; Jang, Kyung Mi; Lee, Ji Yeon; Lim, Jae Hoon

    2004-01-01

    The early assessment of the therapeutic response after percutaneous radiofrequency (RF) ablation is important, in order to correctly decide whether further treatment is necessary. The residual unablated tumor is usually depicted on contrast-enhanced multiphase helical computed tomography (CT) as a focal enhancing structure during the arterial and portal venous phases. Contrast-enhanced color Doppler and power Doppler ultrasonography (US) have also been used to detect residual tumors. Contrast-enhanced gray-scale US, using a harmonic technology which has recently been introduced, allows for the detection of residual tumors after ablation, without any of the blooming or motion artifacts usually seen on contrast-enhanced color or power Doppler US. Based on our experience and reports in the literature, we consider that contrast-enhanced gray-scale harmonic US constitutes a reliable alternative to contrast-enhanced multiphase CT for the early evaluation of the therapeutic response to RF ablation for liver cancer. This technique was also useful in targeting any residual unablated tumors encountered during additional ablation

  19. Contrast-Enhanced Ultrasonography of Hepatocellular Carcinoma After Chemoembolisation Using Drug-Eluting Beads: A Pilot Study Focused on Sustained Tumor Necrosis

    International Nuclear Information System (INIS)

    Moschouris, Hippocrates; Malagari, Katerina; Papadaki, Marina Georgiou; Kornezos, Ioannis; Matsaidonis, Dimitrios

    2010-01-01

    The purpose of this study was to assess the use of contrast-enhanced ultrasonography (CEUS) and the sustained antitumor effect of drug-eluting beads used for transarterial chemoembolisation (TACE) of unresectable hepatocellular carcinoma (HCC). Ten patients with solitary, unresectable HCC underwent CEUS before, 2 days after, and 35 to 40 days after TACE using a standard dose (4 ml) of drug-eluting beads (DC Beads; Biocompatibles, Surrey, UK) preloaded with doxorubicin (25 mg doxorubicin/ml hydrated beads). For CEUS, a second-generation contrast agent (SonoVue, Bracco, Milan, Italy) and a low mechanical-index technique were used. A part of the tumor was characterized as necrotic if it showed complete lack of enhancement. The percentage of necrosis was calculated at the sonographic section that depicted the largest diameter of the tumor. Differences in the extent of early (2 days after TACE) and delayed (35 to 40 days after TACE) necrosis were quantitatively and subjectively assessed. Early post-TACE tumor necrosis ranged from 21% to 70% (mean 43.5% ± 19%). There was a statistically significant (p = 0.0012, paired Student t test) higher percentage of delayed tumor necrosis, which ranged from 24% to 88% (mean 52.3% ± 20.3%). Subjective evaluation showed a delayed obvious increase of the necrotic areas in 5 patients. In 2 patients, tumor vessels that initially remained patent disappeared on the delayed follow-up. A part of tumor necrosis after chemoembolisation of HCC with DEB seems to take place later than 2 days after TACE. CEUS may provide evidence for the sustained antitumor effect of DEB-TACE. Nevertheless, the ideal time for the imaging evaluation of tumor response remains to be defined.

  20. Contrast-Enhanced Harmonic Ultrasonography for the Assessment of Prostate Cancer Aggressiveness: a Preliminary Study

    International Nuclear Information System (INIS)

    Zhu, Yunkai; Chen, Yaqing; Jiang, Jun; Wang, Ren; Zhou, Yongchang; Zhang, Huizhen

    2010-01-01

    To determine whether contrast-enhanced harmonic ultrasonography can be used to predict the aggressiveness of prostate cancer. Contrast-enhanced harmonic ultrasonography was performed in 103 patients suspected of prostate cancer before biopsy. Time intensity curves were reconstructed for systematic biopsy sites and sonographic abnormalities. The characteristics of the curves were described using hemodynamic indices including arrival time (AT), time-to-peak (TTP), and peak intensity (PI). The differences of hemodynamic indices between high-grade and low-grade cancer were analyzed and the correlations between the hemodynamic indices and biopsy Gleason score were studied. Prostate cancer was detected in 41 of 103 patients and there were significant differences in the hemodynamic indices between the biopsy sites of the non-malignant patients and prostate cancer lesions (p < 0.05). The prostate biopsies revealed 154 prostate cancer lesions, including 31 low-grade lesions and 123 high-grade lesions. The hemodynamic indices AT and TTP of highgrade tumors were significantly shorter than those of low-grade tumors (p = 0.001, 0.002). In addition, high-grade peripheral zone (PZ) tumors had higher PI than low-grade PZ tumors (p = 0.009). The PZ prostate cancer Gleason score correlated with PI, AT and TTP, with Spearman correlation coefficients of 0.223, -0.335, and -0.351, respectively (p = 0.013, < 0.001 and < 0.001). Contrast-enhanced ultrasound measurements of hemodynamic indices correlate with the prostate cancer Gleason score

  1. Dynamics of contrast enhancement in MR imaging and power Doppler ultrasonography of solid breast lesions

    International Nuclear Information System (INIS)

    Reinikainen, H.; Paeaekkoe, E.; Suramo, I.; Paeivaensalo, M.; Rissanen, T.

    2002-01-01

    Purpose: To evaluate the dynamics of contrast enhancement in solid breast lesions at contrast-enhanced MR imaging and power Doppler ultrasonography (US) and to compare the methods to histology and to each other. Material and Methods: Forty breast lesions were prospectively examined with dynamic MR and power Doppler US. Time-signal intensity curves of enhancement were obtained for both methods. The shape of the curve was analyzed to be benign, indeterminate or malignant. The curves were also analyzed quantitatively by calculating the slope of the curve and the area under the curve (both methods), relative enhancement (MR), and time to peak (US). The lesions were divided into malignant lesions, fibroadenomas, and other benign lesions. The results were compared to histology. Results: In the subjective analysis of the MR curve in differentiating between benign and malignant lesions the accuracy was 90%. The MR curve also enabled differentiation between fibroadenomas and malignancies. The accuracy of the US curve was 38%. Quantitatively, statistically significant differences were found using all the MR variables, except between malignancies and fibroadenomas. Using the US variables, no significant difference was found between the groups. Conclusion: The dynamics of contrast-enhanced MR were reliable in the differential diagnosis of solid breast lesions, but contrast-enhanced power Doppler US was of limited value

  2. Hepatocellular carcinoma treated with transarterial chemoembolization: Evaluation with parametric contrast-enhanced ultrasonography

    Science.gov (United States)

    Moschouris, Hippocrates; Malagari, Katerina; Marinis, Athanasios; Kornezos, Ioannis; Stamatiou, Konstantinos; Nikas, Georgios; Papadaki, Marina Georgiou; Gkoutzios, Panagiotis

    2012-01-01

    AIM: To evaluate the response of hepatocellular carcinoma (HCC) to transarterial chemoembolization (TACE) using a simplified protocol of parametric contrast-enhanced ultrasound (pCEUS). METHODS: Eighteen patients with HCC (18 target tumors, diameter: 2.8-12 cm) were evaluated before, and 20 d after TACE. The distribution and morphology of TACE-induced necrosis in these tumors precluded accurate evaluation by visual assessment or by simple measurements. For pCEUS, a 4.8 mL bolus of SonoVue (Bracco, Milan, Italy) was intravenously administered and analysis of tumor perfusion during the initial phase of enhancement (0-30 s post injection) was performed with dedicated software (Qontrast, Bracco, Milan, Italy). Time-intensity curves were plotted and three parameters were calculated: peak intensity (PI, in percentage %), time to peak (TTP in seconds, s) and area under the curve during wash-in (AUC-WI, in arbitrary units, a.u). Magnetic resonance imaging was the standard imaging modality for post-treatment evaluation. Changes in tumor size were recorded and response was assessed according to response evaluation criteria in solid tumors criteria. RESULTS: A statistically significant decrease in PI and AUC-WI was observed in the treated tumors post TACE; PIpre: 21.5% ± 8.7% (mean ± SD), PIpost: 12.7% ± 6.7%, P < 0.001, AUC-WI pre: 17493 ± 9563 a.u, AUC-WI post: 9585 ± 5494 a.u, P < 0.001. A slight increase in TTP was noted post TACE, but this was not statistically significant; TTP pre: 13.1 ± 4.3 s, TTP post: 13.6 ± 4.2 s , P = 0.058). The changes in the aforementioned parameters were not accompanied by significant tumor shrinkage. CONCLUSION: pCEUS, even when limited to the study of the arterial phase of tumoral enhancement, can detect and quantify early perfusional changes in HCC post TACE. PMID:22937217

  3. Can contrast-enhanced ultrasonography improve Zone III REBOA placement for prehospital care?

    Science.gov (United States)

    Chaudery, Muzzafer; Clark, James; Morrison, Jonathan J; Wilson, Mark H; Bew, Duncan; Darzi, Ara

    2016-01-01

    Torso hemorrhage is the primary cause of potentially preventable mortality in trauma. Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been advocated as an adjunct to bridge patients to definitive hemorrhage control. The primary aim of this study was to assess whether contrast-enhanced ultrasonography can improve the accuracy of REBOA placement in the infrarenal aorta (Zone III). A fluoroscopy-free "enhanced" Zone III REBOA technique was developed using a porcine cadaver model. A "standard" over-the-wire Seldinger technique was used, which was enhanced with the addition of a microbubble contrast medium to inflate the balloon, observed with ultrasonography. Following this, attending- and resident-level physicians were randomized into two groups. They were taught either the enhanced with ultrasonography guidance (Group A) or the standard measuring length of catheter insertion (Group B) technique as part of a human cadaver trauma skills course. Outcomes assessed included time (seconds) from insertion to inflation, accuracy, and missed targets. All results were benchmarked against three endovascular experts. There were 20 participants who performed REBOA with Group A (51 [31]) being significantly faster than Group B (90 [63]) (p = 0.003) and more accurate (p = 0.023) with no missed targets. Group B had five missed targets, the most common error being inflation within Zone II. For Zone III REBOA, contrast-enhanced ultrasonography technique is faster and more accurate than the standard technique. This may have value in time-critical and austere environments. Clinical studies are now required to evaluate this approach further.

  4. Contrast enhanced ultrasound of splenic lymphoma involvement

    International Nuclear Information System (INIS)

    Goerg, Christian; Faoro, Charis; Bert, Tillmann; Tebbe, Johannes; Neesse, Albrecht; Wilhelm, Christian

    2011-01-01

    Objective: The aim of this study was to compare the value of contrast-enhanced ultrasonography (CEUS) with standard B-mode ultrasound (US) for diagnosis of splenic lymphoma involvement. Methods: From 04/2005 to 10/2008 n = 250 lymphoma patients were investigated by standard B-mode US. A homogeneous splenic echotexture was found in 199 patients (79%). To clarify the benefit of CEUS in this group a pilot series was performed with 16 of the 199 lymphoma patients. All patients with an abnormal splenic echotexture on standard B-Mode US (n = 51) including focal hypoechoic splenic lesions (n = 41) and an inhomogeneous splenic texture (n = 10) were studied by CEUS. CEUS data were retrospectively evaluated. The diagnoses included indolent lymphoma (n = 27), aggressive lymphoma (n = 14), and Hodgkin's disease (n = 10). Number and size of lesions were determined by B-mode US and CEUS. The visualisation of splenic lymphoma involvement by CEUS in comparison to B-mode US was classified as worse, equal, or better. Results: All patients with a homogeneous spleen on B-mode US (n = 16) had no visible focal lesions on CEUS. Study patients with focal lesions (n = 41) had a hypoechoic (n = 22) or isoechoic (n = 19) enhancement during the arterial phase, and a hypoechoic enhancement during the parenchymal phase (n = 41). The visualisation of focal splenic lymphoma was equal (n = 32), better (n = 6), or worse (n = 3). In all study patients with an inhomogeneous spleen on B-mode US (n = 10) no focal lesions were found by CEUS and the value of CEUS therefore was classified as worse. Conclusion: CEUS has no clear advantage for diagnosis of splenic lymphoma involvement.

  5. Contrast enhanced ultrasound of splenic lymphoma involvement

    Energy Technology Data Exchange (ETDEWEB)

    Goerg, Christian, E-mail: goergc@med.uni-marburg.de [Medizinische Universitaetsklinik, Baldingerstrasse, 35033 Marburg/Lahn (Germany); Faoro, Charis [Medizinische Universitaetsklinik, Baldingerstrasse, 35033 Marburg/Lahn (Germany); Bert, Tillmann [Zentralklinik Bad Berka GmbH, Robert-Koch-Allee 9, 99437 Bad Berka (Germany); Tebbe, Johannes [Klinikum Lippe-Detmold, Roentgenstrasse 18, 32756 Detmold (Germany); Neesse, Albrecht; Wilhelm, Christian [Medizinische Universitaetsklinik, Baldingerstrasse, 35033 Marburg/Lahn (Germany)

    2011-11-15

    Objective: The aim of this study was to compare the value of contrast-enhanced ultrasonography (CEUS) with standard B-mode ultrasound (US) for diagnosis of splenic lymphoma involvement. Methods: From 04/2005 to 10/2008 n = 250 lymphoma patients were investigated by standard B-mode US. A homogeneous splenic echotexture was found in 199 patients (79%). To clarify the benefit of CEUS in this group a pilot series was performed with 16 of the 199 lymphoma patients. All patients with an abnormal splenic echotexture on standard B-Mode US (n = 51) including focal hypoechoic splenic lesions (n = 41) and an inhomogeneous splenic texture (n = 10) were studied by CEUS. CEUS data were retrospectively evaluated. The diagnoses included indolent lymphoma (n = 27), aggressive lymphoma (n = 14), and Hodgkin's disease (n = 10). Number and size of lesions were determined by B-mode US and CEUS. The visualisation of splenic lymphoma involvement by CEUS in comparison to B-mode US was classified as worse, equal, or better. Results: All patients with a homogeneous spleen on B-mode US (n = 16) had no visible focal lesions on CEUS. Study patients with focal lesions (n = 41) had a hypoechoic (n = 22) or isoechoic (n = 19) enhancement during the arterial phase, and a hypoechoic enhancement during the parenchymal phase (n = 41). The visualisation of focal splenic lymphoma was equal (n = 32), better (n = 6), or worse (n = 3). In all study patients with an inhomogeneous spleen on B-mode US (n = 10) no focal lesions were found by CEUS and the value of CEUS therefore was classified as worse. Conclusion: CEUS has no clear advantage for diagnosis of splenic lymphoma involvement.

  6. Enhancement pattern of small hepatocellular carcinoma (HCC) at contrast-enhanced US (CEUS), MDCT, and MRI: Intermodality agreement and comparison of diagnostic sensitivity between 2005 and 2010 American Association for the Study of Liver Diseases (AASLD) guidelines

    International Nuclear Information System (INIS)

    Furlan, Alessandro; Marin, Daniele; Cabassa, Paolo; Taibbi, Adele; Brunelli, Elena; Agnello, Francesco; Lagalla, Roberto; Brancatelli, Giuseppe

    2012-01-01

    Objective: To evaluate agreement between contrast-enhanced ultrasound (CEUS), multi-detector row computed tomography (MDCT) and magnetic resonance imaging (MRI) for the assessment of typical and atypical enhancement patterns of small hepatocellular carcinoma (HCC); and to compare diagnostic sensitivity of 2005 and 2010 American Association for the Study of Liver Diseases (AASLD) guidelines. Materials and methods: Between January 2008 and December 2009, we included cirrhotic patients with newly diagnosed 10–20 mm HCC imaged at two contrast-enhanced imaging techniques among CEUS, MDCT, and MRI. Dynamic studies were reviewed by two radiologists to assess enhancement pattern. Percentage of cases with concordant findings and Cohen coefficient (k) were calculated. McNemar's test was used to compare sensitivity between 2005 and 2010 AASLD guidelines. Results: There were 91 patients (69 M; 22 F; mean age, 68 years) with 96 HCCs, studied with a combination of CEUS and MDCT (n = 59), CEUS and MRI (n = 26), or MDCT and MRI (n = 11). Intermodality agreement for assessment of tumor enhancement pattern was 67% (k = 0.294, P = 0.001). Typical enhancement pattern was detected coincidentally at two imaging modalities in 50 (52%) HCCs. Sensitivity for the diagnosis of HCC increased significantly using the 2010 AASLD (81/96 (84%) vs. 50/96 (52%), P < 0.001). Conclusions: Agreement between two imaging modalities for the detection of typical tumor enhancement pattern was reached in 52% of cases. The 2010 AASLD guidelines significantly increased the sensitivity for the diagnosis of HCC

  7. Ultrasonography and contrast-enhanced CT findings of tularemia in the neck.

    Science.gov (United States)

    Doğan, Serap; Ekinci, Afra; Demiraslan, Hayati; Ulu Kılıç, Ayşegül; Mavili, Ertuğrul; Öztürk, Mustafa; İmamoğlu, Hakan; Doğanay, Mehmet

    2016-01-01

    We aimed to evaluate the ultrasonography (US) and contrast-enhanced computed tomography (CECT) findings of tularemia in the neck. US and CECT findings of 58 patients with serologically proven tularemia were retrospectively evaluated. Forty-eight patients underwent US and 42 patients underwent CECT. Lymph node characteristics and parotid preauricular region involvement were analyzed using US and CECT. In addition, involvement of larynx, oropharynx, and retropharynx; presence of periorbital edema; and neck abscess formation were evaluated using CECT. Fine needle aspiration cytology (FNAC) results of enlarged lymph nodes were analyzed in 29 patients. Hypoechoic pattern, round shape, absence of hilum, and cystic necrosis were seen in most of the lymph nodes especially at level 2 and 3 on US and CECT. Matting was more commonly observed than irregular nodal border on US and CECT. Parotid preauricular region involvement was seen in 20.8% of patients on US. Oropharyngeal, retropharyngeal, laryngeal and parotid preauricular region involvement and periorbital edema were seen in 52.4%, 19.1%, 4.8%, 31%, and 9.5% of tularemia patients, respectively. Neck abscess was found in 59.5% of patients on CECT. Suppurative inflammation was the most common finding of FNAC. Tularemia should be considered in the presence of level 2 and 3 lymph nodes with cystic necrosis, matting, absence of calcification, oropharyngeal and retropharyngeal region involvement, and neck abscess, particularly in endemic areas.

  8. The value and limitations of contrast-enhanced transrectal ultrasonography for the detection of prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Han-Xue, E-mail: zhaohx861@163.com [Department of Diagnostic Ultrasound, Beijing Tongren Hospital, Capital Medical University, Dong-Jiao-Min-Xiang, Dong Cheng District, Beijing 100730 (China); Xia, Chun-Xia, E-mail: star9901482@163.com [Department of Diagnostic Ultrasound, Beijing Tongren Hospital, Capital Medical University, Dong-Jiao-Min-Xiang, Dong Cheng District, Beijing 100730 (China); Yin, Hong-Xia, E-mail: hongxia_yin79@yahoo.com.cn [Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Dong-Jiao-Min-Xiang, Dong Cheng District, Beijing 100730 (China); Guo, Ning, E-mail: ningguo99@sina.com.cn [Department of Diagnostic Ultrasound, Beijing Tongren Hospital, Capital Medical University, Dong-Jiao-Min-Xiang, Dong Cheng District, Beijing 100730 (China); Zhu, Qiang, E-mail: qzhutrhos@gmail.com [Department of Diagnostic Ultrasound, Beijing Tongren Hospital, Capital Medical University, Dong-Jiao-Min-Xiang, Dong Cheng District, Beijing 100730 (China)

    2013-11-01

    Objectives: To evaluate the role of contrast-enhanced transrectal ultrasonography (CE-TRUS) for detecting prostate carcinoma. Methods: Sixty-five patients with elevated serum prostate-specific antigen (PSA) and/or abnormal digital rectal examination (DRE) were assessed using transrectal ultrasound (TRUS) and CE-TRUS. In all the patients, CE-TRUS was performed with intravenous injection of contrast agent (SonoVue, 2.4 ml) before biopsy. The cancer detection rates of the two techniques were compared. False-positive and false-negative findings related to CE-TRUS were analyzed in comparison to the pathological results of biopsy or radical prostatectomy. The targeted biopsy to abnormal CE-TRUS areas was also compared to systematic biopsy. Results: Prostate cancer was detected in 29 of the 65 patients. CE-TRUS showed rapid focal enhancement or asymmetric vessels of peripheral zones in 28 patients; 23 of them had prostate cancer. CE-TRUS had 79.3% sensitivity, compared to 65.5% of TRUS (P < 0.05). There were five false-positive and six false-negative findings from CE-TRUS. Benign prostate hyperplasia, and acute and chronic prostatitis were important causes related to the false-positive results of CE-TRUS. Prostate cancer originating from the transition zone or peripheral zone with lower PSA levels, small-size foci, and moderately or well-differentiated tumor was missed by CE-TRUS. The cancer detection rate of targeted biopsy (75%, 33/44 cores) was significantly higher than one of systematic biopsy (48.2%, 162/336) in those 28 cases (P < 0.05). In addition, no significant correlation was found between the cancer detection rate with CE-TRUS and serum PSA levels. Conclusion: CE-TRUS may improve the detection rate of prostate cancer through targeted biopsy of contrast-enhanced abnormalities. Our findings indicate that systematic biopsies should not be eliminated on the basis of false-positive and false-negative findings related to CE-TRUS.

  9. Logistic regression analysis of conventional ultrasonography, strain elastosonography, and contrast-enhanced ultrasound characteristics for the differentiation of benign and malignant thyroid nodules.

    Science.gov (United States)

    Pang, Tiantian; Huang, Leidan; Deng, Yingyuan; Wang, Tianfu; Chen, Siping; Gong, Xuehao; Liu, Weixiang

    2017-01-01

    The aim of the study is to screen the significant sonographic features by logistic regression analysis and fit a model to diagnose thyroid nodules. A total of 525 pathological thyroid nodules were retrospectively analyzed. All the nodules underwent conventional ultrasonography (US), strain elastosonography (SE), and contrast -enhanced ultrasound (CEUS). Those nodules' 12 suspicious sonographic features were used to assess thyroid nodules. The significant features of diagnosing thyroid nodules were picked out by logistic regression analysis. All variables that were statistically related to diagnosis of thyroid nodules, at a level of p regression analysis model. The significant features in the logistic regression model of diagnosing thyroid nodules were calcification, suspected cervical lymph node metastasis, hypoenhancement pattern, margin, shape, vascularity, posterior acoustic, echogenicity, and elastography score. According to the results of logistic regression analysis, the formula that could predict whether or not thyroid nodules are malignant was established. The area under the receiver operating curve (ROC) was 0.930 and the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 83.77%, 89.56%, 87.05%, 86.04%, and 87.79% respectively.

  10. Double contrast-enhanced ultrasonography in the detection of periampullary cancer: Comparison with B-mode ultrasonography and MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Ting [Department of Medical Image Center, Zhujiang Hospital, Southern Medical University, Guangzhou (China); Department of Medical Ultrasonics, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou (China); Su, Zhong-zhen; Wang, Ping; Wu, Tao [Department of Medical Ultrasonics, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou (China); Tang, Wen [Department of Radiology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou (China); Xu, Er-jiao; Ju, Jin-xiu [Department of Medical Ultrasonics, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou (China); Quan, Xian-yue, E-mail: quanxianyue2014@163.com [Department of Medical Image Center, Zhujiang Hospital, Southern Medical University, Guangzhou (China); Zheng, Rong-qin, E-mail: zhengrq@mail.sysu.edu.cn [Department of Medical Ultrasonics, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou (China)

    2016-11-15

    Purpose: To investigate the value of double contrast-enhanced ultrasonography (DCEUS) in the detection of periampullary cancer. Materials and methods: Ninety-nine patients with surgery or biopsy-proven periampullary cancer who underwent both DCEUS and magnetic resonance imaging (MRI) examinations before operation were enrolled in our study. DCEUS in which intravenous microbubbles were used in combination with oral contrast agent and MRI were performed preoperatively to make a detection diagnosis of periampullary cancer. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of DCEUS, B-mode ultrasonography (BUS) and MRI were calculated and compared. Receiver operating characteristic (ROC) curves were used to evaluate the accuracy of BUS, DCEUS and MRI in the detection. Stratified analyses were performed for different pathological types and different sizes of periampullary lesions. The inter- and intra-observer reliability of DCEUS for cancer detection was also investigated. Result: There were no significant differences in sensitivity, specificity, PPV, NPV or accuracy between DCEUS and MRI (all P > 0.05). ROC analysis showed that the accuracy of DCEUS or MRI was higher than that of BUS (P < 0.001), while no significant differences were noted in the accuracy between DCEUS and MR. In the 76 cases of periampullary cancer, DCEUS appeared to be superior to BUS for ampullary carcinoma, duodenum carcinoma and for lesions with an average diameter of less than 3 cm. DCEUS appeared equal to BUS in other groups. No significant differences were noted between DCEUS and MRI in the stratified analysis. A considerably well agreement between DCEUS and MRI was obtained using Kappa analysis (k = 0.649, P < 0.001). The intra- and inter-observer reproducibility were both good for detection of periampullary cancer by DCEUS, with a Kappa values of 0.783 (P < 0.01) and 0.732 (P < 0.01), respectively. Conclusion: DCEUS provides an

  11. Preoperative radiological characterization of hepatic angiomyolipoma using magnetic resonance imaging and contrast-enhanced ultrasonography: a case report

    Directory of Open Access Journals (Sweden)

    Schmid Roland M

    2011-09-01

    Full Text Available Abstract Introduction A hepatic angiomyolipoma is a rare benign tumor of the liver composed of a mixture of smooth muscle cells, blood vessels and a variable amount of adipose tissue. Differentiating them from malignant liver tumors can often be very difficult. Case presentation We report the case of a 43-year-old Caucasian man presenting with a large liver mass in the right lobe. The results of magnetic resonance imaging and contrast-enhanced ultrasonography were consistent with a well-demarcated adipose tissue- containing tumor, showing prolonged hyperperfusion in comparison with the surrounding liver tissue. Surgery was performed and the diagnosis of hepatic angiomyolipoma was made with histopathology. Conclusion Preoperative radiological characterization using magnetic resonance imaging and contrast-enhanced ultrasonography may improve diagnostic accuracy of hepatic angiomyolipoma. Identification of smooth muscle cells, blood vessels and adipose tissue with a positive immunohistochemical reaction for HMB-45 is the final evidence for an angiomyolipoma.

  12. Contrast-enhanced ultrasound for diagnosis of prostate cancer and kidney lesions

    International Nuclear Information System (INIS)

    Mitterberger, Michael; Pelzer, Alexandre; Colleselli, Daniela; Bartsch, Georg; Strasser, Hannes; Pallwein, Leo; Aigner, Friedrich; Gradl, Johann; Frauscher, Ferdinand

    2007-01-01

    Purpose of review: Conventional ultrasonography of both, kidney and prostate, is limited due to the poor contrast of B-mode imaging for parenchymal disease and limited sensitivity of colour Doppler for the detection of capillaries and deep pedicular vessels. Contrast-enhanced ultrasound (CEUS) overcomes these limitations. Recent findings: CEUS investigates the blood flow of the prostate, allows for prostate cancer visualization and for targeted biopsies. Comparisons between systematic and CEUS-targeted biopsies have shown that the targeted approach detects more cancers with a lower number of biopsy cores and with higher Gleason scores compared with the systematic approach. Also the kidney offers promising applications as CEUS improves the detection of abnormal microvascular and macrovascular disorders. Summary: In recent literature CEUS has shown its value for diagnosis of both, prostate cancer and kidney lesions. This paper describes recent improvements and future perspectives of CEUS

  13. Contrast-enhanced transrectal ultrasonography for the detection of diffuse prostate cancer

    International Nuclear Information System (INIS)

    Gao, Y.; Liao, X.H.; Lu, L.; Wang, L.; Ma, Y.; Qin, H.Z.; Yan, X.; Guo, P.

    2016-01-01

    Aim: To evaluate the diagnostic accuracy of contrast-enhanced transrectal ultrasonography (CE-TRUS) versus baseline TRUS (combination of grey-scale and colour Doppler imaging) for diffuse prostate cancer. Materials and methods: Forty-six patients without an obvious focal mass on baseline TRUS (grey-scale and colour Doppler), underwent additional CE-TRUS and TRUS-guided biopsy due to elevated levels of prostate-specific antigen (PSA ≥4 ng/ml) and/or abnormal digital rectal examination (DRE). In all patients, CE-TRUS was performed with intravenous injection of a contrast agent (sulphur hexafluoride microbubble; SonoVue, 2.4 ml) before biopsy. TRUS-guided biopsy targeted suspicious areas detected on CE-TRUS imaging or sampled the outer gland of the normal prostate. The final diagnosis was based on results of the TRUS-guided biopsy. The diagnostic accuracy of baseline TRUS and CE-TRUS for diffuse prostatic lesions was evaluated using receiver operating characteristic (ROC) curve analysis. Results: Diffuse prostate cancer was present in 32 (69.5%) patients and absent in 14 (30.5%) patients. Nineteen patients had diffuse prostate cancer that was not detected by baseline TRUS, whereas 15 cases were identified using CE-TRUS. Conversely, five patients had benign prostatic hypertrophy (BPH) that was diagnosed as cancer by CE-TRUS, and two of these patients were diagnosed with BPH by baseline TRUS. The combined sensitivity, specificity, and accuracy were 87.5%, 64.2%, and 80.4%, respectively, for CE-TRUS, and 40.6%, 78.5%, and 52.1%, respectively, for baseline TRUS. The area under the ROC curve (AUC) values for the diagnostic accuracy of baseline CE-TRUS versus TRUS for diffuse prostate cancer differed significantly at 0.904 and 0.667, respectively (Z=4.098, p<0.0001). Conclusion: CE-TRUS exhibited greater diagnostic accuracy for diffuse prostate cancer than baseline TRUS. CE-TRUS may improve cancer detection over baseline TRUS imaging for the diagnosis of diffuse

  14. Contrast-enhanced ultrasonography in qualitative diagnosis of sentinel lymph node metastasis in breast cancer: A meta-analysis

    Directory of Open Access Journals (Sweden)

    Yi-Xia Zhang

    2015-01-01

    Conclusions: Our meta-analysis suggests that CEUS may have high a diagnostic accuracy in testing for metastatic SLN in breast cancer. Thus, CEUS may be a good tool for differential diagnosis between metastatic and non-metastatic SLN.

  15. [Diagnostic utility of endoscopic ultrasonography elastography and contrast-enhanced harmonic endoscopic ultrasonography in a patient with type 2 autoimmune pancreatitis].

    Science.gov (United States)

    Yokode, Masataka; Shiomi, Hideyuki; Itai, Ryosuke; Mikami, Sakae; Yamashita, Yukimasa; Nakano, Ryota; Ezaki, Takeshi; Masuda, Atsuhiro; Zen, Yoh

    2018-01-01

    A referring hospital diagnosed a 57-year-old man with a pancreatic head mass. The initial endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) was inconclusive because of the small sample size. Endoscopic ultrasonography elastography (EUS-EG) and contrast-enhanced harmonic endoscopic ultrasonography (CE-EUS), conducted at our institute, raised the possibility of mass-forming pancreatitis or autoimmune pancreatitis (AIP). A repeat EUS-FNA revealed inflammatory changes, including a neutrophilic duct injury suggestive of type 2 AIP. The pancreatic lesion responded well to the steroid therapy. The present case suggests that EUS-EG and CE-EUS may be useful for diagnostic exclusion of pancreatic cancers, and the combined use of EUS-EG and CE-EUS, with EUS-FNA, may help characterize inflammatory pancreatic lesions.

  16. EFFECT OF SEDATION ON CONTRAST-ENHANCED ULTRASONOGRAPHY OF THE SPLEEN IN HEALTHY DOGS.

    Science.gov (United States)

    Rossi, Federica; Fina, Caroline; Stock, Emmelie; Vanderperren, Katrien; Duchateau, Luc; Saunders, Jimmy H

    2016-05-01

    Contrast-enhanced ultrasound of the spleen enables the dynamic assessment of the perfusion of this organ, however, both subjective and quantitative evaluation can be strongly influenced by sedative agent administration. The purpose of this prospective, experimental study was to test effects of two sedative agents on splenic perfusion during contrast-enhanced ultrasound of the spleen in a sample of healthy dogs. Contrast-enhanced ultrasound of the spleen was repeated in six healthy Beagles following a cross-over study design comparing three protocols: awake, butorphanol 0.2 mg/Kg intramuscular (IM), and dexmedetomidine 500 μg/m(2) IM. After intravenous injection of a phospholipid stabilized sulfur hexafluoride microbubble solution (SonoVue®, Bracco Imaging, Milano, Italy), the enhancement intensity and perfusion pattern of the splenic parenchyma were assessed and perfusion parameters were calculated. Normal spleen was slightly heterogeneous in the early phase, but the parenchyma was homogeneous at a later phase. Sedation with butorphanol did not modify perfusion of the spleen. Dexmedetomidine significantly reduced splenic enhancement, providing diffuse parenchymal hypoechogenicity during the entire examination. Measured parameters were significantly modified, with increased arrival time (AT; (dogs. Short-term and diffuse heterogeneity of the spleen in the early venous phase was determined to be a normal finding. © 2016 American College of Veterinary Radiology.

  17. A contrast enhancement method for improving the segmentation of breast lesions on ultrasonography.

    Science.gov (United States)

    Flores, Wilfrido Gómez; Pereira, Wagner Coelho de Albuquerque

    2017-01-01

    This paper presents an adaptive contrast enhancement method based on sigmoidal mapping function (SACE) used for improving the computerized segmentation of breast lesions on ultrasound. First, from the original ultrasound image an intensity variation map is obtained, which is used to generate local sigmoidal mapping functions related to distinct contextual regions. Then, a bilinear interpolation scheme is used to transform every original pixel to a new gray level value. Also, four contrast enhancement techniques widely used in breast ultrasound enhancement are implemented: histogram equalization (HEQ), contrast limited adaptive histogram equalization (CLAHE), fuzzy enhancement (FEN), and sigmoid based enhancement (SEN). In addition, these contrast enhancement techniques are considered in a computerized lesion segmentation scheme based on watershed transformation. The performance comparison among techniques is assessed in terms of both the quality of contrast enhancement and the segmentation accuracy. The former is quantified by the measure, where the greater the value, the better the contrast enhancement, whereas the latter is calculated by the Jaccard index, which should tend towards unity to indicate adequate segmentation. The experiments consider a data set with 500 breast ultrasound images. The results show that SACE outperforms its counterparts, where the median values for the measure are: SACE: 139.4, SEN: 68.2, HEQ: 64.1, CLAHE: 62.8, and FEN: 7.9. Considering the segmentation performance results, the SACE method presents the largest accuracy, where the median values for the Jaccard index are: SACE: 0.81, FEN: 0.80, CLAHE: 0.79, HEQ: 77, and SEN: 0.63. The SACE method performs well due to the combination of three elements: (1) the intensity variation map reduces intensity variations that could distort the real response of the mapping function, (2) the sigmoidal mapping function enhances the gray level range where the transition between lesion and background

  18. Is Contrast Enhanced Ultrasonography a useful tool in a beginner's hand? How much can a Computer Assisted Diagnosis prototype help in characterizing the malignancy of focal liver lesions?

    Science.gov (United States)

    Moga, Tudor Voicu; Popescu, Alina; Sporea, Ioan; Danila, Mirela; David, Ciprian; Gui, Vasile; Iacob, Nicoleta; Miclaus, Gratian; Sirli, Roxana

    2017-08-23

    Contrast enhanced ultrasound (CEUS) improved the characterization of focal liver lesions (FLLs), but is an operatordependent method. The goal of this paper was to test a computer assisted diagnosis (CAD) prototype and to see its benefit in assisting a beginner in the evaluation of FLLs. Our cohort included 97 good quality CEUS videos[34% hepatocellular carcinomas (HCC), 12.3% hypervascular metastases (HiperM), 11.3% hypovascular metastases (HipoM), 24.7% hemangiomas (HMG), 17.5% focal nodular hyperplasia (FNH)] that were used to develop a CAD prototype based on an algorithm that tested a binary decision based classifier. Two young medical doctors (1 year CEUS experience), two experts and the CAD prototype, reevaluated 50 FLLs CEUS videos (diagnosis of benign vs. malignant) first blinded to clinical data, in order to evaluate the diagnostic gap beginner vs. expert. The CAD classifier managed a 75.2% overall (benign vs. malignant) correct classification rate. The overall classification rates for the evaluators, before and after clinical data were: first beginner-78%; 94%; second beginner-82%; 96%; first expert-94%; 100%; second expert-96%; 98%. For both beginners, the malignant vs. benign diagnosis significantly improved after knowing the clinical data (p=0.005; p=0,008). The expert was better than the beginner (p=0.04) and better than the CAD (p=0.001). CAD in addition to the beginner can reach the expert diagnosis. The most frequent lesions misdiagnosed at CEUS were FNH and HCC. The CAD prototype is a good comparing tool for a beginner operator that can be developed to assist the diagnosis. In order to increase the classification rate, the CAD system for FLL in CEUS must integrate the clinical data.

  19. Vesicoureteral reflux in children: comparison of contrast - enhanced voiding ultrasonography with radiographic voiding cystourethrography - preliminary report

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Chong Hyun; Kim, Hyun Joo; Goo, Hyun Woo; Kim, Hungy; Lee, Jung Joo; Kim, Ellen Ai-Rhan; Kim, Ki Soo; Park, Young Seo; Pi, Soo Young [Ulsan Univ. College of Medicine, Seoul (Korea, Republic of)

    2001-01-01

    To compared the usefullness of contrst-enhanced voiding ultrasonogrphy (US) with that of radiogrphic voiding cystourethrography (VCUG) for the diagnosis of vesicoureteral reflux (VUR) in children. Ninety-five kidney-ureter units of 47 patients referred for investigation of VUR underwent contrast -enhanced voiding US followed by radiographic VCUG. After baseline US examination of the urinaru tract, residual urine in the bladder was drained through an inserted Foley catheter and the bladder was gravityfilled at a height of 1 m with normal saline. A galactose-based, microbubble-containning echo-enhancing agent (Lvovist; Dchering, Berlin, Germany) was then administered. The amount of this was approximately 10% of bldder capacity, and VUR was diagnosed when microbubbles appeared in the ureter or pelvocalyceal system. Using radiographic VCUG as a reference point, the accuracy with which contrst-enhanced voiding US detected VUR was calcilated. In 87 of 95 kidney-ureter units (91.6%), the two methods showed similiar results regarding the diagnosis or exclusion of VUR, which was detected by both in 12 units, but by neither in 75. VUR was shown to occcur in a total of 20 units, but in eight of these by one method only. In two units, VUR detected by contrast-enhanced voiding US was was not demostarted by radiographic VCUG; in six units, the resverse was true. In the detection of VUR, contrast-enhanced voiding us showed a sensitivity of 66.7%, a sprcificity of 97.4%, a positive predictive value of 85.7%, and a negative predictive value of 92.6%. Contrst-enhanced voiding US is highly specific and has high positive and nagative predictive values; its sensitivity, however, is not sufficiently high. The modality appears to be a useful diagnostic tool for the detection of VUR without exposure to ionizing radiation, though to be certain of its value, more experience of its use its first required.

  20. Vesicoureteral reflux in children: comparison of contrast - enhanced voiding ultrasonography with radiographic voiding cystourethrography - preliminary report

    International Nuclear Information System (INIS)

    Yoon, Chong Hyun; Kim, Hyun Joo; Goo, Hyun Woo; Kim, Hungy; Lee, Jung Joo; Kim, Ellen Ai-Rhan; Kim, Ki Soo; Park, Young Seo; Pi, Soo Young

    2001-01-01

    To compared the usefullness of contrst-enhanced voiding ultrasonogrphy (US) with that of radiogrphic voiding cystourethrography (VCUG) for the diagnosis of vesicoureteral reflux (VUR) in children. Ninety-five kidney-ureter units of 47 patients referred for investigation of VUR underwent contrast -enhanced voiding US followed by radiographic VCUG. After baseline US examination of the urinaru tract, residual urine in the bladder was drained through an inserted Foley catheter and the bladder was gravityfilled at a height of 1 m with normal saline. A galactose-based, microbubble-containning echo-enhancing agent (Lvovist; Dchering, Berlin, Germany) was then administered. The amount of this was approximately 10% of bldder capacity, and VUR was diagnosed when microbubbles appeared in the ureter or pelvocalyceal system. Using radiographic VCUG as a reference point, the accuracy with which contrst-enhanced voiding US detected VUR was calcilated. In 87 of 95 kidney-ureter units (91.6%), the two methods showed similiar results regarding the diagnosis or exclusion of VUR, which was detected by both in 12 units, but by neither in 75. VUR was shown to occcur in a total of 20 units, but in eight of these by one method only. In two units, VUR detected by contrast-enhanced voiding US was was not demostarted by radiographic VCUG; in six units, the resverse was true. In the detection of VUR, contrast-enhanced voiding us showed a sensitivity of 66.7%, a sprcificity of 97.4%, a positive predictive value of 85.7%, and a negative predictive value of 92.6%. Contrst-enhanced voiding US is highly specific and has high positive and nagative predictive values; its sensitivity, however, is not sufficiently high. The modality appears to be a useful diagnostic tool for the detection of VUR without exposure to ionizing radiation, though to be certain of its value, more experience of its use its first required

  1. Irregular vascular pattern by contrast-enhanced ultrasonography and high serum Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein level predict poor outcome after successful radiofrequency ablation in patients with early-stage hepatocellular carcinoma.

    Science.gov (United States)

    Takada, Hitomi; Tsuchiya, Kaoru; Yasui, Yutaka; Nakakuki, Natsuko; Tamaki, Nobuharu; Suzuki, Shoko; Nakanishi, Hiroyuki; Itakura, Jun; Takahashi, Yuka; Kurosaki, Masayuki; Asahina, Yasuhiro; Enomoto, Nobuyuki; Izumi, Namiki

    2016-11-01

    Radiofrequency ablation (RFA) is considered the most effective treatment for early-stage hepatocellular carcinoma (HCC) patients unsuitable for resection. However, poor outcome after RFA has occasionally been reported worldwide. To predict such an outcome, we investigated imaging findings using contrast-enhanced ultrasonography (CEUS) with Sonazoid and serum tumor markers before RFA. This study included 176 early-stage HCC patients who had initially achieved successful RFA. Patients were examined using CEUS; their levels of alpha-fetoprotein (AFP), Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), and des-gamma-carboxy prothrombin before RFA were measured. Sonazoid provided parenchyma-specific contrast imaging and facilitated tumor vascular architecture imaging through maximum intensity projection (MIP). Kaplan-Meier analysis examined cumulative rates of local tumor progression, intrasubsegmental recurrence, and survival; factors associated with these were determined with Cox proportional hazards analysis. Local tumor progression (n = 15), intrasubsegmental recurrence (n = 46), and death (n = 18) were observed. Irregular pattern in MIP classification and serum AFP-L3 level (>10%) before RFA were identified as independent risk factors for local tumor progression and intrasubsegmental recurrence. These two factors were independently associated with poor survival after RFA (irregular pattern in MIP: hazard ratio, (HR) = 8.26; 95% confidence interval, (CI) = 2.24-30.3; P = 0.002 and AFP-L3 > 10%: HR = 2.94; 95% CI = 1.09-7.94; P = 0.033). Irregular MIP pattern by CEUS and high level of serum AFP-L3 were independent risk factors for poor outcome after successful RFA. The Patients with these findings should be considered as special high-risk group in early-stage HCC. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  2. Contrast-enhanced Harmonic power Doppler ultrasonography: Improved depiction of vascularity and characterization of flow pattern in hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Baek, Hyung Chul; Yoon, Kwon Ha; Kim, Chang Guhn; Park, Ki Han; Won, Jong Jin

    2000-01-01

    To evaluate the value of contrast-enhanced harmonic power Doppler ultrasonography (PDUS) in depiction and characterization of tumoral vascularity in hepatocellular carcinoma (HCC). Thirty-three patients with HCC were prospectively evaluated with harmonic PDUS before and after injection of the contrast agent SH U 508A (2.5g, 300 mg/ml ). Unenhanced and serial dynamic scans at 15, 30, 45, 60, 90, 120, 150, 180, 240, 300 seconds after injection of contrast agents were obtained using a tissue harmonic technique with power Doppler imaging. The tumoral vascularity was expressed as percentage of power Doppler area, which was measured quantitatively by a computerized program (Ultrasonic Imaging Tool; Soongsil University, Seoul, Korea). The grade (0, no signal; 1, less than 5%; 2, 5-25%; 3, more than 25%) and flow pattern (intratumoral, detour, basket, and mixed) of tumoral vascularity were analyzed. Peak time of contrast-enhancement was measured on each tumor. After injection of contrast agent, tumoral flow signals increased in all lesions (100%). At unenhanced harmonic PDUS, flow signals were detected in 17 HCCs (52%); 15 tumors (46%) demonstrated grade 1 vascularity; and two (6%), grade 2. At contrast-enhanced harmonic PDUS, all tumors were detected vascularity; five (15%) were grade 1; eight (24%), grade 2; and 20 (61%), grade 3. Flow patterns were demonstated as follows at unenhanced harmonic PDUS; intratumoral pattern in 13 tumors (76%), detour in 2 (12%), and basket in 2 (12%). After injection of contrast agent, intratumoral pattern in 7 tumors (21%), detour 0 (0%), basket in 3 (9%) and mixed in 23 (70%) were demonstrated. Peak time of enhancement after injection of contrast agent was 30- 90 seconds in majority of the patients. Contrast-enhanced harmonic PDUS would be valuable in depiction of vascularity and characterization of flow pattern in HCC.

  3. Contrast-enhanced Harmonic power Doppler ultrasonography: Improved depiction of vascularity and characterization of flow pattern in hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Hyung Chul; Yoon, Kwon Ha; Kim, Chang Guhn; Park, Ki Han; Won, Jong Jin [Wonkwang University School of Medicine, Iksa (Korea, Republic of)

    2000-12-15

    To evaluate the value of contrast-enhanced harmonic power Doppler ultrasonography (PDUS) in depiction and characterization of tumoral vascularity in hepatocellular carcinoma (HCC). Thirty-three patients with HCC were prospectively evaluated with harmonic PDUS before and after injection of the contrast agent SH U 508A (2.5g, 300 mg/ml ). Unenhanced and serial dynamic scans at 15, 30, 45, 60, 90, 120, 150, 180, 240, 300 seconds after injection of contrast agents were obtained using a tissue harmonic technique with power Doppler imaging. The tumoral vascularity was expressed as percentage of power Doppler area, which was measured quantitatively by a computerized program (Ultrasonic Imaging Tool; Soongsil University, Seoul, Korea). The grade (0, no signal; 1, less than 5%; 2, 5-25%; 3, more than 25%) and flow pattern (intratumoral, detour, basket, and mixed) of tumoral vascularity were analyzed. Peak time of contrast-enhancement was measured on each tumor. After injection of contrast agent, tumoral flow signals increased in all lesions (100%). At unenhanced harmonic PDUS, flow signals were detected in 17 HCCs (52%); 15 tumors (46%) demonstrated grade 1 vascularity; and two (6%), grade 2. At contrast-enhanced harmonic PDUS, all tumors were detected vascularity; five (15%) were grade 1; eight (24%), grade 2; and 20 (61%), grade 3. Flow patterns were demonstated as follows at unenhanced harmonic PDUS; intratumoral pattern in 13 tumors (76%), detour in 2 (12%), and basket in 2 (12%). After injection of contrast agent, intratumoral pattern in 7 tumors (21%), detour 0 (0%), basket in 3 (9%) and mixed in 23 (70%) were demonstrated. Peak time of enhancement after injection of contrast agent was 30- 90 seconds in majority of the patients. Contrast-enhanced harmonic PDUS would be valuable in depiction of vascularity and characterization of flow pattern in HCC.

  4. Can contrast-enhanced ultrasonography replace multidetector-computed tomography in the detection of liver metastases from colorectal cancer?

    DEFF Research Database (Denmark)

    Larsen, Lars P.S.; Rosenkilde, Mona; Christensen, Henrik

    2007-01-01

    . The examinations were interpreted blindly and the combination of US, CEUS, biphasic MDCT, IOUS, follow up and biopsy was the gold standard. RESULTS: Three hundred and sixty-five patients were included. All patients had undergone preoperative US, CEUS and MDCT and 65.5% had received IOUS. The gold standard found...

  5. Validity of Contrast Enhanced Ultrasonography and Dynamic Contrast Enhanced MR Enterography in the Assessment of Transmural Activity and Fibrosis in Crohn´s Disease

    DEFF Research Database (Denmark)

    Wilkens, Rune; Hagemann-Madsen, Rikke H; Peters, David A

    2018-01-01

    =0.006). No correlation was found between the severity of inflammation or fibrosis on histopathology and neither DCE-MRE (r=-0.13, p=0.54 for inflammation and r=0.41, p=0.05 for fibrosis) nor CEUS (r=0.16, p=0.45 for inflammation and r=-0.28, p=0.19 for fibrosis). Wall thickness assessed with US...... was correlated with both histological inflammation (r=0.611, p=0.0012) and fibrosis (r=0.399, p=0.048). The same was not true for MR (r=0.41, p=0.047 for inflammation and r=0.29, p=0.16 for fibrosis). Conclusions: Bowel wall thickness assessed with US is a valid marker of inflammation in small intestinal CD...

  6. Semi-automatic motion compensation of contrast-enhanced ultrasound images from abdominal organs for perfusion analysis

    Czech Academy of Sciences Publication Activity Database

    Schafer, S.; Nylund, K.; Saevik, F.; Engjom, T.; Mézl, M.; Jiřík, Radovan; Dimcevski, G.; Gilja, O.H.; Tönnies, K.

    2015-01-01

    Roč. 63, AUG 1 (2015), s. 229-237 ISSN 0010-4825 R&D Projects: GA ČR GAP102/12/2380 Institutional support: RVO:68081731 Keywords : ultrasonography * motion analysis * motion compensation * registration * CEUS * contrast-enhanced ultrasound * perfusion * perfusion modeling Subject RIV: FS - Medical Facilities ; Equipment Impact factor: 1.521, year: 2015

  7. 2D ultrasonography and contrast enhanced ultrasound for the evaluation of cavitating mesenteric lymph node syndrome in a patient with refractory celiac disease and enteropathy T cell lymphoma

    Directory of Open Access Journals (Sweden)

    Pojoga Cristina

    2013-02-01

    Full Text Available Abstract Background The cavitating mesenteric lymph node syndrome (CMLNS is a rare manifestation of celiac disease, with an estimated mortality rate of 50%. Specific infections and malignant lymphoma may complicate its clinical course and contribute to its poor prognosis. Diagnosing the underlying cause of CMLNS can be challenging. This is the first report on contrast enhanced ultrasound (CEUS findings in enteropathy associated T-cell lymphoma (EATL complicating CMLNS in a gluten-free compliant patient with persistent symptoms and poor outcome. Case presentation We present the case of a 51-year old Caucasian male patient, diagnosed with celiac disease and CMLNS. Despite his compliance to the gluten-free diet the symptoms persisted and we eventually considered the possible development of malignancy. No mucosal changes suggestive of lymphoma were identified with capsule endoscopy. Low attenuation mesenteric lymphadenopathy, without enlarged small bowel segments were seen on computed tomography. CEUS revealed arterial rim enhancement around the necrotic mesenteric lymph nodes, without venous wash-out. No malignant cells were identified on laparoscopic mesenteric lymph nodes biopsies. The patient died due to fulminant liver failure 14 months later; the histopathological examination revealed CD3/CD30-positive atypical T-cell lymphocytes in the liver, mesenteric tissue, spleen, gastric wall, kidney, lung and bone marrow samples; no malignant cells were present in the small bowel samples. Conclusions CEUS findings in EATL complicating CMLNS include arterial rim enhancement of the mesenteric tissue around the cavitating lymph nodes, without venous wash-out. This vascular pattern is not suggestive for neoangiogenesis, as arteriovenous shunts from malignant tissues are responsible for rapid venous wash-out of the contrast agent. CEUS failed to provide a diagnosis in this case.

  8. Analysis of contrast-enhanced ultrasonography using time-intensity curves in prostatic hyperplasia and prostate cancer

    International Nuclear Information System (INIS)

    Fang Junchu; Chen Ming; Sun Huifen

    2008-01-01

    Objective: To study the characters of time-intensity curve of contrast-enhanced ultrasonography in benign prostate hyperplasia (BPH) and prostate cancer. Methods: 2.4 ml Sono Vue were injected as a bolus in 40 patients, 23 patients with BPH and 17 with prostate cancer. High perfusion area in both inner and outer gland were measured with time-intensity curves. Results: It was proved by the time-intensity curves that, in BPH cases, the outer prostate gland presented with mild enhancedment and slow wash-off, while the inner gland presented with moderate enhancedment and fast wash-off. Otherwise, both the inner and outer gland in prostate cancer cases presented with high-intensitive enhancedment and slow wash-off. There was marked difference statistical significance on the up slop, average intensity and area under the time-intensity curves in 90 s and 150 s between the cases of BPH and prostate cancer (P<0.05, P<0.01). Conclusion: Quantitative analysis of high perfusion area in both inner and outer glands is helpful for diagnosing BPH and prostate cancer. (authors)

  9. Diagnostic performance of fluorodeoxyglucose-positron emission tomography/computed tomography of breast cancer in detecting axillary lymph node metastasis. Comparison with ultrasonography and contrast-enhanced CT

    International Nuclear Information System (INIS)

    Monzawa, Shuichi; Adachi, Shuji; Suzuki, Kayo; Hirokaga, Koichi; Takao, Shintaro; Sakuma, Toshiko; Hanioka, Keisuke

    2009-01-01

    The purpose of this retrospective study was to evaluate the diagnostic performance of positron emission tomography/computed tomography (PET/CT) with fluorine-18-labeled 2-fluoro-2-deoxy-D-glucose (FDG) in comparison with that of ultrasonography and contrast-enhanced computed tomography (CT) in detecting axillary lymph node metastasis in patients with breast cancer. Fifty patients with invasive breast cancer were recruited. They had received no neoadjuvant chemotherapy and underwent PET/CT, ultrasonography and contrast-enhanced CT before mastectomy. The clinical stage was I in 34 patients, II in 15 patients, and III in one patient. The images of these modalities were interpreted in usual practice before surgery and the diagnostic reports were reviewed for analysis. Sensitivity, specificity, positive predictive value, and negative predictive value of each modality were obtained taking histopathological results of axillary lymph node dissection or sentinel lymph node biopsy as the reference standard. Axillary lymph node metastasis was confirmed in 15 of 50 patients by histopathological studies. PET/CT identified lymph node metastasis in three of these 15 patients. The overall sensitivity and specificity, positive predictive value, and negative predictive value of PET/CT in the diagnosis of axillary lymph node metastasis were 20, 97, 75, and 74%, and those of ultrasonography were 33, 94, 71, and 77% and those of contrast-enhanced CT were 27, 97, 80, and 76%, respectively. PET/CT showed poor sensitivity and high specificity in the detection of axillary lymph node metastasis of breast cancer. Diagnostic performance of PET/CT was not superior to that of ultrasonography and contrast-enhanced CT. (author)

  10. The inter-observer agreement in the assessment of carotid plaque neovascularization by contrast-enhanced ultrasonography: The impact of plaque thickness.

    Science.gov (United States)

    Chen, Jian; Zhang, Yan-Ming; Song, Ze-Zhou; Fu, Yan-Fei; Geng, Yu

    2018-04-10

    The interobserver agreement in the assessment of the grade of carotid plaque neovascularization by contrast-enhanced ultrasonography is poorly established. We examined 140 carotid plaques in 66 patients (all patients had bilateral plaques, and 8 patients had 2 plaques on one side). We performed conventional and contrast-enhanced ultrasonography to analyze the presence of carotid plaque neovascularization, which was graded by two independent observers whose interobserver agreement (κ) was evaluated according to the thickness of carotid plaque. For all carotid plaques, the mean κ was 0.689 (95% confidence interval 0.604-0.774). It was 0.689 (0.569-0.808), 0.637 (0.487-0.787), and 0.740 (0.585-0.896), respectively for carotid plaques with maximal thickness 3 mm. The interobserver agreement for assessing carotid plaque neovascularization by using contrast-enhanced ultrasonography is substantial and acceptable for research purposes, regardless of the maximal thickness of the plaque. © 2018 Wiley Periodicals, Inc.

  11. Added Value of Contrast-Enhanced Ultrasound on Biopsies of Focal Hepatic Lesions Invisible on Fusion Imaging Guidance.

    Science.gov (United States)

    Kang, Tae Wook; Lee, Min Woo; Song, Kyoung Doo; Kim, Mimi; Kim, Seung Soo; Kim, Seong Hyun; Ha, Sang Yun

    2017-01-01

    To assess whether contrast-enhanced ultrasonography (CEUS) with Sonazoid can improve the lesion conspicuity and feasibility of percutaneous biopsies for focal hepatic lesions invisible on fusion imaging of real-time ultrasonography (US) with computed tomography/magnetic resonance images, and evaluate its impact on clinical decision making. The Institutional Review Board approved this retrospective study. Between June 2013 and January 2015, 711 US-guided percutaneous biopsies were performed for focal hepatic lesions. Biopsies were performed using CEUS for guidance if lesions were invisible on fusion imaging. We retrospectively evaluated the number of target lesions initially invisible on fusion imaging that became visible after applying CEUS, using a 4-point scale. Technical success rates of biopsies were evaluated based on histopathological results. In addition, the occurrence of changes in clinical decision making was assessed. Among 711 patients, 16 patients (2.3%) were included in the study. The median size of target lesions was 1.1 cm (range, 0.5-1.9 cm) in pre-procedural imaging. After CEUS, 15 of 16 (93.8%) focal hepatic lesions were visualized. The conspicuity score was significantly increased after adding CEUS, as compared to that on fusion imaging (p making for 11 of 16 patients (68.8%). The addition of CEUS could improve the conspicuity of focal hepatic lesions invisible on fusion imaging. This dual guidance using CEUS and fusion imaging may affect patient management via changes in clinical decision-making.

  12. Growing indications for CEUS: The kidney, testis, lymph nodes, thyroid, prostate, and small bowel

    Energy Technology Data Exchange (ETDEWEB)

    Cantisani, V., E-mail: vito.cantisani@uniroma1.it [Department of Radiology, Anatomopathology and Oncology, “Sapienza” University of Rome (Italy); Bertolotto, M. [Department of Radiology, University of Trieste (Italy); Weskott, H.P. [Central Ultrasound Department, Klinikum Siloah , Hannover (Germany); Romanini, L. [University Hospital of Pavia (Italy); Grazhdani, H. [Department of Radiology, Anatomopathology and Oncology, “Sapienza” University of Rome (Italy); Passamonti, M. [Dipartimento di Scienze Radiologiche, Ospedale di Lodi (Italy); Drudi, F.M.; Malpassini, F. [Department of Radiology, Anatomopathology and Oncology, “Sapienza” University of Rome (Italy); Isidori, A. [Department of Experimental Medicine, “Sapienza” University of Rome, Rome (Italy); Meloni, F.M. [Dipartimento servizi diagnostici, Ospedale Valduce, Como (Italy); Calliada, F. [University Hospital of Pavia (Italy); D’Ambrosio, F. [Department of Radiology, Anatomopathology and Oncology, “Sapienza” University of Rome (Italy)

    2015-09-15

    Highlights: • Contrast enhanced ultrasonography (CEUS) is increasingly used for non-hepatic applications. • There is a growing clinical use for a variety of pathologies of the kidney, testis, and small bowel. • Updated knowledge for proper use of CEUS in uncommon fields is provided. - Abstract: Contrast enhanced ultrasonography (CEUS) is increasingly used for non-hepatic applications as well, so that nearly all organs have been investigated. Among them, there is a growing clinical use for a variety of pathologies of the kidney, testis, and small bowel. The possibility to differentiate benign from malignant nodes in cancer patients has been investigated. A new application is in the detection of sentinel nodes after intradermal microbubble injection. The need to distinguish thyroid nodules eligible for fine needle aspiration cytology has led to the use of CEUS in thyroid examinations as well. The potential of CEUS for prostate cancer detection has been extensively investigated, with encouraging initial results. Early promise, however, has not been fulfilled. New perspective regards evaluation of the extent of prostate tissue devascularization following ablative treatments.

  13. Growing indications for CEUS: The kidney, testis, lymph nodes, thyroid, prostate, and small bowel

    International Nuclear Information System (INIS)

    Cantisani, V.; Bertolotto, M.; Weskott, H.P.; Romanini, L.; Grazhdani, H.; Passamonti, M.; Drudi, F.M.; Malpassini, F.; Isidori, A.; Meloni, F.M.; Calliada, F.; D’Ambrosio, F.

    2015-01-01

    Highlights: • Contrast enhanced ultrasonography (CEUS) is increasingly used for non-hepatic applications. • There is a growing clinical use for a variety of pathologies of the kidney, testis, and small bowel. • Updated knowledge for proper use of CEUS in uncommon fields is provided. - Abstract: Contrast enhanced ultrasonography (CEUS) is increasingly used for non-hepatic applications as well, so that nearly all organs have been investigated. Among them, there is a growing clinical use for a variety of pathologies of the kidney, testis, and small bowel. The possibility to differentiate benign from malignant nodes in cancer patients has been investigated. A new application is in the detection of sentinel nodes after intradermal microbubble injection. The need to distinguish thyroid nodules eligible for fine needle aspiration cytology has led to the use of CEUS in thyroid examinations as well. The potential of CEUS for prostate cancer detection has been extensively investigated, with encouraging initial results. Early promise, however, has not been fulfilled. New perspective regards evaluation of the extent of prostate tissue devascularization following ablative treatments

  14. The 'humble' bubble: Contrast-enhanced ultrasound

    International Nuclear Information System (INIS)

    Marshall, Gill; Sykes, Anne; Berry, Jonathan; Jonker, Leon

    2011-01-01

    The use of contrast-enhanced ultrasound (CEUS) is increasing within the field of medical imaging. Ultrasonic contrast agent (UCA) contain gas microbubbles similar in size to red corpuscles which provide highly reflective interfaces, enabling dynamic demonstration of echogenic streams of the contrast within the anatomical area of interest on real-time grey scale ultrasound. Longevity of the microbubbles has been improved by changing their composition. The application of CEUS in the UK continues to grow, bringing it into territories historically occupied by computerised tomography (CT) scanning and magnetic resonance imaging (MRI). Hence, the role of CEUS may be of interest to all diagnostic imaging practitioners. Here we summarise the mode of action and use of CEUS, and its role within a range of applications. The potential risks of CEUS are compared to other contrast-enhanced imaging techniques. The benefits of CEUS and its implications for diagnostic imaging practice are also covered.

  15. Differential diagnosis between intraductal papillary mucinous neoplasm with an associated invasive carcinoma and pancreatic ductal adenocarcinoma on ultrasonography: the utility of echo intensity and contrast enhancement

    Energy Technology Data Exchange (ETDEWEB)

    Saito, Masato [Dept. of Radiology, Sapporo Teishinkai Hospital, Sapporo (Japan); Hirokawa, Naoki; Usami, Yoko; Someya, Masanori; Sakata, Kohichi [Dept. of Radiology, Sapporo Medical University School of Medicine, Sapporo (Japan)

    2017-07-15

    The aim of this study was to investigate the utility of echo intensity and contrast enhancement in the differential diagnosis between intraductal papillary mucinous neoplasm with an associated invasive carcinoma (IPMN-IC) and pancreatic ductal adenocarcinoma (PDAC) on ultrasonography. This study included eight and 37 patients who had pathologically confirmed IPMN-IC and PDAC, respectively, and were enrolled for a comparative analysis of the sonographic features of the tumors. In the quantitative echo intensity evaluation, the two groups were compared with respect to the difference between the tumor intensity and the pancreatic intensity (TI-PI) and between the tumor intensity and the vascular intensity (TI-VI). In the quantitative contrast enhancement evaluation, the increase in echo intensity (ΔTI) and increase in echo intensity per unit of time (slope) were compared between the groups. The echo intensity and contrast enhancement were also compared between the two groups in patients with T3-T4 disease. In addition, the correlations of the histological type, tumor size, stromal type, and T factor with echogenicity and contrast enhancement were analyzed. IPMN-IC had significantly greater echo intensity and contrast enhancement than PDAC (TI-PI, P=0.004; TI-VI, P=0.001; ΔTI, P=0.012; slope, P=0.002). In T3-T4 disease, IPMN-IC also showed greater echo intensity and faster enhancement than PDAC. Echo intensity and contrast enhancement were correlated with histological type (TI-PI, P=0.003; TI-VI, P<0.001; ΔTI, P=0.007; slope, P<0.001). IPMN-IC and PDAC can be differentiated by the quantitative evaluation of echo intensity and contrast enhancement.

  16. Radiofrequency ablation guided by contrast-enhanced ultrasound for hepatic malignancies: Preliminary results

    International Nuclear Information System (INIS)

    Dong, Y.; Wang, W.-P.; Gan, Y.-H.; Huang, B.-J.; Ding, H.

    2014-01-01

    Aim: To evaluate whether contrast-enhanced ultrasound (CEUS)-guided radiofrequency ablation (RFA) can be performed effectively in small hepatic malignancies that are invisible or poorly visualized at traditional grey-scale ultrasonography (US). Materials and methods: The institutional ethics committee approved the study, and all patients provided written informed consent before their enrolment. The study focused on 55 patients (43 men, 12 women, age 57.4 ± 10.9 years) with 60 hepatic lesions from May 2010 to March 2011. All lesions were treated with multipolar radiofrequency ablation (RFA). During the RFA procedure, with the injection of ultrasound contrast agent (sulphur hexafluoride; SonoVue, Bracco Imaging Spa, Milan, Italy), RFA was conducted under CEUS guidance when the optimal depiction of a lesion was obtained. Artificial pleural effusions were used in those cases obstructed by the lungs. Twenty-four hours after RFA, contrast-enhanced MRI was used as the reference standard to evaluate the primary effectiveness rate and complete tumour necrosis. The follow-up time was 12–24 months (median 15 months). Results: Among 60 hepatic malignancies, CEUS detected 57 lesions (95%), which was higher than that at US (26.6%). Artificial pleural effusions were performed in three cases, resulting in the detection of three additional lesions. The insertion of RFA electrodes was monitored by CEUS in all lesions. Immediately after RFA, complete tumour necrosis were achieved in all 60 lesions as apparent at MRI, for a primary effectiveness rate of 100%. Conclusion: CEUS-guided RFA is a promising technique for targeting and improving the efficiency of treatment of hepatic malignancies. - Highlights: • CEUS guided RFA improved the detectability of hepatic malignancies indistinctive on gray-scale ultrasound. • Pre-operation CEUS helped localization of indistinctive hepatic malignancies. • CEUS guided RFA of hepatic malignancies achieved a more complete ablation

  17. Relationship between Plaque Echo, Thickness and Neovascularization Assessed by Quantitative and Semi-quantitative Contrast-Enhanced Ultrasonography in Different Stenosis Groups.

    Science.gov (United States)

    Song, Yan; Feng, Jun; Dang, Ying; Zhao, Chao; Zheng, Jie; Ruan, Litao

    2017-12-01

    The aim of this study was to determine the relationship between plaque echo, thickness and neovascularization in different stenosis groups using quantitative and semi-quantitative contrast-enhanced ultrasound (CEUS) in patients with carotid atherosclerosis plaque. A total of 224 plaques were divided into mild stenosis (Quantitative and semi-quantitative methods were used to assess plaque neovascularization and determine the relationship between plaque echo, thickness and neovascularization. Correlation analysis revealed no relationship of neovascularization with plaque echo in the groups using either quantitative or semi-quantitative methods. Furthermore, there was no correlation of neovascularization with plaque thickness using the semi-quantitative method. The ratio of areas under the curve (RAUC) was negatively correlated with plaque thickness (r = -0.317, p = 0.001) in the mild stenosis group. With the quartile method, plaque thickness of the mild stenosis group was divided into four groups, with significant differences between the 1.5-2.2 mm and ≥3.5 mm groups (p = 0.002), 2.3-2.8 mm and ≥3.5 mm groups (p quantitative and quantitative CEUS methods characterizing neovascularization of plaque are equivalent with respect to assessing relationships between neovascularization, echogenicity and thickness. However, the quantitative method could fail for plaque <3.5 mm because of motion artifacts. Copyright © 2017 World Federation for Ultrasound in Medicine and Biology. Published by Elsevier Inc. All rights reserved.

  18. Comparison of Contrast-Enhanced Ultrasound and Computed Tomography in Classifying Endoleaks After Endovascular Treatment of Abdominal Aorta Aneurysms: Preliminary Experience

    International Nuclear Information System (INIS)

    Carrafiello, Gianpaolo; Lagana, Domenico; Recaldini, Chiara; Mangini, Monica; Bertolotti, Elena; Caronno, Roberto; Tozzi, Matteo; Piffaretti, Gabriele; Annibale Genovese, Eugenio; Fugazzola, Carlo

    2006-01-01

    The purpose of the study was to assess the effectiveness of contrast-enhanced ultrasonography (CEUS) in endoleak classification after endovascular treatment of an abdominal aortic aneurysm compared to computed tomography angiography (CTA). From May 2001 to April 2003, 10 patients with endoleaks already detected by CTA underwent CEUS with Sonovue (registered) to confirm the CTA classification or to reclassify the endoleak. In three conflicting cases, the patients were also studied with conventional angiography. CEUS confirmed the CTA classification in seven cases (type II endoleaks). Two CTA type III endoleaks were classified as type II using CEUS and one CTA type II endoleak was classified as type I by CEUS. Regarding the cases with discordant classification, conventional angiography confirmed the ultrasound classification. Additionally, CEUS documented the origin of type II endoleaks in all cases. After CEUS reclassification of endoleaks, a significant change in patient management occurred in three cases. CEUS allows a better attribution of the origin of the endoleak, as it shows the flow in real time. CEUS is more specific than CTA in endoleak classification and gives more accurate information in therapeutic planning

  19. Harmonic Contrast-Enhanced Endoscopic Ultrasonography for the Guidance of Fine-Needle Aspiration in Solid Pancreatic Masses

    DEFF Research Database (Denmark)

    Seicean, A; Badea, R; Moldovan-Pop, A

    2015-01-01

    Purpose: The global accuracy of fine-needle aspiration guided by endoscopic ultrasound (EUS-FNA) for pancreatic adenocarcinoma is about 85 %. The use of contrast agents during EUS to highlight vessels and the necrotic parts of pancreatic masses may improve biopsy guidance. Our aim was to assess...... whether the guidance of FNA by harmonic contrast-enhanced endoscopic ultrasound (CH-EUS) would increase diagnostic accuracy relative to conventional EUS-FNA in the same pancreatic masses. Patients and Methods: In a prospective study, EUS-FNA was performed in patients with pancreatic masses on CT scan......, followed by harmonic CH-EUS using SonoVue. A second cluster of CH-EUS-FNA was performed on contrast-enhanced images. The final diagnosis was based on the results of EUS-FNA and surgery, or the findings after 12 months' follow-up. Results: The final diagnosis was adenocarcinoma (n = 35), chronic...

  20. Quantitative Assessment of Synovial Vascularity Using Contrast-Enhanced Power Doppler Ultrasonography: Correlation with Histologic Findings and MR Imaging Findings in Arthritic Rabbit Knee Model

    International Nuclear Information System (INIS)

    Lee, Sang Hoon; Shin, Myung Jin; Kim, Seong Moon; Kim, Namkug; Suh, Sang Hyun; Suh, Jin Suck

    2008-01-01

    To validate contrast-enhanced power Doppler ultrasonography (PD US) for the evaluation of synovial vascularity in an arthritic rabbit knee model in correlation with MR and histological findings. Power Doppler ultrasonography was performed for carrageenin-induced arthritic left knee and control right knee of 13 rabbits, first without and then with sonic contrast agent enhancement (Levovist, Schering, Berlin Germany), followed by gadolinium-enhanced MR imaging. Synovial vascularity was quantitatively assessed by calculating the color pixel area in power Doppler sonography using a computer-aided image analysis program and by grading the enhancement on MR images: grade 1, enhancement of knee joint is less than one-third of the area; grade 2, one-third to two-thirds enhancement; and grade 3, more than two-thirds enhancement. Microvessel density (MVD) was measured on slides stained immunohistochemically for CD31 antigen for histological assessment. The mean area of color pixels in PD US changed from 4.37 to 16.42 mm 2 in the arthritic knee after enhancement (p 2 in the control knee (p 0.05). Sonic contrast-enhanced PD US improves the visualization of synovial vascularity and allows quantitative measurement in experimentally induced rabbit arthritic knees

  1. Comparison of the Mammography, Contrast-Enhanced Spectral Mammography and Ultrasonography in a Group of 116 patients.

    Science.gov (United States)

    Luczyńska, Elzbieta; Heinze, Sylwia; Adamczyk, Agnieszka; Rys, Janusz; Mitus, Jerzy W; Hendrick, Edward

    2016-08-01

    Mammography (MG) is the gold-standard in breast cancer detection - the only method documented to reduce breast cancer mortality. Breast ultrasound (US) has been shown to increase sensitivity to breast cancers in screening women with dense breasts. Contrast-enhanced spectral mammography (CESM) is a novel technique intensively developed in the last few years. The goal of this study was to compare the sensitivity, specificity and accuracy of MG, US and CESM in detecting malignant breast lesions. The study included 116 patients. All patients were symptomatic and underwent MG, US and CESM. A radiologist with 20 years of experience in US and MG breast imaging and 1 year of experience in CESM reviewed images acquired in each of the three modalities separately, within an interval of 14-30 days. All identified lesions were confirmed at core biopsy. BI-RADS classifications on US, MG and CESM were compared to histopathology. MG, CESM and US were compared among 116 patients with 137 lesions encountered. Sensitivity of CESM was 100%, significantly higher than that of MG (90%, p<0.004) or US (92%, p<0.01). CESM accuracy was 78%, also higher than MG (69%, p<0.004) and US (70%, p=0.03). There was no statistically significant difference between AUCs for CESM and US (both 0.83). The AUCs of both US and CESM, however, were significantly larger than that of MG (p<0.0004 for each). CESM permitted better detection of malignant lesions than both MG and US, read individually. CESM found lesion enhancement in some benign lesions, as well, yielding a rate of false-positive diagnoses similar to that of MG and US. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  2. Clinical value of elasticity imaging and contrast-enhanced ultrasound in the diagnosis of papillary thyroid microcarcinoma.

    Science.gov (United States)

    Li, Fengsheng; Zhang, Jianlei; Wang, Yunmei; Liu, Liwen

    2015-09-01

    The present study aimed to evaluate the value of elasticity imaging and contrast-enhanced ultrasonography (CEUS) in the differential diagnosis of papillary thyroid microcarcinoma (TMC). In total, 73 patients exhibiting a total of 80 small thyroid nodules, which were difficult to diagnose using conventional ultrasonography, underwent elasticity imaging and CEUS. The diagnostic findings were subsequently clarified by intraoperative and pathological examination, and the accuracy of the 2 diagnostic methods was compared. The correct diagnostic rate of CEUS was 85% (68/80 nodules), of which 6 cases of TMC were misdiagnosed as benign lesions and 6 benign nodules were misdiagnosed as TMC. By contrast, the accuracy rate of the elasticity imaging, based on the 5-point diagnostic method, was 92.5% (74/80 nodules), of which 3 cases of TMC were misdiagnosed as benign nodules and 3 benign nodules were misdiagnosed as TMC. Furthermore, elasticity imaging in the diagnosis of TMC was determined to have sensitivity, specificity and accuracy rates of 94.0, 90.0 and 92.5%, respectively, whereas the corresponding rates for CEUS were 88.0, 80.0 and 85.0%, respectively. Thus, ultrasonographic elasticity imaging exhibited significant advantages in the diagnosis of TMC compared with CEUS (Padvantage in the diagnosis of TMC; however, an elasticity score of ≥3 is of high clinical value as a diagnostic criterion for TMC.

  3. Bosniak classification system: a prospective comparison of CT, contrast-enhanced US, and MR for categorizing complex renal cystic masses.

    Science.gov (United States)

    Graumann, Ole; Osther, Susanne Sloth; Karstoft, Jens; Hørlyck, Arne; Osther, Palle Jörn Sloth

    2016-11-01

    Background The Bosniak classification was originally based on computed tomographic (CT) findings. Magnetic resonance (MR) and contrast-enhanced ultrasonography (CEUS) imaging may demonstrate findings that are not depicted at CT, and there may not always be a clear correlation between the findings at MR and CEUS imaging and those at CT. Purpose To compare diagnostic accuracy of MR, CEUS, and CT when categorizing complex renal cystic masses according to the Bosniak classification. Material and Methods From February 2011 to June 2012, 46 complex renal cysts were prospectively evaluated by three readers. Each mass was categorized according to the Bosniak classification and CT was chosen as gold standard. Kappa was calculated for diagnostic accuracy and data was compared with pathological results. Results CT images found 27 BII, six BIIF, seven BIII, and six BIV. Forty-three cysts could be characterized by CEUS, 79% were in agreement with CT (κ = 0.86). Five BII lesions were upgraded to BIIF and four lesions were categorized lower with CEUS. Forty-one lesions were examined with MR; 78% were in agreement with CT (κ = 0.91). Three BII lesions were upgraded to BIIF and six lesions were categorized one category lower. Pathologic correlation in six lesions revealed four malignant and two benign lesions. Conclusion CEUS and MR both up- and downgraded renal cysts compared to CT, and until these non-radiation modalities have been refined and adjusted, CT should remain the gold standard of the Bosniak classification.

  4. Liver metastases: Sulphur hexafluoride-enhanced ultrasonography for lesion detection: a systematic review

    NARCIS (Netherlands)

    Cabassa, Paolo; Bipat, Shandra; Longaretti, Laura; Morone, Mario; Maroldi, Roberto

    2010-01-01

    This is a systematic review to evaluate the accuracy of contrast-enhanced ultrasonography (CEUS) performed with "SonoVue" (sulphur hexafluoride) in the detection of hepatic metastases. The MEDLINE, EMBASE and COCHRANE Databases were searched, regardless of language, for relevant articles published

  5. Contrast-enhanced ultrasonographic spoke-wheel sign in hepatic focal nodular hyperplasia

    International Nuclear Information System (INIS)

    Yen, Y.-H.; Wang, J.-H.; Lu, S.-N.; Chen, T.-Y.; Changchien, C.-S.; Chen, C.-H.; Hung, C.-H.; Lee, C.-M.

    2006-01-01

    Background: To determine the utility of contrast-enhanced ultrasonography (CEUS) in assessing hepatic tumors with central feeding arteries found by color/power Doppler ultrasonograophy (CDUS/PDUS). Methods: We prospectively studied 37 hepatic tumors (34 patients), with a mean size of 2.9 cm and each having a central feeding artery, by CDUS/PDUS. The CEUS was performed with a galactose-based microbubble contrast agent. The detection of a spoke-wheel sign was interpreted as evidence of focal nodular hyperplasia (FNH). All patients underwent tumor biopsies or surgical resection. Results: CEUS showed a central feeding artery with a spoke-wheel sign in 36 tumors, including 34 FNHs and 2 hepatocellular carcinomas. The remaining tumor was demonstrated to be FNH despite the absence of a spoke-wheel sign as detected by CEUS. The sensitivity of the spoke-wheel sign or central scar for FNH was 97.1% (34/35), 40% (14/35), 28.6% (10/35), 50% (8/16) and 0% (0/15) for CEUS, CDUS/PDUS, dynamic computed tomography (CT) or magnetic resonance imaging (MRI), hepatic angiography and liver scintigraphy, respectively. The two hepatocellular carcinomas showed scirrhous changes histologically. Conclusions: CEUS is more sensitive than CDUS/PDUS, dynamic CT, MRI, hepatic angiography and liver scintigraphy in the detection of the spoke-wheel sign or central scar in FNH. Scirrhous hepatocellular carcinoma should be included in the differential diagnosis for liver tumors with spoke-wheel sign detected by CEUS

  6. Contrast-enhanced ultrasonographic spoke-wheel sign in hepatic focal nodular hyperplasia

    Energy Technology Data Exchange (ETDEWEB)

    Yen, Y.-H. [Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Kaohsiung 833, Taiwan (China); Wang, J.-H. [Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Kaohsiung 833, Taiwan (China)]. E-mail: wajing@adm.cgmh.org.tw; Lu, S.-N. [Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Kaohsiung 833, Taiwan (China); Chen, T.-Y. [Department of Radiology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, College of Medicine, Chang Gung University, Taoyuan, Taiwan (China); Changchien, C.-S. [Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Kaohsiung 833, Taiwan (China); Chen, C.-H. [Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Kaohsiung 833, Taiwan (China); Hung, C.-H. [Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Kaohsiung 833, Taiwan (China); Lee, C.-M. [Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Kaohsiung 833, Taiwan (China)

    2006-12-15

    Background: To determine the utility of contrast-enhanced ultrasonography (CEUS) in assessing hepatic tumors with central feeding arteries found by color/power Doppler ultrasonograophy (CDUS/PDUS). Methods: We prospectively studied 37 hepatic tumors (34 patients), with a mean size of 2.9 cm and each having a central feeding artery, by CDUS/PDUS. The CEUS was performed with a galactose-based microbubble contrast agent. The detection of a spoke-wheel sign was interpreted as evidence of focal nodular hyperplasia (FNH). All patients underwent tumor biopsies or surgical resection. Results: CEUS showed a central feeding artery with a spoke-wheel sign in 36 tumors, including 34 FNHs and 2 hepatocellular carcinomas. The remaining tumor was demonstrated to be FNH despite the absence of a spoke-wheel sign as detected by CEUS. The sensitivity of the spoke-wheel sign or central scar for FNH was 97.1% (34/35), 40% (14/35), 28.6% (10/35), 50% (8/16) and 0% (0/15) for CEUS, CDUS/PDUS, dynamic computed tomography (CT) or magnetic resonance imaging (MRI), hepatic angiography and liver scintigraphy, respectively. The two hepatocellular carcinomas showed scirrhous changes histologically. Conclusions: CEUS is more sensitive than CDUS/PDUS, dynamic CT, MRI, hepatic angiography and liver scintigraphy in the detection of the spoke-wheel sign or central scar in FNH. Scirrhous hepatocellular carcinoma should be included in the differential diagnosis for liver tumors with spoke-wheel sign detected by CEUS.

  7. Blood Flow Changes in Subsynovial Connective Tissue on Contrast-Enhanced Ultrasonography in Patients With Carpal Tunnel Syndrome Before and After Surgical Decompression.

    Science.gov (United States)

    Motomiya, Makoto; Funakoshi, Tadanao; Ishizaka, Kinya; Nishida, Mutsumi; Matsui, Yuichiro; Iwasaki, Norimasa

    2017-11-24

    Although qualitative alteration of the subsynovial connective tissue in the carpal tunnel is considered to be one of the most important factors in the pathophysiologic mechanisms of carpal tunnel syndrome (CTS), little information is available about the microcirculation in the subsynovial connective tissue in patients with CTS. The aims of this study were to use contrast-enhanced ultrasonography (US) to evaluate blood flow in the subsynovial connective tissue proximal to the carpal tunnel in patients with CTS before and after carpal tunnel release. The study included 15 volunteers and 12 patients with CTS. The blood flow in the subsynovial connective tissue and the median nerve was evaluated preoperatively and at 1, 2, and 3 months postoperatively using contrast-enhanced US. The blood flow in the subsynovial connective tissue was higher in the patients with CTS than in the volunteers. In the patients with CTS, there was a significant correlation between the blood flow in the subsynovial connective tissue and the median nerve (P = .01). The blood flow in both the subsynovial connective tissue and the median nerve increased markedly after carpal tunnel release. Our results suggest that increased blood flow in the subsynovial connective tissue may play a role in the alteration of the microcirculation within the median nerve related to the pathophysiologic mechanisms of CTS. The increase in the blood flow in the subsynovial connective tissue during the early postoperative period may contribute to the changes in intraneural circulation, and these changes may lead to neural recovery. © 2017 by the American Institute of Ultrasound in Medicine.

  8. A Case of Contiguous Primary Hepatic Marginal Zone B-Cell Lymphoma and Hemangioma Ultimately Diagnosed Using Contrast-Enhanced Ultrasonography

    Directory of Open Access Journals (Sweden)

    Kazue Shiozawa

    2015-02-01

    Full Text Available Primary hepatic marginal zone B-cell malignant lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma is extremely rare. We present a case in which a lesion was diagnosed as 2 contiguous tumors (MALT lymphoma and hemangioma using contrast-enhanced ultrasonography (US with sonazoid. There has been no previous case of contiguous hepatic MALT lymphoma and hemangioma. The present case was a female with no medical history. We detected a snowman-like appearance, which was a tumor of 15 mm in diameter with hypo- and hyper-echogenicities in the lateral and medial parts, respectively, in the Couinaud's segment (S6 of the liver on US. The tumor appeared as a single lesion with a low-density area in the unenhanced phase and prolonged enhancement in the equilibrium phases on dynamic CT. On MRI, the whole lesion showed a low-intensity signal on T1-weighted imaging, but isointensity in the lateral part and high intensity in the medial part were seen on T2-weighted imaging. On contrast-enhanced US, the lateral hypoechoic region was homogenously hyperenhanced in the early vascular phase, and the contrast medium was washed out after about 30 s; in contrast, the medial hyperechoic region was gradually stained from the margin toward the central region. The tumor showed a defect in both hypo- and hyperechoic regions in the postvascular phase. Hemangioma was suspected for the medial part based on the typical image findings, but the lateral part was not given a diagnosis. Thus, surgical resection was performed. The medial part was a hemangioma, and the lateral part was a MALT lymphoma by histopathological findings.

  9. Contrast enhanced ultrasound in the assessment of urogenital pathology

    Directory of Open Access Journals (Sweden)

    Libero Barozzi

    2014-12-01

    Full Text Available Contrast enhanced ultrasound (CEUS is an innovative technique that employs microbubble contrast agents to demonstrate parenchymal perfusion. Although initial clinical application was focused on the liver pathology, a wide variety of clinical conditions can be assessed now with CEUS. CEUS is a well-tolerated technique and is acquiring an increasing role in the assessment of renal pathology because contrast agents are not excreted by the kidney and do not affect the renal function. CEUS demonstrated an accuracy similar to contrast enhanced multi-detector computed tomography (CEMDCT in detecting focal lesions, with the advantage of the real-time assessment of microvascular perfusion by using time-intensity curves. The aim of this paper is to review the main indications of CEUS in the assessment of renal and urogenital pathology. Imaging examples are presented and described. Advantages and limitations of CEUS with reference to conventional US and CE-MDCT are discussed.

  10. Added value of contrast-enhanced ultrasound on biopsies of focal hepatic lesions invisible on fusion imaging guidance

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Tae Wook; Lee, Min Woo; Song, Kyoung Doo; Kim, Mimi; Kim, Seung Soo; Kim, Seong Hyun; Ha, Sang Yun [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2017-01-15

    To assess whether contrast-enhanced ultrasonography (CEUS) with Sonazoid can improve the lesion conspicuity and feasibility of percutaneous biopsies for focal hepatic lesions invisible on fusion imaging of real-time ultrasonography (US) with computed tomography/magnetic resonance images, and evaluate its impact on clinical decision making. The Institutional Review Board approved this retrospective study. Between June 2013 and January 2015, 711 US-guided percutaneous biopsies were performed for focal hepatic lesions. Biopsies were performed using CEUS for guidance if lesions were invisible on fusion imaging. We retrospectively evaluated the number of target lesions initially invisible on fusion imaging that became visible after applying CEUS, using a 4-point scale. Technical success rates of biopsies were evaluated based on histopathological results. In addition, the occurrence of changes in clinical decision making was assessed. Among 711 patients, 16 patients (2.3%) were included in the study. The median size of target lesions was 1.1 cm (range, 0.5–1.9 cm) in pre-procedural imaging. After CEUS, 15 of 16 (93.8%) focal hepatic lesions were visualized. The conspicuity score was significantly increased after adding CEUS, as compared to that on fusion imaging (p < 0.001). The technical success rate of biopsy was 87.6% (14/16). After biopsy, there were changes in clinical decision making for 11 of 16 patients (68.8%). The addition of CEUS could improve the conspicuity of focal hepatic lesions invisible on fusion imaging. This dual guidance using CEUS and fusion imaging may affect patient management via changes in clinical decision-making.

  11. Added value of contrast-enhanced ultrasound on biopsies of focal hepatic lesions invisible on fusion imaging guidance

    International Nuclear Information System (INIS)

    Kang, Tae Wook; Lee, Min Woo; Song, Kyoung Doo; Kim, Mimi; Kim, Seung Soo; Kim, Seong Hyun; Ha, Sang Yun

    2017-01-01

    To assess whether contrast-enhanced ultrasonography (CEUS) with Sonazoid can improve the lesion conspicuity and feasibility of percutaneous biopsies for focal hepatic lesions invisible on fusion imaging of real-time ultrasonography (US) with computed tomography/magnetic resonance images, and evaluate its impact on clinical decision making. The Institutional Review Board approved this retrospective study. Between June 2013 and January 2015, 711 US-guided percutaneous biopsies were performed for focal hepatic lesions. Biopsies were performed using CEUS for guidance if lesions were invisible on fusion imaging. We retrospectively evaluated the number of target lesions initially invisible on fusion imaging that became visible after applying CEUS, using a 4-point scale. Technical success rates of biopsies were evaluated based on histopathological results. In addition, the occurrence of changes in clinical decision making was assessed. Among 711 patients, 16 patients (2.3%) were included in the study. The median size of target lesions was 1.1 cm (range, 0.5–1.9 cm) in pre-procedural imaging. After CEUS, 15 of 16 (93.8%) focal hepatic lesions were visualized. The conspicuity score was significantly increased after adding CEUS, as compared to that on fusion imaging (p < 0.001). The technical success rate of biopsy was 87.6% (14/16). After biopsy, there were changes in clinical decision making for 11 of 16 patients (68.8%). The addition of CEUS could improve the conspicuity of focal hepatic lesions invisible on fusion imaging. This dual guidance using CEUS and fusion imaging may affect patient management via changes in clinical decision-making

  12. The contribution of contrast enhanced ultrasound for the characterization of benign liver lesions in clinical practice - a monocentric experience.

    Science.gov (United States)

    Martie, Alina; Bota, Simona; Sporea, Ioan; Sirli, Roxana; Popescu, Alina; Danila, Mirela

    2012-12-01

    Contrast-enhanced ultrasound (CEUS) uses second generation microbubble contrast agents and is considered to be a useful imaging method for focal liver lesions (FLLs) characterization. To observe if CEUS increases the diagnostic performance of benign FLLs as compared with standard ultrasonography examination (US). This is a single centre study developed during September 2009- December 2011 in the Department of Gastroenterology and Hepatology, in Timisoara. We evaluated 386 benign FLLs diagnosed by means of CEUS. Before performing CEUS, all FLLs were examined by US and Power Doppler techniques. At CEUS, the benign nature of a lesion was established by the absence of washout in the portal and late phase. The typical features observed using contrast, allowed their classification in a particular type of pathology, according to the 2008 EFSUMB Guidelines. From 386 benign FLLs, 81 (20.9%) of them were diagnosed in patients with chronic liver disease, while 305 (79.1%) were in patients without chronic hepatopathy. In 355 (92%) cases CEUS established a particular type of pathology. The most frequent lesions were: hemangiomas (37.5%), focal fatty alterations (24.8%), complex cysts (10.7%) and regenerative nodules (11.8%). Based on US we correctly estimated the positive diagnosis in 55.7% cases and using CEUS, the diagnostic performance increased up to 92%. In our study, by means of US the estimate positive diagnosis was made in 55.7% of cases. CEUS properly characterized 92% of benign FLLs and increased the diagnostic performance of these lesions, as compared with US.

  13. Enhancement pattern of hilar cholangiocarcinoma: Contrast-enhanced ultrasound versus contrast-enhanced computed tomography

    International Nuclear Information System (INIS)

    Xu Huixiong; Chen Lida; Xie Xiaoyan; Xie Xiaohua; Xu Zuofeng; Liu Guangjian; Lin Manxia; Wang Zhu; Lu Mingde

    2010-01-01

    Objective: To compare the enhancement pattern of hilar cholangiocarcinoma on contrast-enhanced ultrasound (CEUS) with that on contrast-enhanced computed tomography (CECT). Methods: Thirty-two consecutive patients with pathologically proven hilar cholangiocarcinomas were evaluated by both low mechanical index CEUS and CECT. The enhancement feature of the tumor, portal vein infiltration, and lesion conspicuity on them was investigated. Results: In the arterial phase, the numbers of the lesions showing hyperenhancement, isoenhancement, and hypoenhancement, were 14 (43.8%), 14 (43.8%), and 4 (12.6%), on CEUS, and 12 (37.5%), 9 (28.1%), and 11 (34.4%), on CECT (P = 0.162). In portal phase, the numbers of the lesions showing hypoenhancement, isoenhancement, and hyperenhancement were 30 (93.8%), 1 (3.1%), and 1 (3.1%), on CEUS, and 23 (71.9%), 8 (25.0%), and 1 (3.1%), on CECT (P = 0.046). The detection rates for portal vein infiltration were 84.2% (16/19) for baseline ultrasound, 89.5% (17/19) for CEUS, and 78.9% (15/19) for CECT (all P > 0.05 between every two groups). CEUS significantly improved the lesion conspicuity in comparison with CECT. CEUS and CECT made correct diagnoses in 30 (93.8%) and 25 (78.1%) lesions prior to pathological examination (P = 0.125). Conclusion: The enhancement pattern of hilar cholangiocarcinoma on CEUS was similar with that on CECT in arterial phase, whereas in portal phase hilar cholangiocarcinoma shows hypoenhancement more likely on CEUS. CEUS and CECT lead to similar results in evaluating portal vein infiltration and diagnosis of this entity.

  14. Enhancement pattern of hilar cholangiocarcinoma: Contrast-enhanced ultrasound versus contrast-enhanced computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Xu Huixiong, E-mail: xuhuixiong@hotmail.co [Department of Medical Ultrasonics, The First Affiliated Hospital, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou 510080 (China); Chen Lida; Xie Xiaoyan; Xie Xiaohua; Xu Zuofeng; Liu Guangjian; Lin Manxia; Wang Zhu [Department of Medical Ultrasonics, The First Affiliated Hospital, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou 510080 (China); Lu Mingde, E-mail: lumd@21cn.co [Department of Hepatobiliary Surgery, First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou 510080 (China)

    2010-08-15

    Objective: To compare the enhancement pattern of hilar cholangiocarcinoma on contrast-enhanced ultrasound (CEUS) with that on contrast-enhanced computed tomography (CECT). Methods: Thirty-two consecutive patients with pathologically proven hilar cholangiocarcinomas were evaluated by both low mechanical index CEUS and CECT. The enhancement feature of the tumor, portal vein infiltration, and lesion conspicuity on them was investigated. Results: In the arterial phase, the numbers of the lesions showing hyperenhancement, isoenhancement, and hypoenhancement, were 14 (43.8%), 14 (43.8%), and 4 (12.6%), on CEUS, and 12 (37.5%), 9 (28.1%), and 11 (34.4%), on CECT (P = 0.162). In portal phase, the numbers of the lesions showing hypoenhancement, isoenhancement, and hyperenhancement were 30 (93.8%), 1 (3.1%), and 1 (3.1%), on CEUS, and 23 (71.9%), 8 (25.0%), and 1 (3.1%), on CECT (P = 0.046). The detection rates for portal vein infiltration were 84.2% (16/19) for baseline ultrasound, 89.5% (17/19) for CEUS, and 78.9% (15/19) for CECT (all P > 0.05 between every two groups). CEUS significantly improved the lesion conspicuity in comparison with CECT. CEUS and CECT made correct diagnoses in 30 (93.8%) and 25 (78.1%) lesions prior to pathological examination (P = 0.125). Conclusion: The enhancement pattern of hilar cholangiocarcinoma on CEUS was similar with that on CECT in arterial phase, whereas in portal phase hilar cholangiocarcinoma shows hypoenhancement more likely on CEUS. CEUS and CECT lead to similar results in evaluating portal vein infiltration and diagnosis of this entity.

  15. Early quantification of the therapeutic efficacy of the vascular disrupting agent, CKD-516, using dynamic contrast-enhanced ultrasonography in rabbit VX2 liver tumors

    Energy Technology Data Exchange (ETDEWEB)

    Joo, Ijin; Kim, Jung Hoon; Lee, Jeong Min; Choi, Jin Woo; Han, Joon Koo; Choi, Byung Ihn [Dept. of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2014-03-15

    To evaluate the usefulness of dynamic contrast-enhanced ultrasonography (DCE-US) in the early quantification of hemodynamic change following administration of the vascular disrupting agent (VDA) CKD-516 using a rabbit VX2 liver tumor model. This study was approved by our institutional animal care and use committee. Eight VX2 liver-tumor-bearing rabbits were treated with intravenous CKD-516, and all underwent DCE-US using SonoVue before and again 2, 4, 6, and 24 hours following their treatment. The tumor perfusion parameters were obtained from the time-intensity curve of the DCE-US data. Repeated measures analysis of variance was performed to assess any significant change in tumor perfusion over time. Relative changes in the DCE-US parameters between the baseline and follow-up assessments were correlated with the relative changes in tumor size over the course of seven days using Pearson correlation. CKD-516 treatment resulted in significant changes in the DCE-US parameters, including the peak intensity, total area under the time-intensity curve (AUCtotal), and AUC during wash-out (AUCout) over time (P<0.05). Pairwise comparison tests revealed that the AUCtotal and AUC during wash-in (AUCin) seen on the two-hour follow-up were significantly lower than the baseline values (P<0.05). However, none of early changes in the DCE-US parameters until 24-hour follow-up showed a significant correlation with the relative changes in tumor size during seven days after CKD-516 treatment. Our results suggest that a novel VDA (CKD-516) can cause disruption of tumor perfusion as early as two hours after treatment and that the therapeutic effect of CKD-516 treatment can be effectively quantified using DCE-US.

  16. Selection of an early biomarker for vascular normalization using dynamic contrast-enhanced ultrasonography to predict outcomes of metastatic patients treated with bevacizumab.

    Science.gov (United States)

    Lassau, N; Coiffier, B; Kind, M; Vilgrain, V; Lacroix, J; Cuinet, M; Taieb, S; Aziza, R; Sarran, A; Labbe-Devilliers, C; Gallix, B; Lucidarme, O; Ptak, Y; Rocher, L; Caquot, L M; Chagnon, S; Marion, D; Luciani, A; Feutray, S; Uzan-Augui, J; Benatsou, B; Bonastre, J; Koscielny, S

    2016-10-01

    Dynamic contrast-enhanced ultrasonography (DCE-US) has been used for evaluation of tumor response to antiangiogenic treatments. The objective of this study was to assess the link between DCE-US data obtained during the first week of treatment and subsequent tumor progression. Patients treated with antiangiogenic therapies were included in a multicentric prospective study from 2007 to 2010. DCE-US examinations were available at baseline and at day 7. For each examination, a 3 min perfusion curve was recorded just after injection of a contrast agent. Each perfusion curve was modeled with seven parameters. We analyzed the correlation between criteria measured up to day 7 on freedom from progression (FFP). The impact was assessed globally, according to tumor localization and to type of treatment. The median follow-up was 20 months. The mean transit time (MTT) evaluated at day 7 was the only criterion significantly associated with FFP (P = 0.002). The cut-off point maximizing the difference between FFP curves was 12 s. Patients with at least a 12 s MTT had a better FFP. The results according to tumor type were significantly heterogeneous: the impact of MTT on FFP was more marked for breast cancer (P = 0.004) and for colon cancer (P = 0.025) than for other tumor types. Similarly, the differences in FFP according to MTT at day 7 were marked (P = 0.004) in patients receiving bevacizumab. The MTT evaluated with DCE-US at day 7 is significantly correlated to FFP of patients treated with bevacizumab. This criterion might be linked to vascular normalization. 2007-A00399-44. © The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  17. Detection of vascularity in wrist tenosynovitis: power doppler ultrasound compared with contrast-enhanced grey-scale ultrasound.

    Science.gov (United States)

    Klauser, Andrea S; Franz, Magdalena; Arora, Rohit; Feuchtner, Gudrun M; Gruber, Johann; Schirmer, Michael; Jaschke, Werner R; Gabl, Markus F

    2010-01-01

    We sought to assess vascularity in wrist tenosynovitis by using power Doppler ultrasound (PDUS) and to compare detection of intra- and peritendinous vascularity with that of contrast-enhanced grey-scale ultrasound (CEUS). Twenty-six tendons of 24 patients (nine men, 15 women; mean age ± SD, 54.4 ± 11.8 years) with a clinical diagnosis of tenosynovitis were examined with B-mode ultrasonography, PDUS, and CEUS by using a second-generation contrast agent, SonoVue (Bracco Diagnostics, Milan, Italy) and a low-mechanical-index ultrasound technique. Thickness of synovitis, extent of vascularized pannus, intensity of peritendinous vascularisation, and detection of intratendinous vessels was incorporated in a 3-score grading system (grade 0 to 2). Interobserver variability was calculated. With CEUS, a significantly greater extent of vascularity could be detected than by using PDUS (P < 0.001). In terms of peri- and intratendinous vessels, CEUS was significantly more sensitive in the detection of vascularization compared with PDUS (P < 0.001). No significant correlation between synovial thickening and extent of vascularity could be found (P = 0.089 to 0.097). Interobserver reliability was calculated to be excellent when evaluating the grading score (κ = 0.811 to 1.00). CEUS is a promising tool to detect tendon vascularity with higher sensitivity than PDUS by improved detection of intra- and peritendinous vascularity.

  18. Microwave ablation of liver metastases guided by contrast-enhanced ultrasound

    DEFF Research Database (Denmark)

    Lorentzen, T; Skjoldbye, B O; Nolsoe, C P

    2011-01-01

    The aim of our study was to evaluate the efficacy of microwave (MW) ablation of liver metastases guided by B-mode ultrasound (US) and contrast-enhanced US (CEUS).......The aim of our study was to evaluate the efficacy of microwave (MW) ablation of liver metastases guided by B-mode ultrasound (US) and contrast-enhanced US (CEUS)....

  19. Contrast-enhanced ultrasound evaluation of hepatic microvascular changes in liver diseases.

    Science.gov (United States)

    Ridolfi, Francesco; Abbattista, Teresa; Busilacchi, Paolo; Brunelli, Eugenio

    2012-10-07

    To assess if software assisted-contrast-enhanced ultrasonography (CEUS) provides reproducible perfusion parameters of hepatic parenchyma in patients affected by chronic liver disease. Forty patients with chronic viral liver disease, with (n = 20) or without (n = 20) cirrhosis, and 10 healthy subjects underwent CEUS and video recordings of each examination were then analysed with Esaote's Qontrast software. CEUS dedicated software Qontrast was used to determine peak (the maximum signal intensity), time to peak (TTP), region of blood value (RBV) proportional to the area under the time-intensity curve, mean transit time (MTT) measured in seconds and region of blood flow (RBF). Qontrast-assisted CEUS parameters displayed high inter-observer reproducibility (κ coefficients of 0.87 for MTT and 0.90 TTP). When the region of interest included a main hepatic vein, Qontrast-calculated TTP was significantly shorter in cirrhotic patients (vs non-cirrhotics and healthy subjects) (71.0 ± 11.3 s vs. 82.4 ± 15.6 s, 86.3 ± 20.3 s, P < 0.05). MTTs in the patients with liver cirrhosis were significantly shorter than those of controls (111.9 ± 22.0 s vs. 139.4 ± 39.8 s, P < 0.05), but there was no significant difference between the cirrhotic and non-cirrhotic groups (111.9 ± 22.0 s vs. 110.3 ± 14.6 s). Peak enhancement in the patients with liver cirrhosis was also higher than that observed in controls (23.9 ± 5.9 vs. 18.9 ± 7.1, P = 0.05). There were no significant intergroup differences in the RBVs and RBFs. Qontrast-assisted CEUS revealed reproducible differences in liver perfusion parameters during the development of hepatic fibrogenesis.

  20. Contrast Enhanced Ultrasound of the Kidneys: What Is It Capable of?

    Directory of Open Access Journals (Sweden)

    Demosthenes D. Cokkinos

    2013-01-01

    Full Text Available One of the many imaging uses of contrast enhanced ultrasound (CEUS is studying a wide variety of kidney pathology, due to its ability to detect microvascular blood flow in real time without affecting renal function. CEUS enables dynamic assessment and quantification of microvascularisation up to capillary perfusion. The objective of this paper is to briefly refresh basic knowledge of ultrasound (US contrast agents’ physical properties, to study technical details of CEUS scanning in the kidneys, and to review the commonest renal indications for CEUS, with imaging examples in comparison to baseline unenhanced US and computed tomography when performed. Safety matters and limitations of CEUS of the kidneys are also discussed.

  1. Detection of liver metastases in cancer patients with geographic fatty infiltration of the liver: the added value of contrast-enhanced sonography

    International Nuclear Information System (INIS)

    Bartolotta, Tommaso Vincenzo; Taibbi, Adele; Picone, Dario; Anastasi, Andrea; Midiri, Massimo; Lagalla, Roberto

    2017-01-01

    The aim of this study is to assess the role of contrast-enhanced ultrasonography (CEUS) in the detection of liver metastases in cancer patients with geographic liver fatty deposition on greyscale ultrasonography (US). Thirty-seven consecutive cancer patients (24 women and 13 men; age, 33 to 80 years; mean, 58.1 years) with geographic liver fatty deposition, but without any detectable focal liver lesion on greyscale US, underwent sulphur hexafluoride-enhanced US. Two readers reported by consensus the presence, size, and location of any detected lesion. All patients underwent magnetic resonance imaging (MRI) as a confirmatory study. Sensitivity, specificity, positive and negative predictive values (PPV and NPV), and accuracy were calculated. Seven focal liver lesions (size, 4 to 10 mm; mean, 6.1 mm) were detected in 4/37 patients (10.8%): four metastases (size, 5 to 10 mm; mean, 6.7 mm) were detected both by CEUS and MRI, with one hemangioma and two cysts (size range, 4 to 6 mm; mean, 5.3 mm) detected by MRI only. In 1/37 patients (2.7%), CEUS misdiagnosed geographic fatty change as three metastases. In 32/37 patients (86.5%), no lesions were detected. Sensitivity, specificity, PPV, NPV, and accuracy of CEUS were 100% (95% confidence Interval [CI], 1.000 to 1.000), 97.1% (95% CI, 0.914 to 1.027), 75%, 100%, and 97.3%, respectively. No statistically significant differences were found between CEUS and MRI in the detection of focal liver lesions (P=0.480), whereas both of them performed better than baseline US (P<0.001). CEUS improves the detection of liver metastases in cancer patients with geographic liver fatty deposition on greyscale US

  2. Detection of liver metastases in cancer patients with geographic fatty infiltration of the liver: the added value of contrast-enhanced sonography

    Energy Technology Data Exchange (ETDEWEB)

    Bartolotta, Tommaso Vincenzo; Taibbi, Adele; Picone, Dario; Anastasi, Andrea; Midiri, Massimo; Lagalla, Roberto [Dept. of Radiology-Di.Bi.Med., University of Palermo, Palermo (Italy)

    2017-04-15

    The aim of this study is to assess the role of contrast-enhanced ultrasonography (CEUS) in the detection of liver metastases in cancer patients with geographic liver fatty deposition on greyscale ultrasonography (US). Thirty-seven consecutive cancer patients (24 women and 13 men; age, 33 to 80 years; mean, 58.1 years) with geographic liver fatty deposition, but without any detectable focal liver lesion on greyscale US, underwent sulphur hexafluoride-enhanced US. Two readers reported by consensus the presence, size, and location of any detected lesion. All patients underwent magnetic resonance imaging (MRI) as a confirmatory study. Sensitivity, specificity, positive and negative predictive values (PPV and NPV), and accuracy were calculated. Seven focal liver lesions (size, 4 to 10 mm; mean, 6.1 mm) were detected in 4/37 patients (10.8%): four metastases (size, 5 to 10 mm; mean, 6.7 mm) were detected both by CEUS and MRI, with one hemangioma and two cysts (size range, 4 to 6 mm; mean, 5.3 mm) detected by MRI only. In 1/37 patients (2.7%), CEUS misdiagnosed geographic fatty change as three metastases. In 32/37 patients (86.5%), no lesions were detected. Sensitivity, specificity, PPV, NPV, and accuracy of CEUS were 100% (95% confidence Interval [CI], 1.000 to 1.000), 97.1% (95% CI, 0.914 to 1.027), 75%, 100%, and 97.3%, respectively. No statistically significant differences were found between CEUS and MRI in the detection of focal liver lesions (P=0.480), whereas both of them performed better than baseline US (P<0.001). CEUS improves the detection of liver metastases in cancer patients with geographic liver fatty deposition on greyscale US.

  3. Sentinel node detection in melanomas using contrast-enhanced ultrasound

    DEFF Research Database (Denmark)

    Nielsen, K. Rue; Klyver, H.; Chakera, A. Hougaard

    2009-01-01

    in humans. PURPOSE: To investigate the possible use of CEUS in detecting SN in patients with malignant melanomas (MM), and to improve the method by using different concentrations of contrast agent and various positions of the extremity. MATERIAL AND METHODS: Ten patients with MM on an extremity and one...... healthy volunteer were included. One milliliter of a contrast agent (Sonovue; Bracco, Milan, Italy) was injected subcutaneously on both sides of the scar from the excised tumor. Contrast-enhanced lymph channels and lymph nodes (LNs) were searched for using low-mechanical-index CEUS and by stimulated...... tissue damage, as the contrast agent was not registered for subcutaneous administration. RESULTS: In one patient, two contrast-enhanced inguinal LNs were visualized by CEUS, corresponding to two inguinal SNs found by scintigraphic imaging. No contrast-enhanced lymph channels or LNs were visualized in any...

  4. Ultrasound contrast-enhanced study as an imaging biomarker for anti-cancer drug treatment: preliminary study with paclitaxel in a xenograft mouse tumor model (secondary publication)

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hak Jong; Hwang, Sung Il; Jung, Hyun Sook; Kang, Mi Ra [Dept. of Radiology, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Byun, Jong Hoe; Kong, Hoon Young [Dept. of Molecular Biology, Dankook University, Cheonan (Korea, Republic of)

    2017-10-15

    The purpose of this study was to assess tumor angiogenesis using contrast-enhanced ultrasonography (CEUS) of human prostate cancer cells (PC3) that were implanted in mice before and after paclitaxel injection. Twelve mice were injected with human PC3. The mice were grouped into two groups; one was the paclitaxel-treated group (n=6) and the other was the control group (n=6). Before administering paclitaxel into the peritoneal cavity, baseline CEUS was performed after the administration of 500 μL (1×108 microbubbles) of contrast agent. The area under the curve (AUC) up to 50 seconds after injection was derived from the time-intensity curves. After injection of paclitaxel or saline, CEUS studies were performed at the 1-week follow-up. Changes in tumor volume and the AUC in both two groups were evaluated. After CEUS, the microvessel density (MVD) was compared between the groups. In the paclitaxel-treated group, the AUC from CEUS showed a significant decrease 1-week after paclitaxel administration (P=0.030), even though the tumor volume showed no significant changes (P=0.116). In the control group, there was no significant decrease of the AUC (P=0.173). Pathologically, there was a significant difference in MVD between both groups (P=0.002). The AUC from the time intensity curve derived from CEUS showed an early change in response to the anti-cancer drug treatment that preceded the change in tumor size. The findings of CEUS could serve as an imaging biomarker for assessing tumor responses to anti-cancer drug treatment.

  5. Usefulness of contrast-enhanced transabdominal ultrasound for tumor classification and tumor staging in the pancreatic head

    DEFF Research Database (Denmark)

    Grossjohann, Hanne Sønder; Rappeport, Eli David; Jensen, Claus Verner

    2010-01-01

    To evaluate contrast-enhanced ultrasound (CEUS) and compare it to ultrasound (US) and 64-slice-CT (64-CT) for diagnosing, staging and evaluation of resectability of pancreatic cancer.......To evaluate contrast-enhanced ultrasound (CEUS) and compare it to ultrasound (US) and 64-slice-CT (64-CT) for diagnosing, staging and evaluation of resectability of pancreatic cancer....

  6. Triphasic and epithelioid minimal fat renal angiomyolipoma and clear cell renal cell carcinoma: qualitative and quantitative CEUS characteristics and distinguishing features.

    Science.gov (United States)

    Lu, Qing; Li, Cui-xian; Huang, Bei-jian; Xue, Li-yun; Wang, Wen-ping

    2015-02-01

    To determine the contrast-enhanced ultrasonography (CEUS) characteristics of minimal fat renal angiomyolipoma (AML) (triphasic and epithelioid) and compare them to each other and to clear cell renal cell carcinoma (ccRCC) to explore their differential diagnostic clue. Qualitative and quantitative CEUS analyses were retrospectively conducted for epithelioid renal AMLs (EAMLs) (n = 15), triphasic minimal fat AMLs (TAMLs) (n = 25), and ccRCCs (n = 113). Enhancement patterns and features with CEUS were qualitatively evaluated. As for the quantitative parameters, rise times (RT), time to peak (TTP), and tumor-to-cortex enhancement ratio (TOC ratio) were compared among these renal tumor histotypes. No significant differences were detected on conventional ultrasound in the three histotypes of renal tumor. On qualitative CEUS analysis, centripetal enhancement in cortical phase (73.3% in EAMLs, 84.0% in TAMLs vs. 18.6% in ccRCCs, p qualitative and quantitative characteristics made no significant difference between EAMLs and TAMLs. In the differential diagnosis of EAMLs from TAMLs, pseudocapsule sign was valuable (40.0% in EAMLs vs. 0.0% in TAMLs, p 97.34% as the criteria to differentiate ccRCCs and EAMLs from TAMLs, the sensitivity and specificity were 80.0% and 87.5%, respectively. Qualitative and quantitative CEUS analyses are helpful in the differential diagnosis of ccRCCs, EAMLs, and TAMLs.

  7. THE ABILITY OF CONTRAST-ENHANCED ULTRASOUND IN THE DIAGNOSIS OF LIVER METASTASES IN CERVICAL CANCER

    OpenAIRE

    V. S. Kryazheva; M. A. Chekalova; Z. R-B. Musaeva; V. V. Kuznetsov

    2017-01-01

    Objective: to explore the possibilities of contrast-enhanced ultrasound (CEUS) in the diagnosis of liver metastases in patients with a diagnosis of cervical cancer.Materials and methods. We analyzed the results of 4 clinical cases, of which 3 cases according CEUS diagnosed with liver metastases, in 1 case – nodular hyperplasia.Results and conclusions. Despite the small number of observations, we have concluded that the use of CEUS allows to expand possibilities of the ultrasound method in the...

  8. Power Doppler ultrasonography of painful Achilles tendons and entheses in patients with and without spondyloarthropathy-a comparison with clinical examination and contrast-enhanced MRI

    DEFF Research Database (Denmark)

    Wiell, Charlotte; Szkudlarek, Marcin; Hasselquist, Maria

    2013-01-01

    The objective of this study was to describe ultrasonography (US) and magnetic resonance imaging (MRI) findings at painful Achilles tendons and entheses in patients with and without spondyloarthropathy (SpA and non-SpA) and healthy control persons (CTRLs). Particularly, we aimed to investigate...... if any changes differentiate SpA from non-SpA. Finally, we investigated the reliability of US compared to clinical examination of Achilles tendinopathy, using MRI as gold standard reference. Twelve SpA patients and 15 non-SpA patients with pain and tenderness at at least one Achilles tendon and...

  9. Contrast-enhanced ultrasound features of histologically proven focal nodular hyperplasia: diagnostic performance compared with contrast-enhanced CT

    International Nuclear Information System (INIS)

    Wang, Wei; Chen, Li-Da; Liu, Guang-Jian; Xu, Zuo-Feng; Xie, Xiao-Yan; Wang, Yan; Zhou, Lu-Yao; Lu, Ming-De; Shen, Shun-Li

    2013-01-01

    To investigate and compare contrast-enhanced ultrasound (CEUS) in the characterisation of histologically proven focal nodular hyperplasia (FNH) with contrast-enhanced computed tomography (CECT). CEUS was performed in 85 patients with 85 histologically proven FNHs. Enhancement, centrifugal filling, spoke-wheel arteries, feeding artery and central scarring were reviewed and correlated with lesion size or liver background. Independent factors for predicting FNH from other focal liver lesions (FLLs) were evaluated. Forty-seven FLLs with CECT were randomly selected for comparison of diagnostic performance with CEUS. Centrifugal filling was more common (P = 0.002) and the significant predictor (P = 0.003) in FNHs ≤3 cm. Lesion size or liver background has no significant influence on the detection rate of the spoke-wheel arteries and feeding artery (P > 0.05). Central scarring was found in 42.6 % of FNHs ≥3 cm (P = 0.000). The area under the ROC curve, sensitivity and specificity showed no significant differences between CEUS and CECT (P > 0.05), except that the sensitivity of CEUS was better for reader 1 (P = 0.041). CEUS is valuable in characterising centrifugal filling signs or spoke wheels in small FNHs and should be employed as the first-line imaging technique for diagnosis of FNH. (orig.)

  10. Quantitative Differences Between the First and Second Injection of Contrast Agent in Contrast-Enhanced Ultrasonography of Feline Kidneys and Spleen.

    Science.gov (United States)

    Stock, Emmelie; Vanderperren, Katrien; Haers, Hendrik; Duchateau, Luc; Hesta, Myriam; Saunders, Jimmy H

    2017-02-01

    Contrast-enhanced ultrasound is a valuable and safe technique for the evaluation of organ perfusion. Repeated injections of ultrasound contrast agent are often administered during the same imaging session. However, it remains unclear if quantitative differences are present between the consecutive microbubble injections. Therefore, the first and second injection of contrast agent for the left renal cortex, renal medulla and the splenic parenchyma in healthy cats were compared. A lower peak intensity and area under the curve were observed for the first injection of contrast agent in the feline kidney, both for the renal cortex and medulla, and spleen. Moreover, for the renal cortex, the time-intensity curve was steeper after the second injection. Findings from the present study demonstrate that a second injection of contrast agent provides stronger enhancement. The exact mechanism behind our findings remains unclear; however, saturation of the lung macrophages is believed to play an important role. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  11. Clinical utility of eco-color-power Doppler ultrasonography and contrast enhanced magnetic resonance imaging for interpretation and quantification of joint synovitis: a review.

    Science.gov (United States)

    Carotti, Marina; Galeazzi, Vittoria; Catucci, Francesca; Zappia, Marcello; Arrigoni, Francesco; Barile, Antonio; Giovagnoni, Andrea

    2018-01-19

    With the introduction of new biologics such as anti-TNF-alpha antibodies and other therapies in the treatment of inflammatory arthritis, capable of halting joint destruction and functional disability, there are new pressures on diagnostic and prognostic imaging. Early demonstration of pre-erosive inflammatory features and monitoring of the long-term effects of treatment are becoming increasingly important. Early detection of synovitis offers advantages in terms of allowing early instigation of therapy and may allow the identification of those patients displaying more aggressive disease who might benefit from early intervention with expensive DMARD therapy. Advanced imaging techniques such as ultrasound (US) and magnetic resonance imaging (MRI) have focussed on the demonstration and quantification of synovitis and allow early diagnosis of inflammatory arthropathies such as rheumatoid arthritis (RA) and psoriatic arthritis (PsA). Synovitis represents a potential surrogate measure of disease activity that can be monitored using either MRI or US; the techniques have, generally, focused on monitoring synovial volume or quality as assessed by its vascularity. However to achieve these goals, standardisation and validation of US and MRI are required to ensure accurate diagnosis, reproducibility and reliability. Each modality has different strengths and weaknesses and levels of validation. This article aims to increase the awareness of radiologists and rheumatologists about this field and to encourage them to participate and contribute to the ongoing development of these modalities. Without this collaboration, it is unlikely that these modalities will reach their full potential in the field of rheumatological imaging. This review is in two parts. The first part addresses the role of US and colour or power Doppler sonography (PDUS) in the detection and monitoring of synovitis in inflammatory arthropathies. The second part will look at advanced MR imaging and Dynamic contrast-enhanced

  12. EVAR: Benefits of CEUS for monitoring stent-graft status

    International Nuclear Information System (INIS)

    Cantisani, Vito; Grazhdani, Hektor; Clevert, Dirk-André; Iezzi, Roberto; Aiani, Luca; Martegani, Alberto; Fanelli, Fabrizio; Di Marzo, Luca; Wlderk, Andrea; Cirelli, Carlo; Catalano, Carlo; Di Leo, Nicola; Di Segni, Mattia; Malpassini, Flavio; D’Ambrosio, Ferdinando

    2015-01-01

    Highlights: • In the last two decades several studies have shown the role of contrast enhanced ultrasound [CEUS] in post-EVAR surveillance, with very good diagnostic performance, absence of renal impairment, and no radiation, accompanied by low costs, in comparison with CTA. • In numerous prospective studies and meta-analyses the detection and characterization of endoleaks with CEUS is comparable to that of CTA imaging. • Nowadays in the EVAR surveillance novel strategies which involve CEUS with a central role, are suggested by several authors and applied in many institutions. • CEUS technique, findings, diagnostic accuracy, and its role in the follow up program are discussed in this review article. - Abstract: Endo vascular aortic repair [EVAR] is performed with low peri-operative morbidity and mortality rate and short hospital stay. However, EVAR needs a close and lifelong imagining surveillance for a timely detection of possible complications including endoleaks, graft migration, fractures, and enlargement of aneurysm sac size with eventual rupture. Contrast enhanced computed tomography [CTA] is actually considered the gold-standard in EVAR follow-up, but it is accompanied with radiation burden and renal injury due to the use of contrast media. In the last two decades several studies have shown the role of contrast enhanced ultrasound [CEUS] in post-EVAR surveillance, with very good diagnostic performance, absence of renal impairment, and no radiation, accompanied by low costs, in comparison with CTA. In numerous prospective studies and meta-analyses the detection and characterization of endoleaks with CEUS is comparable to that of CTA imaging. Nowadays, in the EVAR surveillance novel strategies which involve CEUS with a central role, are suggested by several authors and applied in many institutions. In this review article we will present a comprehensive overview and analyses of the literature on the CEUS state-of-art imagining of EVAR follow-up, with

  13. The Feasibility of Contrast-Enhanced Ultrasound During Uterine Artery Embolization: A Pilot Study

    International Nuclear Information System (INIS)

    Dorenberg, Eric J.; Jakobsen, Jarl A.; Brabrand, Knut; Hafsahl, Geir; Smith, Hans-Jorgen

    2007-01-01

    Purpose. To evaluate the feasibility of using contrast-enhanced ultrasound (CEUS) during uterine artery embolization (UAE) in order to define the correct end-point of embolization with complete devascularization of all fibroids. Methods. In this prospective study of 10 consecutive women undergoing UAE, CEUS was performed in the angiographic suite during embolization. When the angiographic end-point, defined as the 'pruned-tree' appearance of the uterine arteries was reached, CEUS was performed while the angiographic catheters to both uterine arteries were kept in place. The decision whether or not to continue the embolization was based on the findings at CEUS. The results of CEUS were compared with those of contrast-enhanced magnetic resonance imaging (MRI) 1 day as well as 3 months following UAE. Results. CEUS was successfully performed in all women. In 4 cases injection of particles was continued based on the findings at CEUS despite angiographically complete embolization. CEUS imaging at completion of UAE correlated well with the findings at MRI. Conclusion. The use of CEUS during UAE is feasible and may increase the quality of UAE

  14. Contrast-enhanced ultrasound vs multidetector-computed tomography for detecting liver metastases in colorectal cancer: a prospective, blinded, patient-by-patient analysis

    DEFF Research Database (Denmark)

    Rafaelsen, S R; Jakobsen, A

    2011-01-01

    This study compared the sensitivity and specificity of contrast-enhanced ultrasound (CEUS) and multidetector-computed tomography (MDCT) in the detection of liver metastases in patients with colorectal cancer.......This study compared the sensitivity and specificity of contrast-enhanced ultrasound (CEUS) and multidetector-computed tomography (MDCT) in the detection of liver metastases in patients with colorectal cancer....

  15. Intraoperative Cerebral Glioma Characterization with Contrast Enhanced Ultrasound

    Directory of Open Access Journals (Sweden)

    Francesco Prada

    2014-01-01

    Full Text Available Background. Contrast enhanced ultrasound (CEUS is a dynamic and continuous modality providing real-time view of vascularization and flow distribution patterns of different organs and tumors. Nevertheless its intraoperative use for brain tumors visualization has been performed few times, and a thorough characterization of cerebral glioma had never been performed before. Aim. To perform the first characterization of cerebral glioma using CEUS and to possibly achieve an intraoperative differentiation of different gliomas. Methods. We performed CEUS in an off-label setting in 69 patients undergoing surgery for cerebral glioma. An intraoperative qualitative analysis was performed comparing iCEUS with B-mode imaging. A postprocedural semiquantitative analysis was then performed for each case, according to EFSUMB criteria. Results were related to histopathology. Results. We observed different CE patterns: LGG show a mild, dotted CE with diffuse appearance and slower, delayed arterial and venous phase. HGG have a high CE with a more nodular, nonhomogeneous appearance and fast perfusion patterns. Conclusion. Our study characterizes for the first time human brain glioma with CEUS, providing further insight regarding these tumors’ biology. CEUS is a fast, safe, dynamic, real-time, and economic tool that might be helpful during surgery in differentiating malignant and benign gliomas and refining surgical strategy.

  16. Contrast-enhanced Ultrasound for Non-tumor Liver Diseases

    Directory of Open Access Journals (Sweden)

    H Maruyama

    2012-03-01

    Full Text Available Contrast-enhanced ultrasound (CEUS is a simple, safe and reliable technique for the clinical management of patients with various liver diseases. Although the major target of the technique may be focal hepatic lesions, it is also effective for the diagnosis of non-tumor liver diseases, such as grading hepatic fibrosis, characterization of chronic liver diseases and diagnosis of portal vein thrombosis. This review article aimed to overview the recent application of CEUS in the assessment of non-tumor liver diseases. Keywords: Cirrhosis, contrast agent, fibrosis, idiopathic portal hypertension, microbubble, portal vein thrombosis, ultrasound.

  17. Diagnostic Accuracy of Detecting Hashimoto's Thyroiditis in Thyroid Cancer Patients Who Underwent Thyroid Surgery: Comparison of Ultrasonography, Positron Emission Tomography/CT, Contrast Enhanced CT, and Anti-Thyroid Antibody

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    Kim, Young Gyun; Lee, Tae Hyun; Park, Dong Hee; Nam, Sang Been [Dept. of Radiology, Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    2012-11-15

    To compare the diagnostic accuracy of ultrasonography (US), F18-fluorodeoxyglucose positron emission tomography/CT (PET/CT), contrast enhanced CT (CECT), serum anti-thyroid antibody for detecting Hashimoto's thyroiditis in thyroid cancer patients who underwent neck surgery. A total of 150 patients with suspicious for thyroid cancer, who had previously undergone US guided needle aspiration of thyroid, were evaluated with the use of US, PET/CT, CECT and serum anti-thyroid antibody. The four studies were performed within two months before neck surgery. Hashimoto's thyroiditis was confirmed by histopathological results. The diagnostic accuracy of US, PET/CT, CECT and serum anti-thyroid antibody were calculated statistically. Hashimoto's thyroiditis was diagnosed in 51 out of the 150 patients, following neck surgery. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of US were 76.5%, 92.9%, 84.8%, 88.5%, and 87.3%, respectively. The corresponding values of PET/CT were 37.3%, 96.0%, 82.6%, 74.8%, and 76.0%, and CECT were 62.7%, 89.9%, 76.2%, 82.4%, and 80.7%, and serum anti-thyroid antibody level were 90.2%, 93.9%, 88.5%, 94.9%, and 92.7%, respectively. McNemar test revealed significant difference among PET/CT and others, but no significant differences among US, CECT and serum anti-thyroid antibody. Overall, serum anti-thyroid antibody showed most accurate diagnostic performance. In detecting Hashimoto's thyroiditis, serum anti-thyroid antibody showed higher diagnostic accuracy than others. US also showed relatively high diagnostic accuracy.

  18. Diagnostic Accuracy of Detecting Hashimoto's Thyroiditis in Thyroid Cancer Patients Who Underwent Thyroid Surgery: Comparison of Ultrasonography, Positron Emission Tomography/CT, Contrast Enhanced CT, and Anti-Thyroid Antibody

    International Nuclear Information System (INIS)

    Kim, Young Gyun; Lee, Tae Hyun; Park, Dong Hee; Nam, Sang Been

    2012-01-01

    To compare the diagnostic accuracy of ultrasonography (US), F18-fluorodeoxyglucose positron emission tomography/CT (PET/CT), contrast enhanced CT (CECT), serum anti-thyroid antibody for detecting Hashimoto's thyroiditis in thyroid cancer patients who underwent neck surgery. A total of 150 patients with suspicious for thyroid cancer, who had previously undergone US guided needle aspiration of thyroid, were evaluated with the use of US, PET/CT, CECT and serum anti-thyroid antibody. The four studies were performed within two months before neck surgery. Hashimoto's thyroiditis was confirmed by histopathological results. The diagnostic accuracy of US, PET/CT, CECT and serum anti-thyroid antibody were calculated statistically. Hashimoto's thyroiditis was diagnosed in 51 out of the 150 patients, following neck surgery. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of US were 76.5%, 92.9%, 84.8%, 88.5%, and 87.3%, respectively. The corresponding values of PET/CT were 37.3%, 96.0%, 82.6%, 74.8%, and 76.0%, and CECT were 62.7%, 89.9%, 76.2%, 82.4%, and 80.7%, and serum anti-thyroid antibody level were 90.2%, 93.9%, 88.5%, 94.9%, and 92.7%, respectively. McNemar test revealed significant difference among PET/CT and others, but no significant differences among US, CECT and serum anti-thyroid antibody. Overall, serum anti-thyroid antibody showed most accurate diagnostic performance. In detecting Hashimoto's thyroiditis, serum anti-thyroid antibody showed higher diagnostic accuracy than others. US also showed relatively high diagnostic accuracy.

  19. Contrast-enhanced ultrasound imaging of active bleeding associated with hepatic and splenic trauma.

    Science.gov (United States)

    Lv, F; Tang, J; Luo, Y; Li, Z; Meng, X; Zhu, Z; Li, T

    2011-10-01

    The aim of this study was to evaluate contrast-enhanced ultrasound (CEUS) imaging of active bleeding from hepatic and splenic trauma. Three hundred and ninety-two patients with liver or/and spleen trauma (179 liver and 217 spleen injuries), who underwent CEUS examinations following contrast-enhanced computed tomography (CT), were enrolled in this retrospective study over a period of >4 years. CEUS detected contrast medium extravasation or pooling in 16% (63/396) of liver or spleen lesions in 61 patients, which was confirmed by contrast-enhanced CT. Special attention was paid to observing the presence, location, and characteristics of the extravasated or pooled contrast medium. The CEUS detection rate for active bleeding was not different from that of contrast-enhanced CT (p=0.333). Information from surgery, minimally invasive treatment and conservative treatment was used as reference standard, and the sensitivities of the two techniques were not different (p=0.122). Of 63 lesions in 61 patients, CEUS showed that 74.6% (47/63) (21 liver lesions and 26 spleen lesions) presented contrast medium extravasation or pooling, both in the organ and out the capsule, in 14.3% (9/63) and only outside the capsule in 11.1% (7/63). CEUS imaging of active bleeding from hepatic and splenic trauma presented various characteristics, and the sizes and shapes of the active bleeding due to contrast medium extravasation or pooling were variable. CEUS can show the active bleeding associated with hepatic and splenic trauma with various imaging characteristics, thus making it possible to diagnose active bleeding using CEUS.

  20. THE ABILITY OF CONTRAST-ENHANCED ULTRASOUND IN THE DIAGNOSIS OF LIVER METASTASES IN CERVICAL CANCER

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    V. S. Kryazheva

    2017-01-01

    Full Text Available Objective: to explore the possibilities of contrast-enhanced ultrasound (CEUS in the diagnosis of liver metastases in patients with a diagnosis of cervical cancer.Materials and methods. We analyzed the results of 4 clinical cases, of which 3 cases according CEUS diagnosed with liver metastases, in 1 case – nodular hyperplasia.Results and conclusions. Despite the small number of observations, we have concluded that the use of CEUS allows to expand possibilities of the ultrasound method in the differential diagnosis of focal changes in the liver.

  1. Contrast-enhanced ultrasound study of primary hepatic angiosarcoma: A pitfall of non-enhancement

    International Nuclear Information System (INIS)

    Wang, Liang; Lv, Ke; Chang, Xiao-Yan; Xia, Yu; Yang, Zhi-Ying; Jiang, Yu-Xin; Dai, Qing; Tan, Li; Li, Jian-Chu

    2012-01-01

    Highlights: ► The contrast-enhanced ultrasound (CEUS) characteristics of primary hepatic angiosarcoma (PHA) in three patients were retrospectively analyzed. ► PHA appeared similar peripheral enhancement pattern in our series. ► Non-necrotic tumor tissue of PHA unexpectedly demonstrated non-enhancement on CEUS. ► It may be associated with the very low velocity of blood flow in the central region of tumors. ► This interesting finding warrants further investigations, particularly on intratumoral hemodynamics. -- Abstract: Objective: To investigate the contrast-enhanced ultrasound (CEUS) characteristics of primary hepatic angiosarcoma (PHA). Methods: The sonographic findings and CEUS images of PHA in three patients were retrospectively analyzed. Results: In our study, 3 cases of PHA (2 multiple nodules and 1 solitary mass) showed similar enhancement pattern on CEUS, characterized by remarkable central non-enhancement and peripheral irregular enhancement in the arterial and portal phase, and complete wash-out in the late phase. Furthermore, we unexpectedly found that abundant neoplastic tissues were present in the central area of non-enhancement on pathological evaluation. Based on literature review, we supposed that the unusual finding may be associated with the very low velocity of blood flow in the central region of tumors. Conclusion: CEUS could well depict PHA with some common features, which may provide valuable clues in diagnosis of this rare disease. And non-necrotic tumor tissue of PHA could also demonstrate non-enhancement on CEUS, which warrant further investigations

  2. Contrast-Enhanced Ultrasound Guided Biopsy of Undetermined Abdominal Lesions: A Multidisciplinary Decision-Making Approach

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    Feng Mao

    2017-01-01

    Full Text Available Aim. To investigate the value of contrast-enhanced ultrasound (CEUS guided biopsy of undetermined abdominal lesions in multidisciplinary treatment (MDT decision-making approach. Methods. Between Jan 2012 and Dec 2015, 60 consecutive patients (male, 37; female, 23; mean age, 51.3 years ± 14.6 who presented with undetermined abdominal lesions were included. CEUS and core needle percutaneous biopsy was performed under real-time CEUS guidance in all lesions. Data were recorded and compared with conventional ultrasound (US guidance group (n=75. All CEUS findings and clinical data were evaluated in MDT. Results. CEUS enabled the delimitation of more (88.3% versus 41.3% and larger (14.1 ± 10.7 mm versus 32.3 ± 18.5 mm nonenhanced necrotic areas. More inner (20.0% versus 6.7% and surrounding (18.3% versus 2.7% major vessels were visualized and avoided during biopsies. CEUS-guided biopsy increased the diagnostic accuracy from 93.3% to 98.3%, with correct diagnosis in 57 of 60 lesions (95.0%. The therapeutic plan was influenced by CEUS guided biopsies findings in the majority of patients (98.3%. Conclusion. The combination of CEUS guided biopsy and MDT decision-making approach is useful in the diagnostic work-up and therapeutic management.

  3. Contrast-Enhanced Ultrasound Guided Biopsy of Undetermined Abdominal Lesions: A Multidisciplinary Decision-Making Approach.

    Science.gov (United States)

    Mao, Feng; Dong, Yi; Ji, Zhengbiao; Cao, Jiaying; Wang, Wen-Ping

    2017-01-01

    Aim. To investigate the value of contrast-enhanced ultrasound (CEUS) guided biopsy of undetermined abdominal lesions in multidisciplinary treatment (MDT) decision-making approach. Methods. Between Jan 2012 and Dec 2015, 60 consecutive patients (male, 37; female, 23; mean age, 51.3 years ± 14.6) who presented with undetermined abdominal lesions were included. CEUS and core needle percutaneous biopsy was performed under real-time CEUS guidance in all lesions. Data were recorded and compared with conventional ultrasound (US) guidance group ( n = 75). All CEUS findings and clinical data were evaluated in MDT. Results. CEUS enabled the delimitation of more (88.3% versus 41.3%) and larger (14.1 ± 10.7 mm versus 32.3 ± 18.5 mm) nonenhanced necrotic areas. More inner (20.0% versus 6.7%) and surrounding (18.3% versus 2.7%) major vessels were visualized and avoided during biopsies. CEUS-guided biopsy increased the diagnostic accuracy from 93.3% to 98.3%, with correct diagnosis in 57 of 60 lesions (95.0%). The therapeutic plan was influenced by CEUS guided biopsies findings in the majority of patients (98.3%). Conclusion. The combination of CEUS guided biopsy and MDT decision-making approach is useful in the diagnostic work-up and therapeutic management.

  4. Hepatic contrast-enhance ultrasound: impact of its introduction in the Australian context

    International Nuclear Information System (INIS)

    Won, So Yeun; Singh, Neha; Lim, Beng Ghee; Stella, Damien; Gibson, Robert

    2014-01-01

    Contrast-enhanced ultrasound (CEUS) is a relatively new imaging modality in Australia. We discuss our early experience with CEUS at Royal Melbourne Hospital in assessment of focal liver lesions and its clinical impact. Radiology department and hospital computerised information systems were used to identify and collate information regarding the indication, previous and follow-up imaging, CEUS findings and subsequent final diagnoses of patients who underwent hepatic CEUS from 12/12/2007 to 20/4/2012. A total of 388 hepatic CEUS were performed, examining 409 lesions. The cases were grouped as either 'initial study' or 'follow-up' group, with main focus on the former group. Of the 367 lesions in the 'initial study' group, CEUS was able to distinguish benign from malignant pathology in 344 cases (93.8%). This was especially beneficial in setting of known malignancy with indeterminate liver lesions found on CT to confidently exclude metastatic disease. For 124 of 162 patients who had an incidentally detected indeterminate liver lesion, CEUS was the final imaging investigation required to make a diagnosis. CEUS is a valuable tool in assessment of focal liver lesions in conjunction with other conventional modalities in a variety of clinical settings. In particular, it provided definitive diagnosis in a significant proportion of incidentally identified liver lesions many of which are benign, saving patient anxiety and further unnecessary follow-up.

  5. Application of contrast-enhanced ultrasound in the diagnosis of solid pancreatic lesions—A comparison of conventional ultrasound and contrast-enhanced CT

    International Nuclear Information System (INIS)

    Fan, Zhihui; Li, Ying; Yan, Kun; Wu, Wei; Yin, Shanshan; Yang, Wei; Xing, Baocai

    2013-01-01

    Objective: To explore the diagnostic value of contrast-enhanced ultrasound (CEUS) by comparison with conventional ultrasound (US) and contrast-enhanced CT (CECT) in solid pancreatic lesions. Method: Ninety patients with solid pancreatic focal lesions were enrolled, including 36 cases of pancreatic carcinoma, 28 cases of pancreatitis, 6 cases of pancreatic neuroendocrine tumor, 12 cases of solid pseudopapillary tumor of the pancreas, 6 cases of pancreatic metastases, 1 case of cavernous hemolymphangioma and 1 case of lymphoma. US and CEUS were applied respectively for the diagnosis of a total of 90 cases of solid pancreatic lesions. The diagnostic results were scored on a 5-point scale. Results of CEUS were compared with CECT. Results: (1) 3-score cases (undetermined) diagnosed by CEUS were obviously fewer than that of US, while the number of 1-score (definitely benign) and 5-score (definitely malignant) cases diagnosed by CEUS was significantly more than that of US. There was a significant difference in the distribution of final scores using the two methods (p < 0.001). The overall diagnostic accuracies of the 90 cases for CEUS and US were 83.33% and 44.44%, respectively, which indicated an obvious advantage for CEUS (p < 0.001). (2) The diagnostic consistency among three ultrasound doctors: the kappa values calculated for US were 0.537, 0.444 and 0.525, compared with 0.748, 0.645 and 0.795 for CEUS. The interobserver agreement for CEUS was higher than that for US. (3) The sensitivity, specificity and accuracy of the diagnosis of pancreatic carcinoma with CEUS and CECT were 91.7% and 97.2%, 87.0% and 88.9%, and 88.9% and 92.2%, respectively, while for the diagnosis of pancreatitis, the corresponding indices were 82.1% and 67.9%, 91.9% and 100%, and 88.9% and 90%, respectively, showing no significant differences (p > 0.05). Conclusion: CEUS has obvious superiority over conventional US in the general diagnostic accuracy of solid pancreatic lesions and in the

  6. Application of contrast-enhanced ultrasound in the diagnosis of solid pancreatic lesions—A comparison of conventional ultrasound and contrast-enhanced CT

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    Fan, Zhihui, E-mail: fanzhihui_1026@163.com [Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Department of Ultrasound, Peking University Cancer Hospital and Institute, No. 52, Fucheng Road, Haidian District, Beijing 100142 (China); Li, Ying, E-mail: 18901033676@126.com [Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Department of Radiology, Peking University Cancer Hospital and Institute, No. 52, Fucheng Road, Haidian District, Beijing 100142 (China); Yan, Kun, E-mail: ydbz@sina.com [Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Department of Ultrasound, Peking University Cancer Hospital and Institute, No. 52, Fucheng Road, Haidian District, Beijing 100142 (China); Wu, Wei, E-mail: wuwei@163.com [Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Department of Ultrasound, Peking University Cancer Hospital and Institute, No. 52, Fucheng Road, Haidian District, Beijing 100142 (China); Yin, Shanshan, E-mail: yshshmd@yahoo.com [Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Department of Ultrasound, Peking University Cancer Hospital and Institute, No. 52, Fucheng Road, Haidian District, Beijing 100142 (China); Yang, Wei, E-mail: weiwei02032001@gmail.com [Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Department of Ultrasound, Peking University Cancer Hospital and Institute, No. 52, Fucheng Road, Haidian District, Beijing 100142 (China); Xing, Baocai, E-mail: xinbaocai88@sina.com [Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Department of Hepatic Biliary and Pancreatic Surgery, Peking University Cancer Hospital and Institute, No. 52, Fucheng Road, Haidian District, Beijing 100142 (China); and others

    2013-09-15

    Objective: To explore the diagnostic value of contrast-enhanced ultrasound (CEUS) by comparison with conventional ultrasound (US) and contrast-enhanced CT (CECT) in solid pancreatic lesions. Method: Ninety patients with solid pancreatic focal lesions were enrolled, including 36 cases of pancreatic carcinoma, 28 cases of pancreatitis, 6 cases of pancreatic neuroendocrine tumor, 12 cases of solid pseudopapillary tumor of the pancreas, 6 cases of pancreatic metastases, 1 case of cavernous hemolymphangioma and 1 case of lymphoma. US and CEUS were applied respectively for the diagnosis of a total of 90 cases of solid pancreatic lesions. The diagnostic results were scored on a 5-point scale. Results of CEUS were compared with CECT. Results: (1) 3-score cases (undetermined) diagnosed by CEUS were obviously fewer than that of US, while the number of 1-score (definitely benign) and 5-score (definitely malignant) cases diagnosed by CEUS was significantly more than that of US. There was a significant difference in the distribution of final scores using the two methods (p < 0.001). The overall diagnostic accuracies of the 90 cases for CEUS and US were 83.33% and 44.44%, respectively, which indicated an obvious advantage for CEUS (p < 0.001). (2) The diagnostic consistency among three ultrasound doctors: the kappa values calculated for US were 0.537, 0.444 and 0.525, compared with 0.748, 0.645 and 0.795 for CEUS. The interobserver agreement for CEUS was higher than that for US. (3) The sensitivity, specificity and accuracy of the diagnosis of pancreatic carcinoma with CEUS and CECT were 91.7% and 97.2%, 87.0% and 88.9%, and 88.9% and 92.2%, respectively, while for the diagnosis of pancreatitis, the corresponding indices were 82.1% and 67.9%, 91.9% and 100%, and 88.9% and 90%, respectively, showing no significant differences (p > 0.05). Conclusion: CEUS has obvious superiority over conventional US in the general diagnostic accuracy of solid pancreatic lesions and in the

  7. An Algorithm of Image Heterogeneity with Contrast-Enhanced Ultrasound in Differential Diagnosis of Solid Thyroid Nodules.

    Science.gov (United States)

    Jin, Lifang; Xu, Changsong; Xie, Xueqian; Li, Fan; Lv, Xiuhong; Du, Lianfang

    2017-01-01

    Enhancement heterogeneity on contrast-enhanced ultrasonography (CEUS) is used to differentiate between benign and malignant thyroid nodules. In this study, we used an algorithm to quantify enhancement heterogeneity of solid thyroid nodules on CEUS. The heterogeneity value (HV) is calculated as standard deviation/mean intensity × 100 (using Adobe Photoshop). The heterogeneity ratio (HR) is calculated as the ratio of the HV of the nodule to that of the surrounding parenchyma. Three phases-ascending, peak and descending phases-were studied. HV values at ascending (HV a ) and peak (HV p ) phases were significantly higher in malignant nodules than in benign nodules (95.57 ± 43.87 vs. 73.06 ± 44.04, p = 0.009, and 32.53 ± 10.73 vs. 26.44 ± 8.25, p = 0.002, respectively). HR a , HR p and HR d were significantly higher in malignant nodules than in benign nodules (1.93 ± 1.03 vs. 1.00 ± 0.47, p = 0.000, 1.43 ± 0.51 vs. 1.09 ± 0.28, p = 0.000, and 1.33 ± 0.40 vs. 1.08 ± 0.33, p = 0.001, respectively). HR a achieved optimal diagnostic performance on receiver operating characteristic curve analysis. The algorithm used for assessment of image heterogeneity on CEUS examination may be a useful adjunct to conventional ultrasound for differential diagnosis of solid thyroid nodules. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  8. Common and uncommon features of focal splenic lesions on contrast-enhanced ultrasound: a pictorial review

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    Zavariz, Julia D., E-mail: julia.zavariz@hc.fm.usp.br [Universidade de São Paulo (HC/FMUSP), São Paulo, SP (Brazil). Faculdade de Medicina. Hospital das Clínicas; Konstantatou, Eleni; Deganello Annamaria; Bosanac, Diana; Huang, Dean Y.; Sellars, Maria E.; Sidhu, Paul S. [Department of Radiology, King’s College Hospital, Denmark Hill, London (United Kingdom)

    2017-11-15

    The characterization of focal splenic lesions by ultrasound can be quite challenging. The recent introduction of contrast-enhanced ultrasound (CEUS) has come to play a valuable role in the field of imaging splenic pathologies, offering the possibility of an ionizing radiation-free investigation. Because CEUS has been incorporated into everyday clinical practice, malignant diseases such as focal lymphomatous infiltration, metastatic deposits, benign cysts, traumatic fractures, and hemangiomas can now be accurately depicted and characterized without the need for further imaging. More specifically, splenic traumatic fractures do not require additional imaging by computed tomography (with ionizing radiation exposure) for follow-up, because splenic fractures and their complications are safely imaged with CEUS. In the new era of CEUS, more patients benefit from radiation-free investigation of splenic pathologies with high diagnostic accuracy. (author)

  9. Indeterminate solid hepatic lesions identified on non-diagnostic contrast-enhanced computed tomography: Assessment of the additional diagnostic value of contrast-enhanced ultrasound in the non-cirrhotic liver

    International Nuclear Information System (INIS)

    Quaia, Emilio; De Paoli, Luca; Angileri, Roberta; Cabibbo, Biagio; Cova, Maria Assunta

    2014-01-01

    Objective: To assess the additional diagnostic value of contrast-enhanced ultrasound (CEUS) in the characterization of indeterminate solid hepatic lesions identified on non-diagnostic contrast-enhanced computed tomography (CT). Methods: Fifty-five solid hepatic lesions (1–4 cm in diameter) in 46 non-cirrhotic patients (26 female, 20 male; age ± SD, 55 ± 10 years) underwent CEUS after being detected on contrast-enhanced CT which was considered as non-diagnostic after on-site analysis. Two blinded independent readers assessed CT and CEUS scans and were asked to classify retrospectively each lesion as a malignant or benign based on reference diagnostic criteria for the different hepatic lesion histotypes. Diagnostic accuracy and confidence (area – A z – under ROC curve) were assessed by using gadobenate dimeglumine-enhanced magnetic resonance (MR) imaging (n = 30 lesions), histology (n = 7 lesions), or US follow-up (n = 18 lesions) as the reference standards. Results: Final diagnoses included 29 hemangiomas, 3 focal nodular hyperplasias, 1 hepatocellular adenoma, and 22 metastases. The additional review of CEUS after CT images improved significantly (P < .05) the diagnostic accuracy (before vs after CEUS review = 49% [20/55] vs 89% [49/55] – reader 1 and 43% [24/55] vs 92% [51/55] – reader 2) and confidence (A z , 95% Confidence Intervals before vs after CEUS review = .773 [.652–.895] vs .997 [.987–1] – reader 1 and .831 [.724–.938] vs .998 [.992–1] – reader 2). Conclusions: CEUS improved the characterization of indeterminate solid hepatic lesions identified on non-diagnostic contrast-enhanced CT by identifying some specific contrast enhancement patterns.

  10. Vascular Structure Identification in Intraoperative 3D Contrast-Enhanced Ultrasound Data

    Directory of Open Access Journals (Sweden)

    Elisee Ilunga-Mbuyamba

    2016-04-01

    Full Text Available In this paper, a method of vascular structure identification in intraoperative 3D Contrast-Enhanced Ultrasound (CEUS data is presented. Ultrasound imaging is commonly used in brain tumor surgery to investigate in real time the current status of cerebral structures. The use of an ultrasound contrast agent enables to highlight tumor tissue, but also surrounding blood vessels. However, these structures can be used as landmarks to estimate and correct the brain shift. This work proposes an alternative method for extracting small vascular segments close to the tumor as landmark. The patient image dataset involved in brain tumor operations includes preoperative contrast T1MR (cT1MR data and 3D intraoperative contrast enhanced ultrasound data acquired before (3D-iCEUS s t a r t and after (3D-iCEUS e n d tumor resection. Based on rigid registration techniques, a preselected vascular segment in cT1MR is searched in 3D-iCEUS s t a r t and 3D-iCEUS e n d data. The method was validated by using three similarity measures (Normalized Gradient Field, Normalized Mutual Information and Normalized Cross Correlation. Tests were performed on data obtained from ten patients overcoming a brain tumor operation and it succeeded in nine cases. Despite the small size of the vascular structures, the artifacts in the ultrasound images and the brain tissue deformations, blood vessels were successfully identified.

  11. Contrast-enhanced ultrasound features of hepatocellular carcinoma not detected during the screening procedure.

    Science.gov (United States)

    Dong, Yi; Wang, Wen-Ping; Mao, Feng; Dietrich, Christoph

    2017-08-01

    Aim  The aim of this retrospective study is to report on the characteristics of contrast-enhanced ultrasound (CEUS) of primarily not detected hepatocellular carcinoma (HCC) during the screening procedure of patients at risk. Methods  Sixty-four patients with a finally solitary and histologically proven HCC not detected HCC during the screening procedure were retrospectively analyzed. Most of HCC lesions (90.6 %, 58/64) measured < 20 mm in diameter. All HCC lesions were not detected during the initial screening procedure but suspected using contrast-enhanced magnetic resonance imaging. The final gold standard was biopsy or surgery with histological examination. Results  On CEUS, 62/64 (96.8 %) of HCC were characterized as an obviously hyperenhanced lesion in arterial phase, and 41/64 (64.1 %) of HCC were characterized as hypoenhancing lesions in the portal venous and late phases. During the arterial phase of CEUS, 96.8 % of HCC displayed homogeneous hyperenhancement. Knowing the CEUS and magnetic resonance imaging findings, 45/64 (70.3 %) could have been detected using B-mode ultrasound (BMUS). Conclusion  BMUS as a screening procedure is generally accepted. Contrast-enhanced imaging modalities have improved detection and characterization of HCC. Homogeneous hyperenhancement during the arterial phase and mild washout are indicative for HCC in liver cirrhosis. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Intra-biliary contrast-enhanced ultrasound for evaluating biliary obstruction during percutaneous transhepatic biliary drainage: A preliminary study

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    Xu, Er-jiao [Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou 510630 (China); Zheng, Rong-qin, E-mail: zhengrq@mail.sysu.edu.cn [Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou 510630 (China); Su, Zhong-zhen; Li, Kai; Ren, Jie; Guo, Huan-yi [Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou 510630 (China)

    2012-12-15

    Objectives: The aimed of this study was to investigate the value of intra-biliary contrast-enhanced ultrasound (IB-CEUS) for evaluating biliary obstruction during percutaneous transhepatic biliary drainage (PTBD). Materials and methods: 80 patients with obstructive jaundice who underwent IB-CEUS during PTBD were enrolled. The diluted ultrasound contrast agent was injected via the drainage catheter to perform IB-CEUS. Both conventional ultrasound and IB-CEUS were used to detect the tips of the drainage catheters and to compare the detection rates of the tips. The obstructive level and degree of biliary tract were evaluated by IB-CEUS. Fluoroscopic cholangiography (FC) and computer tomography cholangiography (CTC) were taken as standard reference for comparison. Results: Conventional ultrasound displayed only 43 tips (43/80, 53.8%) of the drainage catheters within the bile ducts while IB-CEUS identified all 80 tips (80/80, 100%) of the drainage catheters including 4 of them out of the bile duct (P < 0.001). IB-CEUS made correct diagnosis in 44 patients with intrahepatic and 36 patients with extrahepatic biliary obstructions. IB-CEUS accurately demonstrated complete obstruction in 56 patients and incomplete obstruction in 21 patients. There were 3 patients with incomplete obstruction misdiagnosed to be complete obstruction by IB-CEUS. The diagnostic accuracy of biliary obstruction degree was 96.3% (77/80). Conclusion: IB-CEUS could improve the visualization of the drainage catheters and evaluate the biliary obstructive level and degree during PTBD. IB-CEUS may be the potential substitute to FC in the PTBD procedure.

  13. Contrast-enhanced ultrasound in the diagnosis of nodules in liver cirrhosis.

    Science.gov (United States)

    Kim, Tae Kyoung; Jang, Hyun-Jung

    2014-04-07

    Contrast-enhanced ultrasound (CEUS) using microbubble contrast agents are useful for the diagnosis of the nodules in liver cirrhosis. CEUS can be used as a problem-solving method for indeterminate nodules on computed tomography (CT) or magnetic resonance imaging (MRI) or as an initial diagnostic test for small newly detected liver nodules. CEUS has unique advantages over CT and MRI including no renal excretion of contrast, real-time imaging capability, and purely intravascular contrast. Hepatocellular carcinoma (HCC) is characterized by arterial-phase hypervascularity and later washout (negative enhancement). Benign nodules such as regenerative nodules or dysplastic nodules are usually isoechoic or slightly hypoechoic in the arterial phase and isoechoic in the late phase. However, there are occasional HCC lesions with atypical enhancement including hypovascular HCC and hypervascular HCC without washout. Cholangiocarcinomas are infrequently detected during HCC surveillance and mostly show rim-like or diffuse hypervascularity followed by rapid washout. Hemangiomas are often found at HCC surveillance and are easily diagnosed by CEUS. CEUS can be effectively used in the diagnostic work-up of small nodules detected at HCC surveillance. CEUS is also useful to differentiate malignant and benign venous thrombosis and to guide and monitor the local ablation therapy for HCC.

  14. Patterns of appearance and risk of misdiagnosis of intrahepatic cholangiocarcinoma in cirrhosis at contrast enhanced ultrasound.

    Science.gov (United States)

    Galassi, Marzia; Iavarone, Massimo; Rossi, Sandro; Bota, Simona; Vavassori, Sara; Rosa, Laura; Leoni, Simona; Venerandi, Laura; Marinelli, Sara; Sangiovanni, Angelo; Veronese, Letizia; Fraquelli, Mirella; Granito, Alessandro; Golfieri, Rita; Colombo, Massimo; Bolondi, Luigi; Piscaglia, Fabio

    2013-05-01

    Primary aim was to validate the percentage of intrahepatic cholangiocarcinomas (ICC) which have a contrast vascular pattern at contrast enhanced ultrasound (CEUS) at risk of misdiagnosis with hepatocellular carcinoma (HCC) and, secondary aim, to verify if any characteristics in the CEUS pattern helps to identify ICC. All ICC on cirrhosis seen in three Italian centres (Bologna, Milan and Pavia) between 2003 and 2011, in which CEUS and at least another imaging technique (CT or MRI) had been performed, were retrospectively identified. Those patients with ICC size comparable to the early HCC stage (Milan criteria, considered as small ICC) were enrolled for this study. The enhancement pattern at CEUS was analysed and compared with CT or MRI. A total of 25 small ICC made this study group. CEUS was at risk of misdiagnosis of ICC for HCC in a significantly higher number of cases than in CT (performed in 24 ICC) (52% vs. 4.2%, P = 0.009) and MRI (11 ICC) (52% vs. 9.1%, P = 0.02). A different contrast pattern among all techniques was found in 6 of 10 ICC lesions submitted to the three imaging methods. In the arterial phase, ICC lacked global hyperenhacement in approximately 50% of cases at CEUS and the degree of intensity of wash-out in the late phase was marked in 24% of nodules. CEUS misdiagnosed as HCC a significantly higher number of ICC lesions in cirrhotic patients than CT and MRI. However, some CEUS contrast features can help suspect ICC, especially in some cases with inconclusive CT or MRI. © 2013 John Wiley & Sons A/S.

  15. Small nodules (1-2 cm) in liver cirrhosis: Characterization with contrast-enhanced ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Hyun-Jung [Department of Medical Imaging, Toronto General Hospital, University of Toronto, 585 University Avenue, Toronto, Ontario M5G 2N2 (Canada); Kim, Tae Kyoung [Department of Medical Imaging, Toronto General Hospital, University of Toronto, 585 University Avenue, Toronto, Ontario M5G 2N2 (Canada)], E-mail: taekyoung.kim@uhn.on.ca; Wilson, Stephanie R. [Department of Medical Imaging, Toronto General Hospital, University of Toronto, 585 University Avenue, Toronto, Ontario M5G 2N2 (Canada)

    2009-12-15

    Objective: To determine the diagnostic efficacy of arterial phase contrast-enhanced ultrasound (CEUS) for characterizing small hepatic nodules (1-2 cm) in patients with high-risk for hepatocellular carcinoma (HCC). Materials and methods: Over 12 months, CEUS was performed in 59 patients at high-risk for HCC with small hepatic nodules (1-2 cm; mean, 1.5 cm). Based only on arterial phase (<45 s) vascular intensity and pattern, lesions were prospectively diagnosed as HCC if there was hypervascularity without known features of hemangioma. The diagnosis of HCC was made regardless of the presence or absence of washout. Verification of diagnosis was made by liver transplantation (n = 13), biopsy (n = 12), resection (n = 3) or clinical and imaging follow-up for at least 12 months (n = 31). Results: At of the time of CEUS, the 59 nodules were diagnosed as HCC in 26 and benign lesions in 33, including 20 regenerative/dysplastic nodules (RN/DN), 11 hemangiomas, and 2 focal fat sparing. All 26 nodules with arterial phase hypervascularity without hemangioma-like features were HCC. However, CEUS misdiagnosed HCC as RN/DN in 4 cases with arterial iso- (n = 3) or hypovascularity (n = 1). CEUS correctly diagnosed all 11 hemangiomas. The sensitivity, specificity, and accuracy of CEUS for diagnosing HCC were 86.7, 100, and 93.2%. Conclusions: Arterial phase vascular intensity and pattern of CEUS are highly accurate for the diagnosis of small (1-2 cm) HCC and hemangioma in liver cirrhosis. On CEUS, arterial phase hypervascularity without a hemangioma-pattern alone may be sufficient for diagnosis of small HCC. Infrequent iso/hypovascular HCC may erroneously suggest RN/DN necessitating biopsy or close follow-up.

  16. CEUS: An essential component in a multimodality approach to small nodules in patients at high-risk for hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Hyun-Jung, E-mail: Hyun-Jung.jang@uhn.ca [Department of Medical Imaging, Toronto General Hospital, University of Toronto, 585 University Avenue, Toronto, Ontario M5G 2N2 (Canada); Kim, Tae Kyoung, E-mail: Taekyoung.Kim@uhn.ca [Department of Medical Imaging, Toronto General Hospital, University of Toronto, 585 University Avenue, Toronto, Ontario M5G 2N2 (Canada); Burns, Peter N, E-mail: burns@sri.utoronto.ca [Department of Imaging Research, University of Toronto, Sunnybrook Health Sciences centre, 2075 Bayview Avenue, Toronto ON M4 N 3M5 (Canada); Wilson, Stephanie R, E-mail: Stephanie.wilson@albertahealthservices.ca [Department of Radiology, University of Calgary, Foothills Medical Centre, 1403 29 Street NW, Calgary, AB T2R 1M5 (Canada)

    2015-09-15

    Highlights: • CEUS resolves hypervascular pseudolesions, frequent on CT and MR, from vascular shunts. • US has the advantage of showing a baseline nodule for characterization. • CEUS shows excellent sensitivity to contrast agents, providing superior arterial phase sensitivity. • Real-time CEUS performance shows optimally perfusion patterns of benign tumor nodules. • CEUS performed at surveillance detection of nodules is efficient and effective. - Abstract: Contrast-enhanced ultrasound (CEUS) plays an essential role in the evaluation of small nodules in livers at high-risk for hepatocellular carcinoma (HCC) and offers unique advantages over CT/MRI. These include the sensitive depiction of arterial hypervascularity of HCC, better demonstration of rapid washout for non-HCC malignancy as well as of very late washout of HCC. Visualization of early vascular filling patterns for benign hypervascular lesions is of indisputable value. A frequently uncounted benefit of CEUS includes the value of its performance following nodule detection at ultrasound surveillance, including one-stop exclusion of typical benignancy, preclusion of arterial pseudolesions shown on CT/MR, and the avoidance of miscorrelation of a nodule on surveillance and subsequent diagnostic imaging. Therefore, CEUS can effectively be used in the diagnostic algorithm for new liver nodules detected during HCC surveillance. Despite the fact that CEUS is actively used as a major diagnostic test for HCC in Asia, Europe, and Canada with increasing demands in clinical practice, CEUS is not included in the diagnostic tests for HCC in some major practice guidelines. In this manuscript, we focus on small nodules in patients at high-risk for HCC, and review some of the unique advantages of CEUS that contribute to lesion characterization and subsequent patient management, showing why CEUS should be an essential component of the diagnostic algorithm for HCC.

  17. Diagnostic Performance and Confidence of Contrast-Enhanced Ultrasound in the Differential Diagnosis of Cystic and Cysticlike Liver Lesions.

    Science.gov (United States)

    Corvino, Antonio; Catalano, Orlando; Corvino, Fabio; Sandomenico, Fabio; Petrillo, Antonella

    2017-09-01

    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. 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 (A z ), and interobserver agreement were calculated. Diagnostic performance improved after review of CEUS examinations by both readers (conventional US A z = 0.781 vs 0.972; CEUS A z = 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%). 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.

  18. Gray-scale contrast-enhanced utrasonography in detecting sentinel lymph nodes: An animal study

    International Nuclear Information System (INIS)

    Wang Yuexiang; Cheng Zhigang; Li Junlai; Tang Jie

    2010-01-01

    Objective: To investigate the usefulness of gray-scale contrast-enhanced ultrasonography for detecting sentinel lymph nodes. Methods: Contrast-enhanced ultrasonography was performed in five normal dogs (four female and one male) after subcutaneous administration of a sonographic contrast agent (Sonovue, Bracco, Milan, Italy). Four distinct regions in each animal were examined. After contrast-enhanced ultrasonography, 0.8 ml of blue dye was injected into the same location as Sonovue and the sentinel lymph nodes were detected by surgical dissection. The findings of contrast-enhanced ultrasonography were compared with those of the blue dye. Results: Twenty-one sentinel lymph nodes were detected by contrast-enhanced ultrasonography while 23 were identified by blue dye with surgical dissection. Compared with the blue dye, the detection rate of enhanced ultrasonography for the sentinel lymph nodes is 91.3% (21/23). Two patterns of enhancement in the sentinel lymph nodes were observed: complete enhancement (5 sentinel lymph nodes) and partial enhancement (16 sentinel lymph nodes). The lymphatic channels were demonstrated as hyperechoic linear structures leading from the injection site and could be readily followed to their sentinel lymph nodes. Histopathologic examination showed proliferation of lymphatic follicles or lymphatic sinus in partial enhanced sentinel lymph nodes while normal lymphatic tissue was demonstrated in completely enhanced sentinel lymph nodes. Conclusions: Sonovue combined with gray-scale contrast-enhanced ultrasonography may provide a feasible method for detecting sentinel lymph nodes.

  19. Microbubble Composition and Preparation for High-Frequency Contrast-Enhanced Ultrasound Imaging : In Vitro and in Vivo Evaluation

    NARCIS (Netherlands)

    Daeichin, Verya; van Rooij, Tom; Skachkov, Ilya; Ergin, Bulent; Specht, Patricia A.C.; Lima, Alexandre; Ince, Can; Bosch, Johan G.; van der Steen, A.F.W.; de Jong, N.; Kooiman, Klazina

    2017-01-01

    Although high-frequency ultrasound imaging is gaining attention in various applications, hardly any ultrasound contrast agents (UCAs) dedicated to such frequencies (>15 MHz) are available for contrast-enhanced ultrasound (CEUS) imaging. Moreover, the composition of the limited commercially

  20. Microbubble Composition and Preparation for High-Frequency Contrast-Enhanced Ultrasound Imaging: In Vitro and In Vivo Evaluation

    NARCIS (Netherlands)

    Daeichin, Verya; van Rooij, Tom; Skachkov, Ilya; Ergin, Bulent; Specht, Patricia A. C.; Lima, Alexandre; Ince, Can; Bosch, Johan G.; van der Steen, Antonius F. W.; de Jong, Nico; Kooiman, Klazina

    2017-01-01

    Although high-frequency ultrasound imaging is gaining attention in various applications, hardly any ultrasound contrast agents (UCAs) dedicated to such frequencies (>15 MHz) are available for contrast-enhanced ultrasound (CEUS) imaging. Moreover, the composition of the limited commercially available

  1. Microbubble Composition and Preparation for High-Frequency Contrast-Enhanced Ultrasound Imaging: In Vitro and in Vivo Evaluation

    NARCIS (Netherlands)

    V. Daeichin (Verya); T. van Rooij (Tom); I. Skachkov (Ilya); B. Ergin (Bulent); P. Specht (Patricia); A.A.P. Lima (Alexandre ); C. Ince (Can); J.G. Bosch (Hans); A.F.W. van der Steen (Ton); N. de Jong (Nico); K. Kooiman (Klazina)

    2017-01-01

    textabstractAlthough high-frequency ultrasound imaging is gaining attention in various applications, hardly any ultrasound contrast agents (UCAs) dedicated to such frequencies (>15 MHz) are available for contrast-enhanced ultrasound (CEUS) imaging. Moreover, the composition of the limited

  2. Contrast-enhanced color Doppler ultrasound characteristics in hypervascular breast tumors: comparison with MRI

    International Nuclear Information System (INIS)

    Alamo, L.; Fischer, U.

    2001-01-01

    The aim of this study was to evaluate the accuracy of contrast-enhanced color Doppler ultrasound (CE-US) in comparison with contrast-enhanced MR imaging (CE-MRI) in the discrimination of hypervascularized breast tumors. An additional CE-US of the breast was preoperatively performed in 40 patients with a hypervascular breast lesion detected on CE-MRI. The presence of blood flow signals and the morphological characteristics of the vessels in the breast lesions were evaluated pre- and post-contrast administration, as well as the dynamic aspects of the Doppler signal, including time interval to maximum signal enhancement and persistence of the signal enhancement. Twenty-three carcinomas and 17 fibroadenomas were explored. Considering initial signal enhancement > 100 % after the administration of contrast material as a criterion suggesting malignancy, CE-MRI showed a sensitivity of 100 % and a specificity of 76.5 % in the detection of malignant breast tumors. Color Doppler signals were consistently demonstrated in all carcinomas and in 68.7 % of fibroadenomas after the administration of Levovist, with CE-US showing a sensitivity of 95.6 % and a specificity of 5.9 %. Neither the mean number of vessels per tumor, nor the location of vessels, the time to maximum increase of the Doppler signal or the persistence of signal enhancement showed significant differences between benign and malignant lesions. Additional CE-US does not increase the low specificity of MRI in patients with hypervascularized breast tumors. (orig.)

  3. Evaluation of the thrombus of abdominal aortic aneurysms using contrast enhanced ultrasound - preliminary results

    Science.gov (United States)

    Łukasiewicz, Adam; Garkowski, Adam; Rutka, Katarzyna; Janica, Jacek; Łebkowska, Urszula

    2016-09-01

    It is hypothesized that the degree of vascularization of the thrombus may have a significant impact on the rupture of aortic aneurysms. The presence of neovascularization of the vessel wall and mural thrombus has been confirmed only in histopathological studies. However, no non-invasive imaging technique of qualitative assessment of thrombus and neovascularization has been implemented so far. Contrast-enhanced ultrasound (CEUS) has been proposed as a feasible and minimally invasive technique for in vivo visualization of neovascularization in the evaluation of tumors and atherosclerotic plaques. The aim of this study was the evaluation of mural thrombus and AAAs wall with CEUS. CEUS was performed in a group of seventeen patients with AAAs. The mural thrombus enhancement was recognized in 12 cases, yet no significant correlation between the degree of contrast enhancement and AAAs diameter, thrombus width, and thrombus echogenicity was found. We observed a rise in AAAs thrombus heterogeneity with the increase in the aneurysm diameter (r = 0.62, p = 0.017). In conclusion CEUS can visualize small channels within AAAs thrombus, which could be a result of an ongoing angiogenesis. There is a need for further research to find out whether the degree of vascularization of the thrombus may have a significant impact on the rupture of aneurysms.

  4. Contrast enhancement CT by iopamidol

    International Nuclear Information System (INIS)

    Mori, Masaki; Makita, Nobue; Yanai, Kyoko

    1984-01-01

    In order to evaluate the contrast enhancement effect and safety of iopamidol (IOP) in CT examination, IOP was compared with angiographin (AG). In the liver and abdominal aorta, peak CT values were obtained earlier and were higher in the group with AG than in the group with IOP. However, CT values in the group with IOP decreased a little more slowly than those in the group with AG. There was no significant difference in the effect on contrast enhancement between the groups. Intravenous injection of IOP caused lower degree of burning sensation than that of AG, and some of the patients with IOP did not feel burning sensation at all. Changes in clinical laboratory values were slight before and after intravenous injection of IOP. These results suggest that IOP is satisfactory in terms of safety and effect on contrast enhancement in CT examination. (Namekawa, K.)

  5. Breast tumor size assessment: comparison of conventional ultrasound and contrast-enhanced ultrasound.

    Science.gov (United States)

    Jiang, Yu-Xin; Liu, He; Liu, Ji-Bin; Zhu, Qing-Li; Sun, Qiang; Chang, Xiao-Yan

    2007-12-01

    Accurate assessment of tumor size is necessary when selecting patients for breast-conserving surgery. In the study of breast contrast-enhanced ultrasound (CEUS), we found that tumor size discrepancy between CEUS and conventional ultrasound (US) existed in some breast lesions, for which the reasons are not clear. Breast CEUS examinations were performed in 104 patients with breast lesions. The measurement of the 104 breast tumors on conventional US was obtained and compared with the measurement on CEUS. A difference in measuring tumor size of >3 mm for tumors up to 1.7 cm and 4 mm for tumors >or=1.7 cm, was defined as a significant discrepancy between conventional US and CEUS. The histopathological examination of size discrepancy was performed and the margin characteristics of breast cancers with larger measurements were compared with those with unchanged measurements. Among the 104 lesions (43 malignant, 60 benign, 1 borderline), the size of 27 breast cancers and one granulomatous mastitis appeared larger at CEUS. Pathologic examinations of the region corresponding to the measurement discrepancy were mainly ductal carcinomas in situ (DCIS), invasive carcinoma with a DCIS component, adenosis with lobular hyperplasia in breast cancers and inflammatory cell infiltration in one granulomatous mastitis. Well-defined margin characteristics were significantly different between breast cancers with larger measurements at CEUS and those with unchanged measurements of size (p = 0.002), whereas no significant difference was found between the two groups in ill-defined, spiculated, hyperechoic halo, microlobulated and angulated margins (p = 0.463, 0.117, 0.194, 0.666 and 0.780, respectively). This initial study suggests that significant discrepancy of breast lesion measurement between conventional US and CEUS is more likely presented in breast cancer than benign lesions. The pathologic findings corresponding to the region of size increased at CEUS are malignant in most malignant

  6. Value of contrast-enhanced ultrasound in rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Zordo, Tobias de; Mlekusch, Sabine P.; Feuchtner, Gudrun M. [Department of Radiology II, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck (Austria); Mur, Erich [Department of Internal Medicine, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck (Austria); Schirmer, Michael [Department of Internal Medicine, Hospital of the Elisabethines Klagenfurt, Voelkermarkter Strasse 15-19, 9020 Klagenfurt (Austria); Klauser, Andrea S. [Department of Radiology II, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck (Austria)], E-mail: andrea.klauser@i-med.ac.at

    2007-11-15

    The purpose of this review is to describe the spectrum of sonographic findings in rheumatic diseases with respect to the diagnostic potential using US contrast media which prove activity or inactivity in synovial tissue where new treatment regimes target. Synovial activity can be found in non-erosive and erosive forms of primary and secondary osteoarthritis, and in inflammatory forms of joint diseases like rheumatoid arthritis and peripheral manifestations of spondyloarthritis including, ankylosing spondylitis, Reiter's syndrome, psoriatic arthritis and enteropathic arthritis. It can also be present in metabolic and endocrine forms of arthritis, in connective tissue arthropathies like systemic lupus erythematosus or scleroderma and in infectious arthritis. Ultrasound should be used as first-line imaging modality in suspected early cases of RA and other forms of arthritis, whereas contrast-enhanced ultrasound (CEUS) can further enable for sensitive assessment of vascularity which correlates with disease activity.

  7. Value of contrast-enhanced ultrasound in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Zordo, Tobias de; Mlekusch, Sabine P.; Feuchtner, Gudrun M.; Mur, Erich; Schirmer, Michael; Klauser, Andrea S.

    2007-01-01

    The purpose of this review is to describe the spectrum of sonographic findings in rheumatic diseases with respect to the diagnostic potential using US contrast media which prove activity or inactivity in synovial tissue where new treatment regimes target. Synovial activity can be found in non-erosive and erosive forms of primary and secondary osteoarthritis, and in inflammatory forms of joint diseases like rheumatoid arthritis and peripheral manifestations of spondyloarthritis including, ankylosing spondylitis, Reiter's syndrome, psoriatic arthritis and enteropathic arthritis. It can also be present in metabolic and endocrine forms of arthritis, in connective tissue arthropathies like systemic lupus erythematosus or scleroderma and in infectious arthritis. Ultrasound should be used as first-line imaging modality in suspected early cases of RA and other forms of arthritis, whereas contrast-enhanced ultrasound (CEUS) can further enable for sensitive assessment of vascularity which correlates with disease activity

  8. Evaluation of tumor response to intra-arterial chemoembolization of hepatocellular carcinoma: Comparison of contrast-enhanced ultrasound with multiphase computed tomography.

    Science.gov (United States)

    Paul, S B; Dhamija, E; Gamanagatti, S R; Sreenivas, V; Yadav, D P; Jain, S; Shalimar; Acharya, S K

    2017-03-01

    To compare the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) with that of multiphase computed tomography (CT) in the evaluation of tumor response to transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC). Fifty patients (41 men, 9 women; mean age, 53 years±12.5 [SD]) with a total of 70 HCCs (mean size, 5cm±3 [SD]) were evaluated. Post-TACE therapeutic assessment of HCC was done at 4 weeks. Patients with TACE done earlier and reporting with suspicion for recurrence were also included. Patients with hepatic masses seen on ultrasound were enrolled and subjected to CEUS, multiphase CT and magnetic resonance imaging (MRI). Hyperenhancing area at the tumor site on arterial phase of CEUS/multiphase CT/MRI was termed as residual disease (RD), the patterns of which were described on CEUS. Diagnostic accuracies of CEUS and MPCT were compared to that of MRI that was used as the reference standard. CEUS detected RD in 43/70 HCCs (61%). RD had a heterogeneous pattern in 22/43 HCCs (51%). Sensitivities of CEUS and multiphase CT were 94% (34/36; 95% CI: 81-99%) and 50% (18/36; 95% CI: 33-67%) respectively. Significant difference in sensitivity was found between CEUS and multiphase CT (P=0.0001). CEUS and multiphase CT had 100% specificity (95% CI: 83-100%). CEUS is a useful technique for detecting RD in HCC after TACE. For long term surveillance, CEUS should be complemented with multiphase CT/MRI for a comprehensive evaluation. Copyright © 2016 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

  9. Radiofrequency ablation of renal tumours: diagnostic accuracy of contrast-enhanced ultrasound for early detection of residual tumour

    International Nuclear Information System (INIS)

    Hoeffel, Christine; Pousset, Maud; Elie, Caroline; Timsit, Marc-Olivier; Mejean, Arnaud; Merran, Samuel; Tranquart, Francois; Khairoune, Ahmed; Helenon, Olivier; Correas, Jean-Michel; Joly, Dominique; Richard, Stephane

    2010-01-01

    To evaluate the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) in the early detection of residual tumour after radiofrequency ablation (RFA) of renal tumours. Patients referred to our institution for RFA of renal tumours prospectively underwent CEUS and computed tomography (CT) or magnetic resonance imaging (MRI) before, within 1 day and 6 weeks after treatment. Identification of residual tumour was assessed by three blinded radiologists. Reference standard was CT/MRI performed at least 1 year after RFA. A total of 66 renal tumours in 43 patients (median age 62 years; range 44-71.5) were studied. Inter-reader agreement (κ value) was 0.84 for CEUS. Prevalence of residual disease was 19%. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), respectively, were as follows: 64% [confidence interval (CI) 39-84], 98% [CI 91-100], 82% [CI 52-95] and 92% [CI 83-97] on 24-h CEUS; 79% [CI 52-92], 100% [CI 94-100], 100% [CI 74-100] and 95% [CI 87-100] on 6-week CEUS; 79% [CI 52-92], 95% [CI 86-98], 79% [CI 52-92] and 95% [CI 86-98] on 24-h CT/MRI; and 100% [CI 72-100], 98% [CI 90-100], 91% [CI 62-98] and 100% [CI 93-100] on 6-week CT/MRI. CEUS has high specificity for the early diagnosis of residual tumour after renal RFA. (orig.)

  10. Contrast-enhanced Ultrasound for Detection of Crohn's Disease Activity: Systematic Review and Meta-analysis.

    Science.gov (United States)

    Serafin, Zbigniew; Białecki, Marcin; Białecka, Agnieszka; Sconfienza, Luca Maria; Kłopocka, Maria

    2016-03-01

    Reports on imaging of active Crohn's disease (aCD) using contrast-enhanced ultrasound (CEUS) are encouraging. However, the statistical power of most published papers is limited due to the small size of the patient groups included. This study was performed to verify the diagnostic value of CEUS in detecting aCD. A systematic literature search was performed by two independent reviewers for articles on the test characteristics of CEUS for the identification of aCD. The quality of the analysed studies was evaluated using a quality assessment tool for diagnostic accuracy studies (QUADAS-2). Pooling was performed using a diagnostic random-effect model and bivariate analysis. Eight articles were included in the final analysis, with a total of 332 patients. There was no significant publication bias. Significant heterogeneity was found regarding CEUS methodology and sonographic definitions of aCD. In a bivariate analysis, pooled sensitivity was 0.94 (95% CI 0.87-0.97) and pooled specificity was 0.79 (95% CI 0.67-0.88). Spearman correlation statistics presented no significant diagnostic threshold effect (r = 0.12, p > 0.9). Subgroup analysis showed that relative intestine wall enhancement had the highest diagnostic value (area under the curve 94%), while the presence of enhancement and analysis of the slope were less useful (area under the curve 91 and 90%, respectively). CEUS presents good sensitivity and moderate specificity in the detection of the aCD. Large-scale randomized trials with quantitative evaluation of CEUS images are necessary to promote this technique in clinical practice. Copyright © 2015 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  11. Quantitative evaluation of contrast-enhanced ultrasound after intravenous administration of a microbubble contrast agent for differentiation of benign and malignant thyroid nodules: assessment of diagnostic accuracy.

    Science.gov (United States)

    Nemec, Ursula; Nemec, Stefan F; Novotny, Clemens; Weber, Michael; Czerny, Christian; Krestan, Christian R

    2012-06-01

    To investigate the diagnostic accuracy, through quantitative analysis, of contrast-enhanced ultrasound (CEUS), using a microbubble contrast agent, in the differentiation of thyroid nodules. This prospective study enrolled 46 patients with solitary, scintigraphically non-functional thyroid nodules. These patients were scheduled for surgery and underwent preoperative CEUS with pulse-inversion harmonic imaging after intravenous microbubble contrast medium administration. Using histology as a standard of reference, time-intensity curves of benign and malignant nodules were compared by means of peak enhancement and wash-out enhancement relative to the baseline intensity using a mixed model ANOVA. ROC analysis was performed to assess the diagnostic accuracy in the differentiation of benign and malignant nodules on CEUS. The complete CEUS data of 42 patients (31/42 [73.8%] benign and 11/42 [26.2%] malignant nodules) revealed a significant difference (P benign and malignant nodules. Furthermore, based on ROC analysis, CEUS demonstrated sensitivity of 76.9%, specificity of 84.8% and accuracy of 82.6%. Quantitative analysis of CEUS using a microbubble contrast agent allows the differentiation of benign and malignant thyroid nodules and may potentially serve, in addition to grey-scale and Doppler ultrasound, as an adjunctive tool in the assessment of patients with thyroid nodules. • Contrast-enhanced ultrasound (CEUS) helps differentiate between benign and malignant thyroid nodules. • Quantitative CEUS analysis yields sensitivity of 76.9% and specificity of 84.8%. • CEUS may be a potentially useful adjunct in assessing thyroid nodules.

  12. Diagnostic accuracy of contrast-enhanced ultrasound in differentiating benign and malignant focal liver lesions: a retrospective study

    International Nuclear Information System (INIS)

    Ooi, Chin-Chin; Low, Su-Chong Albert; Lim, Sze-Ying; Bakar, Rafidah Abu; Lo, Richard Hoau-Gong; Schneider-Kolsky, Michal; Lombardo, Paul

    2010-01-01

    Full text: Purpose: The purpose of this study was to access the diagnostic accuracy of our early experience with contrast-enhanced ultrasound (CEUS) in the characterisation of focal liver lesions (FLLs) using histopathology, contrastenhanced computed tomography (CT), magnetic resonance imaging (MRI) or other imaging follow-up as the standard of reference. Materials and Methods: Seventy-three patients with 82 FLLs who underwent liver CEUS from January 2006 to December 2008 were retrospectively reviewed. CEUS was performed with up to 4.8 mL of SonoVue (Bracco, Milan, Italy) using a low mechanical index mode. The CEUS findings were compared with histopathology, or where histopathology was not available, clinical and imaging follow-up over at least 12 months was used as the standard of reference. Results: Of the 82 FLLs, 50 were malignant and 32 were benign at final diagnosis. CEUS correctly identified 43 malignant FLLs, with final diagnosis confirmed by histopathology in 13 lesions and clinico-radiological follow-up in 30 lesions. Twenty-nine lesions were correctly identified as benign on CEUS, with all these lesions confirmed on c1inico-radiological follow-up. CEUS demonstrated a sensitivity of 86.0% and a specificity of 90.6% in the characterisation of liver lesions as malignant, with an overall accuracy of 87.8% (P< 0.05). Conclusion: Our early experience has shown that CEUS can be accurate in differentiating malignant from benign FLLs and may become a useful first-line imaging tool where CT or MRI are not available or contra-indicated.

  13. Changes in the micro-circulation of skeletal muscle due to varied isometric exercise assessed by contrast-enhanced ultrasound

    International Nuclear Information System (INIS)

    Krix, Martin; Weber, Marc-Andre; Kauczor, Hans-Ulrich; Delorme, Stefan; Krakowski-Roosen, Holger

    2010-01-01

    Purpose: To quantitatively assess local muscle micro-circulation with real-time contrast-enhanced ultrasound (CEUS) during different exercises and compare the results with performed muscle work and global blood flow. Materials and methods: Sixteen low mechanical index CEUS examinations of the right lower leg flexors of healthy volunteers were performed using a continuous infusion of SonoVue (4.8 mL/300 s). Several muscle perfusion parameters were extracted from derived CEUS signal intensity time curves during different isometric exercises (10-50% of maximum individual strength for 20-30 s) and then correlated with the performed muscle work or force, and the whole lower leg blood flow which we measured simultaneously by venous occlusion plethysmography (VOP). Results: The shapes of the CEUS curve during and after exercise differed individually depending on the performed muscle work. The maximum blood volume MAX was observed only after exercise cessation and was significantly correlated with the performed muscle force (r = 0.77, p < 0.0001). The blood volume over exercise time was inversely correlated with the spent muscle work (r = -0.60, p = 0.006). CEUS and VOP measurements correlated only at rest and after the exercise. During exercise, mean CEUS local blood volume decreased (from 3.48 to 2.19 (∼mL)), while mean VOP global blood flow increased (mean, from 3.96 to 7.71 mL/100 mg/min). Conclusion: Real-time low-MI CEUS provides complementary information about the local muscle micro-circulation compared to established blood flow measures. CEUS may be used for a better understanding of muscle perfusion physiology and in the diagnosis of micro-circulation alterations such as in peripheral arterial occlusive disease or diabetic angiopathy.

  14. Detection of urinary leakage after radical retropubic prostatectomy by contrast enhanced ultrasound - do we still need conventional retrograde cystography?

    Science.gov (United States)

    Schoeppler, Gita M; Buchner, Alexander; Zaak, Dirk; Khoder, Wael; Staehler, Michael; Stief, Christian G; Reiser, Maximilian F; Clevert, Dirk-Andre

    2010-12-01

    To prospectively evaluate the accuracy of transvesical contrast-enhanced ultrasound (CEUS) as an alternative method for the detection of anastomotic leakage after radical retropubic prostatectomy (RRP) in comparison with the current standard method of conventional retrograde cystography (CG). Forty-three patients underwent RRP for histologically proven localized prostate cancer. The vesico-urethral anastomosis was evaluated 8 days after RRP by CG and CEUS. Any peri-anastomotic leakage was assessed and determined in CG and CEUS as follows: no extravasation (EV), small leakage (≤0.5 cm), moderate leakage (>0.5 cm to ≤2 cm), large leakage (>2 cm diameter of EV seen). In total, 21 (49%) patients showed a watertight anastomosis. Ten (23%), two (4.7%) and ten (23%) patients showed a small, intermediate and large EV, respectively. In 31 cases (72%) there was 100% agreement of CG and CEUS for detection of no, moderate and large EV, respectively. In nine cases a small and in two cases a moderate EV was categorized as watertight anastomosis by CEUS. Only in one case did CG detect a small EV where a large EV was detected in CEUS. The agreement between both methods was 95% for detecting absence or large leakages. CEUS is a promising imaging modality that seems to be equivalent to CG for detecting the presence of a large anastomotic leakage that is clinically relevant for postoperative persistence of the indwelling catheter. CEUS could be a cheap and time-saving alternative to the CG without exposure of the patient to radiation. © 2010 THE AUTHORS. JOURNAL COMPILATION © 2010 BJU INTERNATIONAL.

  15. Contrast enhanced ultrasound in the evaluation and percutaneous treatment of hepatic and renal tumors

    International Nuclear Information System (INIS)

    Meloni, Maria Franca; Smolock, Amanda; Cantisani, Vito; Bezzi, Mario; D'Ambrosio, Ferdinando; Proiti, Maria; Lee, Fred; Aiani, Luca; Calliada, Fabrizio; Ferraioli, Giovanna

    2015-01-01

    Highlights: • Image-guided percutaneous ablation techniques are increasingly being used for the treatment of malignant tumors of the liver and kidney when surgery is not indicated. • Percutaneous ablation relies on imaging at every step of the process in order to detect, guide, and confirm complete tumor coagulation. • CEUS is a real-time dynamic imaging technique that plays an important role in the management of patients treated with ablation for malignant tumors. • This review focuses on the role of CEUS in the evaluation of patients undergoing percutaneous treatments for hepatic and renal tumors. - Abstract: Image-guided percutaneous ablation techniques are increasingly being used for the treatment of malignant tumors of the liver and kidney. Contrast enhanced ultrasound (CEUS) is a real-time dynamic imaging technique that plays an important role in the pre-, intra-, and post-procedural management of these patients. This review will focus on the role of CEUS in the evaluation of patients undergoing treatment with percutaneous ablation for hepatic or renal tumors

  16. Assessment of renal perfusion with contrast-enhanced ultrasound: Preliminary results in early diabetic nephropathies.

    Science.gov (United States)

    Dong, Yi; Wang, Wen-Ping; Lin, Pan; Fan, Peili; Mao, Feng

    2016-01-01

    We performed a prospective study to evaluate the value of contrast-enhanced ultrasound (CEUS) in quantitative evaluation of renal cortex perfusion in patients suspected of early diabetic nephropathies (DN), with the estimated GFR (MDRD equation) as the gold standard. The study protocol was approved by the hospital review board; each patient gave written informed consent. Our study included 46 cases (21 males and 25 females, mean age 55.6 ± 4.14 years) of clinical confirmed early DN patients. After intravenous bolus injection of 1 ml sulfur hexafluoride microbubbles of ultrasound contrast agent, real time CEUS of renal cortex was performed successively using a 2-5 MHz convex probe. Time-intensity curves (TICs) and quantitative indexes were created with Qlab software. Receiver operating characteristic (ROC) curves were used to predict the diagnostic criteria of CEUS quantitative indexes, and their diagnostic efficiencies were compared with resistance index (RI) and peak systolic velocity (PSV) of renal segmental arteries by chi square test. Our control group included forty-five healthy volunteers. Difference was considered statistically significant with P  0.05). CEUS might be helpful to improve early diagnosis of DN by quantitative analyses. AUC and DPI might be valuable quantitative indexes.

  17. Perfusion characteristics of parotid gland tumors evaluated by contrast-enhanced ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Klotz, Laura V., E-mail: Laura.Klotz@med.uni-muenchen.de [Department of Surgery, University of Munich, Munich (Germany); Gürkov, Robert [Department of Otorhinolaryngology, University of Munich, Munich (Germany); Eichhorn, Martin E. [Department of Surgery, University of Munich, Munich (Germany); Siedek, Vanessa; Krause, Eike [Department of Otorhinolaryngology, University of Munich, Munich (Germany); Jauch, Karl-Walter [Department of Surgery, University of Munich, Munich (Germany); Reiser, Maximilian F.; Clevert, Dirk-Andre [Department of Clinical Radiology, University of Munich, Munich (Germany)

    2013-12-01

    Purpose: Contrast enhanced ultrasound (CE-US) is a promising imaging modality for non-invasive analysis of parotid gland lesions because their vascularisation differs from normal gland tissue. This clinical study should further investigate CE-US as a diagnostic tool for parotid gland tumors. Materials and methods: 39 patients underwent CE-US measurements after intravenous application of a contrast agent (SonoVue, Bracco, Italy) before surgical tumor resection. Time–intensity curves gradients were calculated and parameters of intratumoral microcirculation were analysed. The vascularisation parameters were compared among the different tumor entities as defined per definitive histological diagnosis. Results: Histological analyses revealed 17 pleomorphic adenoma, 15 cystadenolymphoma and 7 malignoma. A significant difference of area below intensity time curve (AUC) and mean transit time (MTT) was measured in the malignant lesions compared to benign tumors (p < 0.05). A significant difference of AUC and maximum of signal increase (ΔSI{sub max}) for pleomorphic adenoma versus cystadenolymphoma was found (p < 0.05). Conclusion: CE-US seems to be a quantitative and independent method for the assessment of malign and benign parotid gland tumors. Further studies and clinical experience will have to validate this method as a reliable diagnostic tool that facilitates preoperative planning.

  18. Analysis of achilles tendon vascularity with second-generation contrast-enhanced ultrasound.

    Science.gov (United States)

    Genovese, Eugenio; Ronga, Mario; Recaldini, Chiara; Fontana, Federico; Callegari, Leonardo; Maffulli, Nicola; Fugazzola, Carlo

    2011-01-01

    To compare morphological, power Doppler, and contrast-enhanced ultrasound (CEUS) features of the Achilles tendon between asymptomatic athletes and athletes who had undergone surgical repair of a previous rupture. Twenty-four athletes were divided in two groups (A and B). Group A included 14 patients with a median age of 32 years (range 27 to 47 years) who had undergone surgical repair for unilateral Achilles tendon rupture. Group B (control group) included 10 subjects with a median age of 34 years (range 27 to 40 years) with no previous or present history of tendinopathy. All patients were evaluated with ultrasound, power Doppler, and CEUS with second-generation contrast agent. We studied the uninjured Achilles tendon in athletes of group A and either the left or the right Achilles tendon of the athletes in group B. CEUS showed a significantly greater ability to detect a greater number of vascular spots within the uninjured tendon of group A compared to group B (power Doppler ultrasound in the uninjured contralateral Achilles tendon. CEUS is useful to evaluate vascularity not detected by other imaging techniques. Vascularity in the uninjured tendon seems to be increased in patients who had a previous rupture. Copyright © 2011 Wiley Periodicals, Inc.

  19. Real-time contrast-enhanced ultrasound in diagnosing of focal spleen lesions

    International Nuclear Information System (INIS)

    Yu Xiaoling; Yu Jie; Liang Ping; Liu Fangyi

    2012-01-01

    Objective: To investigate the features of focal spleen lesions (FSLs) on contrast-enhanced ultrasound (CEUS) imaging. Materials and methods: CEUS with a blot injection of SonoVue was performed in 48 patients with 75 FSLs (median diameter 2.6 cm) and their perfusion characteristics were analyzed by using contrast pulse sequences (CPS) technique. Results: Among 19 malignant lesions (10 metastases, 7 lymphoma, 1 hemangiosarcoma, 1 epithelioid hemangioendothelioma) and 56 benign lesion (23 hemangiomas, 14 cysts, 8 infarctions, 4 splenic ruptures, 3 tuberculosis, 2 abscess, 1 pseudoaneurysm, 1 lymphangioma), 25 benign lesions were demonstrated nonenhancement. For malignancy, 50.0% (5/10) metastases and 57.1% (4/7) lymphomas were showed hypoenhancement in the arterial phase, and 18 (94.7%) of malignant lesions were hypo-enhancement in the parenchymal phase. Among 31 benign lesions with enhancement, 27 (87.1%) were showed isoenhancement or hyperenhancement in the arterial phase and 22 (71.0%) lesions were isoenhancement or hyperenhancement in the parenchymal phase. The sensitivity, specificity and accuracy of diagnosis for FSLs were 91.1%, 95.0% and 92.0% for CEUS and 75.0%, 84.2% and 77.3% respectively, for the conventional baseline ultrasound (BUS). Conclusion: Real-time CEUS can provide valuable information for the diagnosis and differential diagnosis of FSLs.

  20. Focal masses in a non-cirrhotic liver: The additional benefit of CEUS over baseline imaging

    Energy Technology Data Exchange (ETDEWEB)

    Chiorean, L., E-mail: lilichiorean@yahoo.com [Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University (China); Med. Klinik 2, Caritas Krankenhaus Bad Mergentheim, Uhlandstr. 7, D-97980 Bad Mergentheim (Germany); Département d’imagerie médicale, Clinique des Cévennes, 07100 Annonay (France); Cantisani, V., E-mail: vito.cantisani@uniroma1.it [Dipartimento di Scienze Radiologiche, Oncologiche, Anatomo-patologiche, Policlinico Umberto I, Univ. Sapienza, Roma (Italy); Jenssen, C., E-mail: C.Jenssen@khmol.de [Innere Medizin, Krankenhaus Märkisch Oderland, Prötzeler Chaussee 5, 15433 Strausberg (Germany); Sidhu, P.S., E-mail: paulsidhu@nhs.net [Department of Radiology, King' s College Hospital, Denmark Hill, London SE5 9RS, England (United Kingdom); Baum, U., E-mail: Ulrich.Baum@ckbm.de [Department of Radiology, Caritas Krankenhaus Bad Mergentheim, Uhlandstr. 7, D-97980 Bad Mergentheim (Germany); Dietrich, C.F., E-mail: christoph.dietrich@ckbm.de [Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University (China); Med. Klinik 2, Caritas Krankenhaus Bad Mergentheim, Uhlandstr. 7, D-97980 Bad Mergentheim (Germany)

    2015-09-15

    Highlights: • Contrast-enhanced ultrasound in detection of focal liver lesions. • Contrast-enhanced ultrasound in characterization of focal liver lesions. • Contrast-enhanced ultrasound in differential diagnosis of focal liver lesions. • Contrast-enhanced ultrasound in final diagnosis of focal liver lesions. • Contrast-enhanced ultrasound in liver metastases screening. • Roles of cross-sectional imaging techniques for focal liver lesions assessment. • Advantages of contrast-enhanced ultrasound over other imaging procedures. - Abstract: Incidentally detected focal liver lesions are commonly encountered in clinical practice presenting a challenge in the daily department work flow. Guidelines for the management of incidental focal liver lesions have been published but comments, illustrations and recommendations regarding practical issues are crucial. The unique features of contrast-enhanced ultrasound in non-invasive assessment of focal liver lesion enhancement throughout the vascular phases in real-time has allowed an impressive improvement in the diagnostic accuracy of ultrasound. We highlight the additional benefit of contrast-enhanced ultrasound over conventional B-mode ultrasound imaging in detection, characterization, differential and final diagnosis of focal liver lesions, as well as for liver metastases screening. The current roles of cross-sectional imaging are explained in detail, with indications and limitations for each procedure. The advantages of CEUS, such as non-ionizing radiation exposure, cost benefits, non-iodinate contrast agents, and repeatability are also described ultimately improving patient management.

  1. Quantitative evaluation of muscle perfusion with CEUS and with MR

    Energy Technology Data Exchange (ETDEWEB)

    Weber, Marc-Andre; Delorme, Stefan [German Cancer Research Centre, Department of Radiology, Heidelberg (Germany); Krix, Martin [German Cancer Research Centre, Department of Radiology, Heidelberg (Germany); Bracco ALTANA Pharma GmbH, Konstanz (Germany)

    2007-10-15

    Functional imaging might increase the role of imaging in muscular diseases, since alterations of muscle morphology alone are not specific for a particular disease. Perfusion, i.e., the blood flow per tissue and time unit including capillary flow, is an important functional parameter. Pathological changes of skeletal muscle perfusion can be found in various clinical conditions, such as degenerative or inflammatory myopathies or peripheral arterial occlusive disease. This article reviews the theoretical basics of functional radiological techniques for assessing skeletal muscle perfusion and focuses on contrast-enhanced ultrasound (CEUS) and magnetic resonance imaging (MRI) techniques. Also, the applications of microvascular imaging, such as in detection of myositis and for discriminating myositis from other myopathies or evaluating peripheral arterial occlusive disease, are presented, and possible clinical indications are discussed. In conclusion, dedicated MR and CEUS methods are now available that visualize and quantify (patho-)physiologic information about microcirculation within skeletal muscles in vivo and hence establish a useful diagnostic tool for muscular diseases. (orig.)

  2. Quantitative evaluation of muscle perfusion with CEUS and with MR

    International Nuclear Information System (INIS)

    Weber, Marc-Andre; Delorme, Stefan; Krix, Martin

    2007-01-01

    Functional imaging might increase the role of imaging in muscular diseases, since alterations of muscle morphology alone are not specific for a particular disease. Perfusion, i.e., the blood flow per tissue and time unit including capillary flow, is an important functional parameter. Pathological changes of skeletal muscle perfusion can be found in various clinical conditions, such as degenerative or inflammatory myopathies or peripheral arterial occlusive disease. This article reviews the theoretical basics of functional radiological techniques for assessing skeletal muscle perfusion and focuses on contrast-enhanced ultrasound (CEUS) and magnetic resonance imaging (MRI) techniques. Also, the applications of microvascular imaging, such as in detection of myositis and for discriminating myositis from other myopathies or evaluating peripheral arterial occlusive disease, are presented, and possible clinical indications are discussed. In conclusion, dedicated MR and CEUS methods are now available that visualize and quantify (patho-)physiologic information about microcirculation within skeletal muscles in vivo and hence establish a useful diagnostic tool for muscular diseases. (orig.)

  3. Contrast enhanced CT of spinal cord angioma

    International Nuclear Information System (INIS)

    Nakamura, Takahiko; Ebitani, Tsutomu; Honma, Takao; Sofue, Muroto; Nakamura, Shigeru

    1982-01-01

    Contrast enhanced CT on 6 patients with spinal cord angioma showed enhancement in 2 of them. The conditions to produce contrast enhancement were the window width of 100 - 200, and the window level of 0 - 50. In spinal cord angioma, contrast enhanced CT is presently only an adjunct to angiography and myelography. Nevertheless, contrast enhanced CT is useful in the screening test for spinal cord angioma, in the patients who are nonindicated to angiography, and in the postoperative follow-up. (Ueda, J.)

  4. Contrast-enhanced ultrasound-guided radiofrequency ablation in inconspicuous hepatocellular carcinoma on B-mode ultrasound.

    Science.gov (United States)

    Kim, Eui Joo; Kim, Yun Soo; Shin, Seung Kak; Kwon, Oh Sang; Choi, Duck Joo; Kim, Ju Hyun

    2017-11-01

    B-mode ultrasound (US) has difficulty targeting small hepatocellular carcinomas (HCCs) with poor conspicuity during radiofrequency ablation (RFA). Contrast-enhanced ultrasound (CEUS) can improve visualization of small or inconspicuous HCCs. This study was conducted to evaluate the effectiveness of CEUS-guided RFA electrode insertion during the arterial phase in inconspicuous HCCs. Ninety-three treatment-naïve HCCs from 80 patients treated with RFA from August 2012 to December 2014 were retrospectively reviewed. Seventy-five HCCs from 65 patients underwent B-mode US-guided RFA, and 15 HCCs from 14 patients that were inconspicuous on B-mode US underwent CEUS-guided RFA during the arterial phase after injection of sulfur hexafluoride microbubbles (SonoVue®). Technical success was assessed by contrast-enhanced computed tomography within 1 week and 3 months after the procedure. The mean size of HCCs treated with CEUS-guided RFA was smaller than that of HCCs treated with B-mode US-guided RFA (1.17±0.36 vs. 1.63±0.55 cm, p=0.003). Technical success rates of CEUS-guided RFA within 1 week and 3 months were 100% (15/15) and 93.3% (14/15), respectively. Technical success rates of B-mode US-guided RFA were 97.3% (73/75) and 94.5% (69/73), respectively. CEUS-guided RFA is highly efficacious for ablation of very small and inconspicuous HCCs.

  5. Contrast enhanced MRI findings of ductal carcinoma in situ

    International Nuclear Information System (INIS)

    Kang, Bong Joo; Cha, Eun Suk; Kim, Hyeon Sook; Suh, Young Jin; Choi, Hyun Joo

    2006-01-01

    The purpose of this study is to describe characteristic contrast enhanced MR mammographic findings of ductal carcinoma in situ (DCIS) and also DCIS with microinvasion. From January 2000 to July 2005, 32 women with 33 lesions affected by DCIS or DCIS with microinvasion underwent contrast enhanced MRI, and they were then retrospectively evaluated. All the patients had previously undergone mammography and ultrasonography. All the findings of mammography, ultrasonography (US), and MRI were analyzed by using an ACR BI-RADS lexicon. All 33 cases were enhanced on the enhanced MR images. A smooth margined homogeneous enhanced mass was seen in the two (2/33) cases, and nonmass enhancement was seen in 31 (31/33) cases. Among the non-mass enhancement, focal enhancement (7/31), ductal enhancement (5/31), segmental enhancement (9/31), and regional enhancement (10/31) were observed. On the kinetic study, a wash-out pattern (10/33), a plateau pattern (20/33), and a persistent pattern (3/33) were demonstrated. No significant differences were noted between the pure and microinvasive DCIS. There is no significant difference between pure and microinvasive DCIS. However, contrast enhanced MR images can demonstrate occult foci, multifocal lesion and the tumor extent of DCIS on mammogram or ultrasonogram

  6. Usefulness of combined use of contrast-enhanced ultrasound and TI-RADS classification for the differentiation of benign from malignant lesions of thyroid nodules.

    Science.gov (United States)

    Zhang, Yan; Zhou, Ping; Tian, Shuang-Ming; Zhao, Yong-Feng; Li, Jia-Le; Li, Lan

    2017-04-01

    To study the thyroid image reporting and data system (TI-RADS) classification and the contrast-enhanced ultrasound (CEUS) enhancement pattern of thyroid nodules, and to determine whether combined use of both methods is helpful in the diagnosis of thyroid nodules. A total of 319 thyroid nodules in 246 patients were assessed with TI-RADS, CEUS and a combination of both methods. The diagnostic performance of TI-RADS, CEUS and a combination of both methods was compared. The accuracy in the diagnosis of thyroid nodules was 90.3 % for TI-RADS, 90.0 % for CEUS and 96.0 % for a combination of both methods respectively. A statistically significant difference was not observed in the diagnostic accuracy of CEUS and TI-RADS (P > 0.05). However, a significant difference was observed between a combination of both methods and either alone (P TI-RADS classifications of 4a and 4b thyroid nodules compared with TI-RADS alone (P  0.05). The improved TI-RADS, when combined with CEUS, could significantly improve the diagnostic accuracy for thyroid nodules, especially for TI-RADS class-4 thyroid nodules. • TI-RADS can be used as the primary diagnostic standard for thyroid nodules • CEUS can be used as an important complement to TI-RADS • The improved TI-RADS can significantly improve the qualitative diagnostic accuracy.

  7. A study of plaque vascularization and inflammation using quantitative contrast-enhanced US and PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Hjelmgren, Ola, E-mail: ola.hjelmgren@wlab.gu.se [Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Department of Molecular and Clinical Medicine, Clinical Physiology, Gothenburg (Sweden); Sahlgrenska University Hospital, Department of Clinical Physiology, Gothenburg (Sweden); Johansson, Lars, E-mail: lars.johansson@radiol.uu.se [Uppsala University, Department of Radiology, Uppsala (Sweden); Prahl, Ulrica, E-mail: ulrica-prahl-gullberg@wlab.gu.se [Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Department of Molecular and Clinical Medicine, Clinical Physiology, Gothenburg (Sweden); Schmidt, Caroline, E-mail: caroline.schmidt@wlab.gu.se [Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Department of Molecular and Clinical Medicine, Clinical Physiology, Gothenburg (Sweden); Fredén-Lindqvist, Johan, E-mail: johan.freden-lindqvist@vgregion.se [Sahlgrenska University Hospital, Department of Clinical Physiology, Gothenburg (Sweden); Bergström, Göran M.L., E-mail: goran.bergstrom@hjl.gu.se [Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Department of Molecular and Clinical Medicine, Clinical Physiology, Gothenburg (Sweden); Sahlgrenska University Hospital, Department of Clinical Physiology, Gothenburg (Sweden)

    2014-07-15

    Background: Contrast-enhanced ultrasound (CEUS) is an in vivo methodology to quantify carotid plaque vascularization. Increased metabolism in plaques, measured as FDG uptake in PET/CT examination, has been associated with markers of inflammation in histological samples. In this study, we tested the association between FDG uptake and vascularization measured by CEUS to assess whether CEUS can be used as an in vivo marker of plaque vulnerability. Methods: After informed consent, subjects aged >60 years with carotid plaque height exceeding 2.5 mm were recruited. CEUS was performed and analyzed using earlier described protocol and software, Contrast Quantification Program, which calculates the fraction of the plaque being contrast positive (CQP value). PET/CT examination was performed within 3 months of CEUS (median time 7 days). PET/CT images were acquired 90 min after FDG injection (2.7 MBq/kg). FDG uptake was measured as tissue background index (TBI), calculated using Spearman's rho as mean standard uptake value (SUV) of the plaque divided by mean SUV in the jugular vein (mean of 7 measuring points). Local ethics committee approved the study. Results: We recruited 13 subjects (5 women) with a mean age of 71 years, 6 had a history of stroke or TIA, 1 had a history of ipsilateral stroke. CQP values showed a significant, positive correlation with TBI of carotid plaques, r = 0.67, p < 0.02. Conclusions: Plaque vascularization measured by CEUS correlates positively with FDG uptake measured by PET/CT in humans. This indicates an association between vascularization and inflammation and/or hypoxia, supporting the use of CEUS as a non-invasive method to detect plaque vulnerability.

  8. A study of plaque vascularization and inflammation using quantitative contrast-enhanced US and PET/CT

    International Nuclear Information System (INIS)

    Hjelmgren, Ola; Johansson, Lars; Prahl, Ulrica; Schmidt, Caroline; Fredén-Lindqvist, Johan; Bergström, Göran M.L.

    2014-01-01

    Background: Contrast-enhanced ultrasound (CEUS) is an in vivo methodology to quantify carotid plaque vascularization. Increased metabolism in plaques, measured as FDG uptake in PET/CT examination, has been associated with markers of inflammation in histological samples. In this study, we tested the association between FDG uptake and vascularization measured by CEUS to assess whether CEUS can be used as an in vivo marker of plaque vulnerability. Methods: After informed consent, subjects aged >60 years with carotid plaque height exceeding 2.5 mm were recruited. CEUS was performed and analyzed using earlier described protocol and software, Contrast Quantification Program, which calculates the fraction of the plaque being contrast positive (CQP value). PET/CT examination was performed within 3 months of CEUS (median time 7 days). PET/CT images were acquired 90 min after FDG injection (2.7 MBq/kg). FDG uptake was measured as tissue background index (TBI), calculated using Spearman's rho as mean standard uptake value (SUV) of the plaque divided by mean SUV in the jugular vein (mean of 7 measuring points). Local ethics committee approved the study. Results: We recruited 13 subjects (5 women) with a mean age of 71 years, 6 had a history of stroke or TIA, 1 had a history of ipsilateral stroke. CQP values showed a significant, positive correlation with TBI of carotid plaques, r = 0.67, p < 0.02. Conclusions: Plaque vascularization measured by CEUS correlates positively with FDG uptake measured by PET/CT in humans. This indicates an association between vascularization and inflammation and/or hypoxia, supporting the use of CEUS as a non-invasive method to detect plaque vulnerability

  9. Diagnosis of portal vein thrombosis discontinued with liver tumors in patients with liver cirrhosis and tumors by contrast-enhanced US: A pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Song Zezhou; Huang Min [Department of Ultrasound, First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang Province (China); Jiang Tianan, E-mail: tiananjiang@hzcnc.co [Department of Ultrasound, First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang Province (China); Zhao Qiyu [Department of Hepatobiliary Pancreatic Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou (China); Yao Lei; Mou Yun; Zhao Junkang; Ao Jianyang [Department of Ultrasound, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang Province (China); Chen Fen [Department of Hepatobiliary Pancreatic Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou (China); Chen Yan [Department of Ultrasound, First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang Province (China)

    2010-08-15

    Aims: We assessed the role of contrast-enhanced ultrasound (CEUS) in the differential diagnosis between benign and malignant portal vein thrombosis (PVT) in patients who had liver tumors. Methods: Seventeen consecutive patients who had cirrhosis, liver tumors, and PVT were prospectively studied with CEUS. CEUS was performed at low mechanical index after intravenous administration of a second-generation contrast agent (SonoVue, Bracco, Milan, Italy). Presence or absence of thrombus enhancement on CEUS were considered diagnostic for malignant or benign PVT. Five patients also underwent percutaneous portal vein fine-needle biopsy under US guidance. All patients were followed-up. Shrinkage of the thrombus and/or recanalization of the vessels on CDUS during follow-up were considered definitive evidence of the benign nature of the thrombosis, whereas the enlargement of the thrombus, disruption of the vessel wall, and parenchymal infiltration over follow-up were considered consistent with malignancy. Results: Follow-up showed signs of malignant thrombosis in 14 of 17 patients. CEUS showed early arterial enhancement of the PVT in 14 patients of 14 malignant PVT, 1 patient of 3 benign PVT and the absence of thrombus enhancement in 2 patients of 3 benign PVT. FNB confirmed the results for malignant PVT in four of five patients, for benign granulomatous inflammation PVT in one of five patients in which CEUS showed early arterial enhancement of the PVT. The sensitivity, specificity and accuracy is 100%, 66.7% and 93.3% at diagnosis of malignant PVT using CEUS. In one patient with intrahepatic bile duct stone, CEUS were positive for malignant PVT, whereas FNB was negative (benign granulomatous inflammation PVT); follow-up examination confirmed benign PVT. Conclusion: CEUS seems to be the pretty sensitive and specific test for diagnosing malignant portal vein thrombosis in patients with cirrhosis and tumors.

  10. Complex cystic renal masses: characterization with contrast-enhanced US.

    Science.gov (United States)

    Ascenti, Giorgio; Mazziotti, Silvio; Zimbaro, Giovanni; Settineri, Nicola; Magno, Carlo; Melloni, Darwin; Caruso, Rosario; Scribano, Emanuele

    2007-04-01

    To prospectively compare contrast material-enhanced ultrasonography (US) with computed tomography (CT) in the classification of complex cystic renal masses with the Bosniak system. Ethics committee approval and written informed consent were obtained. Forty patients (17 women, 23 men; age range, 31-77 years) with 44 complex cystic renal masses detected with conventional US were prospectively examined by using second-harmonic US with a second-generation contrast agent and multiphasic helical CT. Thirty-six patients had one lesion, and four patients had two lesions. Surgical resection in nine patients and imaging follow-up in 31 patients were used to determine the outcome. On contrast-enhanced US images, masses were classified as Bosniak category II (n = 18), IIF (ie, lesions were classified as category II and follow-up was needed) (n = 16), III (n = 7), or IV (n = 3) lesions. On CT images, masses were classified as Bosniak category II (n = 24), IIF (n = 10), III (n = 7), or IV (n = 3) lesions. Interobserver agreement was high (kappa = 0.86, P < .001) for classification with US. Complete concordance between the readers was found for classification with CT. Complete concordance between contrast-enhanced US and CT was observed in the differentiation of surgical and nonsurgical complex cysts. Complete concordance among the three readers in the assessment of vascularity with contrast-enhanced US was found. Interobserver agreement in the evaluation of enhancement on CT images was high (kappa = 0.88, P < .001). Concordance between contrast-enhanced US and CT in the evaluation of vascularization was high (kappa = 0.77, P < .001). The study data suggest that contrast-enhanced second-harmonic US is appropriate for renal cyst classification with the Bosniak system.

  11. Multiple FNH-Like Lesions in a Patient with Chronic Budd-Chiari Syndrome: Gd-EOB-Enhanced MRI and BR1 CEUS Findings

    Directory of Open Access Journals (Sweden)

    Caroline Newerla

    2012-01-01

    Full Text Available A-26-year old female patient with chronic Budd-Chiari syndrome due to different underlying blood disorders applied for a two-year followup of the liver with Gadolinium-ethoxybenzyl-diethylenetriaminepentaacetic-acid-(Gd-EOB-DTPA- enhanced MRI. The liver function tests were raised. Besides showing a progressive hepatosplenomegaly and a cirrhotic liver alteration, the MRI revealed multiple new nodular lesions in all liver segments. These lesions showed typical patterns in the precontrast images, while there was an arterial and a persistent portal venous enhancement. In the hepatobiliary liver-specific late phase, a central “washout” and a persistent rim enhancement were observed (target sign. The additionally performed contrast-enhanced ultrasonography showed a strong zentrifugal arterial enhancement of the lesions followed by an isoechoic enhancement in the portal venous and delayed liver phase. Histologically these lesions turned out as focal nodular hyperplasias (FNH or FNH-like lesions, also known as large regenerative nodules (LRNs. Differentiation between regenerative nodules like LRN and hepatocellular carcinoma (HCC in cirrhotic livers is crucial, and the target sign in the hepatobiliary phase of Gd-EOB-DTPA as well as the centrifugal arterial enhancement followed by an isoenhancement during a CEUS might be useful for establishing the correct diagnosis of such hypervascular lesions with proliferated and likely aberrant bile ducts.

  12. Diagnostic accuracy of magnetic resonance, computed tomography and contrast enhanced ultrasound in radiological multimodality assessment of peribiliary liver metastases.

    Directory of Open Access Journals (Sweden)

    Vincenza Granata

    Full Text Available We compared diagnostic performance of Magnetic Resonance (MR, Computed Tomography (CT and Ultrasound (US with (CEUS and without contrast medium to identify peribiliary metastasis.We identified 35 subjects with histological proven peribiliary metastases who underwent CEUS, CT and MR study. Four radiologists evaluated the presence of peribiliary lesions, using a 4-point confidence scale. Echogenicity, density and T1-Weigthed (T1-W, T2-W and Diffusion Weighted Imaging (DWI signal intensity as well as the enhancement pattern during contrast studies on CEUS, CT and MR so as hepatobiliary-phase on MRI was assessed.All lesions were detected by MR. CT detected 8 lesions, while US/CEUS detected one lesion. According to the site of the lesion, respect to the bile duct and hepatic parenchyma: 19 (54.3% were periductal, 15 (42.8% were intra-periductal and 1 (2.8% was periductal-intrahepatic. According to the confidence scale MRI had the best diagnostic performance to assess the lesion. CT obtained lower diagnostic performance. There was no significant difference in MR signal intensity and contrast enhancement among all metastases (p>0.05. There was no significant difference in CT density and contrast enhancement among all metastases (p>0.05.MRI is the method of choice for biliary tract tumors but it does not allow a correct differential diagnosis among different histological types of metastasis. The presence of biliary tree dilatation without hepatic lesions on CT and US/CEUS study may be an indirect sign of peribiliary metastases and for this reason the patient should be evaluated by MRI.

  13. Applicability of contrast-enhanced ultrasound in the diagnosis of plantar fasciitis.

    Science.gov (United States)

    Broholm, R; Pingel, J; Simonsen, L; Bülow, J; Johannsen, F

    2017-12-01

    Contrast-enhanced ultrasound (CEUS) is used to visualize the microvascularization in various tissues. The purpose of this study was to investigate whether CEUS could be used to visualize the microvascular volume (MV) in the plantar fascia, and to compare the method to clinical symptoms and B-mode ultrasound (US) in patients with plantar fasciitis (PF). Twenty patients with unilateral PF were included and were divided by US in insertional thickening (10), midsubstance thickening (5), and no US changes (5). The MV was measured simultaneously in both heels. Four areas in the plantar fascia and plantar fat pad were measured independently by two observers. Inter- and intra-observer correlation analyses were performed. The asymptomatic heels showed a constantly low MV, and for the whole group of patients, a significantly higher MV was found in the symptomatic plantar fascia and plantar fat pad. Inter-observer correlation as well as intra-observer agreement was excellent. The MV in the plantar fascia and plantar fat pad can be measured reliably using CEUS, suggesting that it is a reproducible method to examine patients with plantar fasciitis. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Detection of cavernous transformation of the portal vein by contrast-enhanced ultrasound.

    Science.gov (United States)

    Hwang, Misun; Thimm, Matthew A; Guerrerio, Anthony L

    2018-06-01

    Cavernous transformation of the portal vein can be missed on color Doppler exam or arterial phase cross-sectional imaging due to their slow flow and delayed enhancement. Contrast-enhanced ultrasound (CEUS) offers many advantages over other imaging techniques and can be used to successfully detect cavernous transformations of the portal vein. A 10-month-old female was followed for repeat episodes of hematemesis. Computed tomography angiography (CTA) and magnetic resonance arteriogram (MRA) and portal venography were performed. Color Doppler exam of the portal vein was performed followed by administration of Lumason, a microbubble US contrast agent. Magnetic resonance arteriogram, CTA, and color Doppler exam at the time of initial presentation was unremarkable without obvious vascular malformation within the limits of motion degraded exam. At 8-month follow-up, esophagogastroduodenoscopy revealed a vascular malformation in the distal esophagus which was sclerosed. At 6 month after sclerosis of the lesion, portal venography revealed occlusion of the portal vein with extensive collateralization. Color Doppler revealed subtle hyperarterialization and periportal collaterals. CEUS following color Doppler exam demonstrated extensive enhancement of periportal collaterals. Repeat color Doppler after contrast administration demonstrated extensive Doppler signal in the collateral vessels, suggestive of cavernous transformation. We describe a case of cavernous transformation of the portal vein missed on initial color Doppler, CTA and MRA, but detected with contrast-enhanced ultrasound technique.

  15. Contrast-enhanced ultrasound in diagnosis and characterization of focal hepatic lesions.

    Science.gov (United States)

    Molins, Inés Gómez; Font, Juan Manuel Fernández; Alvaro, Juan Carrero; Navarro, Jose Luís Lledó; Gil, Marta Fernández; Rodríguez, Conrado M Fernández

    2010-12-28

    The extensive use of imaging techniques in differential diagnosis of abdominal conditions and screening of hepatocellular carcinoma in patients with chronic hepatic diseases, has led to an important increase in identification of focal liver lesions. The development of contrast-enhanced ultrasound (CEUS) opens a new window in the diagnosis and follow-up of these lesions. This technique offers obvious advantages over the computed tomography and magnetic resonance, without a decrease in its sensitivity and specificity. The new second generation contrast agents, due to their intravascular distribution, allow a continuous evaluation of the enhancement pattern, which is crucial in characterization of liver lesions. The dual blood supply in the liver shows three different phases, namely arterial, portal and late phases. The enhancement during portal and late phases can give important information about the lesion's behavior. Each liver lesion has a different enhancement pattern that makes possible an accurate approach to their diagnosis. The role of emerging techniques as a contrast-enhanced three-dimensional US is also discussed. In this article, the advantages, indications and technique employed during CEUS and the different enhancement patterns of most benign and malignant focal liver lesions are discussed.

  16. Volume navigation with contrast enhanced ultrasound and image fusion for percutaneous interventions: first results.

    Directory of Open Access Journals (Sweden)

    Ernst Michael Jung

    Full Text Available 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.

  17. Usefulness of combining gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging and contrast-enhanced ultrasound for diagnosing the macroscopic classification of small hepatocellular carcinoma.

    Science.gov (United States)

    Kobayashi, Tomoki; Aikata, Hiroshi; Hatooka, Masahiro; Morio, Kei; Morio, Reona; Kan, Hiromi; Fujino, Hatsue; Fukuhara, Takayuki; Masaki, Keiichi; Ohno, Atsushi; Naeshiro, Noriaki; Nakahara, Takashi; Honda, Yohji; Murakami, Eisuke; Kawaoka, Tomokazu; Tsuge, Masataka; Hiramatsu, Akira; Imamura, Michio; Kawakami, Yoshiiku; Hyogo, Hideyuki; Takahashi, Shoichi; Chayama, Kazuaki

    2015-11-01

    Non-simple nodules in hepatocellular carcinoma (HCC) correlate with poor prognosis. Therefore, we examined the diagnostic ability of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (EOB-MRI) and contrast-enhanced ultrasound (CEUS) for diagnosing the macroscopic classification of small HCCs. A total of 85 surgically resected nodules (≤30 mm) were analyzed. HCCs were pathologically classified as simple nodular (SN) and non-SN. By evaluating hepatobiliary phase (HBP) of EOB-MRI and Kupffer phase of CEUS, the diagnostic abilities of both modalities to correctly distinguish between SN and non-SN were compared. Forty-six nodules were diagnosed as SN and the remaining 39 nodules as non-SN. The area under the ROC curve (AUROCs, 95% confidence interval) for the diagnosis of non-SN were EOB-MRI, 0.786 (0.682-0.890): CEUS, 0.784 (0.679-0.889), in combination, 0.876 (0.792-0.959). The sensitivity, specificity, and accuracy were 64.1%, 95.7%, and 81.2% in EOB-MRI, 56.4%, 97.8%, and 78.8% in CEUS, and 84.6%, 95.7%, and 90.6% in combination, respectively. High diagnostic ability was obtained when diagnosed in both modalities combined. The sensitivity was especially statistically significant compared to CEUS. Combined diagnosis by EOB-MRI and CEUS can provide high-quality imaging assessment for determining non-SN in small HCCs. • Non-SN has a higher frequency of MVI and intrahepatic metastasis than SN. • Macroscopic classification is useful to choose the treatment strategy for small HCCs. • Diagnostic ability for macroscopic findings of EOB-MRI and CEUS were statistically equal. • The diagnosis of macroscopic findings by individual modality has limitations. • Combined diagnosis of EOB-MRI and CEUS provides high diagnostic ability.

  18. Real-time 3-dimensional contrast-enhanced ultrasound in detecting hemorrhage of blunt renal trauma.

    Science.gov (United States)

    Xu, Rui-Xue; Li, Ye-Kuo; Li, Ting; Wang, Sha-Sha; Yuan, Gui-Zhong; Zhou, Qun-Fang; Zheng, Hai-Rong; Yan, Fei

    2013-10-01

    The objective of this study is to evaluate the diagnostic value of real-time 3-dimensional contrast-enhanced ultrasound in the hemorrhage of blunt renal trauma. Eighteen healthy New Zealand white rabbits were randomly divided into 3 groups. Blunt renal trauma was performed on each group by using minitype striker. Ultrasonography, color Doppler flow imaging, and contrast-enhanced 2-dimensional and real-time 3-dimensional ultrasound were applied before and after the strike. The time to shock and blood pressure were subjected to statistical analysis. Then, a comparative study of ultrasound and pathology was carried out. All the struck kidneys were traumatic. In the ultrasonography, free fluid was found under the renal capsule. In the color Doppler flow imaging, active hemorrhage was not identified. In 2-dimensional contrast-enhanced ultrasound, active hemorrhage of the damaged kidney was characterized. Real-time 3-dimensional contrast-enhanced ultrasound showed a real-time and stereoscopic ongoing bleeding of the injured kidney. The wider the hemorrhage area in 4-dimensional contrast-enhanced ultrasound was, the faster the blood pressure decreased. Real-time 3-dimensional contrast-enhanced ultrasound is a promising noninvasive tool for stereoscopically and vividly detecting ongoing hemorrhage of blunt renal trauma in real time. © 2013.

  19. Dynamic contrast-enhanced ultrasound and transient arterial occlusion for quantification of arterial perfusion reserve in peripheral arterial disease

    International Nuclear Information System (INIS)

    Amarteifio, E.; Wormsbecher, S.; Krix, M.; Demirel, S.; Braun, S.; Delorme, S.; Böckler, D.; Kauczor, H.-U.; Weber, M.-A.

    2012-01-01

    Objective: To quantify muscular micro-perfusion and arterial perfusion reserve in peripheral arterial disease (PAD) with dynamic contrast-enhanced ultrasound (CEUS) and transient arterial occlusion. Materials and methods: This study had local institutional review board approval and written informed consent was obtained from all subjects. We examined the dominant lower leg of 40 PAD Fontaine stage IIb patients (mean age, 65 years) and 40 healthy volunteers (mean age, 54 years) with CEUS (7 MHz; MI, 0.28) during continuous intravenous infusion of 4.8 mL microbubbles. Transient arterial occlusion at mid-thigh level simulated physical exercise. With time–CEUS–intensity curves obtained from regions of interest within calf muscles, we derived the maximum CEUS signal after occlusion (max) and its time (t max ), slope to maximum (m), vascular response after occlusion (AUC post ), and analysed accuracy, receiver operating characteristic (ROC) curves, and correlations with ankle-brachial index (ABI) and walking distance. Results: All parameters differed in PAD and volunteers (p max was delayed (31.2 ± 13.6 vs. 16.7 ± 8.5 s, p post as optimal parameter combination for diagnosing PAD and therefore impaired arterial perfusion reserve. Conclusions: Dynamic CEUS with transient arterial occlusion quantifies muscular micro-perfusion and arterial perfusion reserve. The technique is accurate to diagnose PAD.

  20. Assessment of skeletal muscle microcirculation in type 2 diabetes mellitus using dynamic contrast-enhanced ultrasound: a pilot study.

    Science.gov (United States)

    Amarteifio, Erick; Wormsbecher, Stephanie; Demirel, Serdar; Krix, Martin; Braun, Simone; Rehnitz, Christoph; Delorme, Stefan; Kauczor, Hans-Ulrich; Weber, Marc-André

    2013-09-01

    To investigate muscular micro-perfusion by employing dynamic contrast-enhanced ultrasound (CEUS) and performing transient arterial occlusion in patients with type 2 diabetes mellitus (DM-2). Twenty DM-2 patients (mean age, 58 ± 8.6 years; duration of diabetes, 15.4 ± 12.1 years) and 20 healthy volunteers (mean age, 54 ± 5.4 years) participated. CEUS was applied to the calf, while 4.8 mL of SonoVue(®) was injected intravenously. At the thigh level, arterial occlusion (60 s) was performed. CEUS parameters (tmax, max, AUCpost and m) were evaluated and Pearson-product-moment correlation coefficients were computed. A moderate negative correlation of HbA1c and max was established (-0.53). Max in patients with DM-2 >10 years was 79.89 ± 37.4. Max in patients with DM-2 duration 10 years was 3924.01 ± 1630.52. AUCpost in patients with DM-2 duration <10 years was 6453.59 ± 3206.23 (p = 0.04). Patients with long history of DM-2 present with impaired muscular perfusion. CEUS and transient arterial occlusion may provide appropriate methods for semi-quantitative evaluation of muscular micro-perfusion in patients with DM-2.

  1. Clinical utility of three-dimensional contrast-enhanced ultrasound in the differentiation between noninvasive and invasive neoplasms of urinary bladder.

    Science.gov (United States)

    Li, Qiu-yang; Tang, Jie; He, En-hui; Li, Yan-mi; Zhou, Yun; Zhang, Xu; Chen, Guangfu

    2012-11-01

    The purpose of this study was to evaluate the effectiveness of three-dimensional contrast-enhanced ultrasound in differentiating invasive and noninvasive neoplasms of urinary bladder. A total of 60 lesions in 60 consecutive patients with bladder tumors received three dimensional ultrasonography, low acoustic power contrast enhanced ultrasonography and low acoustic power three-dimensional contrast-enhanced ultrasound examination. The IU22 ultrasound scanner and a volume transducer were used and the ultrasound contrast agent was SonoVue. The contrast-specific sonographic imaging modes were PI (pulse inversion) and PM (power modulation). The three dimensional ultrasonography, contrast enhanced ultrasonography, and three-dimensional contrast-enhanced ultrasound images were independently reviewed by two readers who were not in the images acquisition. Images were analyzed off-site. A level of confidence in the diagnosis of tumor invasion of the muscle layer was assigned on a 5° scale. Receiver operating characteristic analysis was used to assess overall confidence in the diagnosis of muscle invasion by tumor. Kappa values were used to assess inter-readers agreement. Histologic diagnosis was obtained for all patients. Final pathologic staging revealed 44 noninvasive tumors and 16 invasive tumors. Three-dimensional contrast-enhanced ultrasound depicted all 16 muscle-invasive tumors. The diagnostic performance of three-dimensional contrast-enhanced ultrasound was better than those of three dimensional ultrasonography and contrast enhanced ultrasonography. The receiver operating characteristic curves were 0.976 and 0.967 for three-dimensional contrast-enhanced ultrasound, those for three dimensional ultrasonography were 0.881 and 0.869, those for contrast enhanced ultrasonography were 0.927 and 0.929. The kappa values in the three dimensional ultrasonography, contrast enhanced ultrasonography and three-dimensional contrast-enhanced ultrasound for inter-reader agreements

  2. Clinical utility of three-dimensional contrast-enhanced ultrasound in the differentiation between noninvasive and invasive neoplasms of urinary bladder

    International Nuclear Information System (INIS)

    Li, Qiu-yang; Tang, Jie; He, En-hui; Li, Yan-mi; Zhou, Yun; Zhang, Xu; Chen, Guangfu

    2012-01-01

    Objectives: The purpose of this study was to evaluate the effectiveness of three-dimensional contrast-enhanced ultrasound in differentiating invasive and noninvasive neoplasms of urinary bladder. Methods: A total of 60 lesions in 60 consecutive patients with bladder tumors received three dimensional ultrasonography, low acoustic power contrast enhanced ultrasonography and low acoustic power three-dimensional contrast-enhanced ultrasound examination. The IU22 ultrasound scanner and a volume transducer were used and the ultrasound contrast agent was SonoVue. The contrast-specific sonographic imaging modes were PI (pulse inversion) and PM (power modulation). The three dimensional ultrasonography, contrast enhanced ultrasonography, and three-dimensional contrast-enhanced ultrasound images were independently reviewed by two readers who were not in the images acquisition. Images were analyzed off-site. A level of confidence in the diagnosis of tumor invasion of the muscle layer was assigned on a 5° scale. Receiver operating characteristic analysis was used to assess overall confidence in the diagnosis of muscle invasion by tumor. Kappa values were used to assess inter-readers agreement. Histologic diagnosis was obtained for all patients. Results: Final pathologic staging revealed 44 noninvasive tumors and 16 invasive tumors. Three-dimensional contrast-enhanced ultrasound depicted all 16 muscle-invasive tumors. The diagnostic performance of three-dimensional contrast-enhanced ultrasound was better than those of three dimensional ultrasonography and contrast enhanced ultrasonography. The receiver operating characteristic curves were 0.976 and 0.967 for three-dimensional contrast-enhanced ultrasound, those for three dimensional ultrasonography were 0.881 and 0.869, those for contrast enhanced ultrasonography were 0.927 and 0.929. The kappa values in the three dimensional ultrasonography, contrast enhanced ultrasonography and three-dimensional contrast-enhanced ultrasound

  3. California Commercial End-Use Survey - CEUS

    Science.gov (United States)

    Efficiency in Existing Buildings Energy Efficiency Program Contacts Financing Opportunities Home Energy Rebates and Incentives Energy Efficiency Financing Energy Innovations Small Grant (EISG) EPIC Funding commercial building type categories. Download the CEUS Project Final Report. Publication # CEC-400-2006-005

  4. The Future of Contrast-Enhanced Mammography.

    Science.gov (United States)

    Covington, Matthew F; Pizzitola, Victor J; Lorans, Roxanne; Pockaj, Barbara A; Northfelt, Donald W; Appleton, Catherine M; Patel, Bhavika K

    2018-02-01

    The purpose of this article is to discuss facilitators of and barriers to future implementation of contrast-enhanced mammography (CEM) in the United States. CEM provides low-energy 2D mammographic images analogous to digital mammography and contrast-enhanced recombined images that allow assessment of neovascularity similar to that offered by MRI. The utilization of CEM in the United States is currently low but could increase rapidly given the many potential indications for its clinical use.

  5. Contrast Enhanced US in the Abdomen

    International Nuclear Information System (INIS)

    Chung, Yong Eun; Kim, Ki Whang

    2012-01-01

    Contrast enhanced ultrasound, which was introduced in 1996, has been widely used in Europe and Eastern Asia. Ultrasound contrast agent can be classified as first generation and second generation, depending on the gas within the microbubble. With the first generation contrast agent, the high MI technique was used, and only intermittent scanning was possible due to destruction of the microbubble during scanning. Use of the second generation contrast agent with the low MI technique makes continuous scanning possible. Contrast enhanced US can be used in detection and differentiation of focal liver lesions. It is also helpful for monitoring of radiofrequency ablation and for targeting of US guided biopsy. Currently, because morphologic criteria alone may not reflect the response of the tumor to treatment, new criteria are needed for treatment evaluation after administration of anti-angiogenic agents. Contrast enhanced US could provide quantitative markers for evaluation of the response to treatment via use of dynamic contrast enhanced US. Due to cost-effectiveness, contrast enhanced US is not yet widely used in Korea; however, considering recent issues regarding contrast agent related adverse reaction, such as contrast induced nephropathy and nephrogenic systemic fibrosis, and radiation exposure, contrast enhanced US might be more widely used in Korea, as an alternative imaging modality in the future.

  6. Characterization of Focal Liver Lesions using CEUS and MRI with Liver-Specific Contrast Media: Experience of a Single Radiologic Center.

    Science.gov (United States)

    Beyer, Lukas Philipp; Wassermann, Florian; Pregler, Benedikt; Michalik, Katharina; Rennert, Janine; Wiesinger, Isabel; Stroszczynski, Christian; Wiggermann, Philipp; Jung, Ernst Michael

    2017-12-01

     The purpose of this study was to compare contrast-enhanced ultrasound (CEUS), magnetic resonance imaging (MRI) using liver-specific contrast agent and a combination of both for the characterization of focal liver lesions (FLL).  83 patients with both benign and malignant liver lesions were examined using CEUS and MRI after the intravenous administration of liver-specific contrast media. All patients had inconclusive results from prior imaging examinations. Histopathological specimens could be obtained in 53 patients. Ultrasound was performed using a multi-frequency curved probe (1 - 6 MHz) after the injection of 1 - 2.4 ml ultrasound contrast media. The sensitivity, specificity, positive predictive value and negative predictive value of CEUS, MRI and a combination of both (CEUS + MRI) were compared.  The sensitivity, specificity, positive and negative predictive values regarding lesion classification were 90.9 %, 70.6 %, 92.3 % and 66.6 %, respectively, for CEUS; 90.9 %, 82.4 %, 95.2 % and 70.0 %, respectively, for MRI; and 96.9 %, 70.6 %, 92.7 % and 85.7 % respectively, for CEUS + MRI. There were no statistically significant differences. 6 malignant lesions were missed using CEUS or MRI alone (false negatives). The use of both modalities combined reduced the false-negative results to 2.  CEUS and MRI with liver-specific contrast media are very reliable and of equal informative value in the characterization of focal liver lesions. The number of false-negative results can be decreased using a combination of the two methods. © Georg Thieme Verlag KG Stuttgart · New York.

  7. Data on consistency among different methods to assess atherosclerotic plaque echogenicity on standard ultrasound and intraplaque neovascularization on contrast-enhanced ultrasound imaging in human carotid artery

    Directory of Open Access Journals (Sweden)

    Mattia Cattaneo

    2016-12-01

    Full Text Available Here we provide the correlation among different carotid ultrasound (US variables to assess echogenicity n standard carotid US and to assess intraplaque neovascularization on contrast enhanced US. We recruited 45 consecutive subjects with an asymptomatic≥50% carotid artery stenosis. Carotid plaque echogenicity at standard US was visually graded according to Gray–Weale classification (GW and measured by the greyscale median (GSM, a semi-automated computerized measurement performed by Adobe Photoshop®. On CEUS imaging IPNV was graded according to the visual appearance of contrast within the plaque according to three different methods: CEUS_A (1=absent; 2=present; CEUS_B a three-point scale (increasing IPNV from 1 to 3; CEUS_C a four-point scale (increasing IPNV from 0 to 3. We have also implemented a new simple quantification method derived from region of interest (ROI signal intensity ratio as assessed by QLAB software. Further information is available in “Contrast-enhanced ultrasound imaging of intraplaque neovascularization and its correlation to plaque echogenicity in human carotid arteries atherosclerosis (M. Cattaneo, D. Staub, A.P. Porretta, J.M. Gallino, P. Santini, C. Limoni et al., 2016 [1].

  8. Feasibility and usefulness of using swallow contrast-enhanced ultrasound to diagnose Zenker's diverticulum: preliminary results.

    Science.gov (United States)

    Cui, Xin-Wu; Ignee, Andre; Baum, Ulrich; Dietrich, Christoph F

    2015-04-01

    Zenker's diverticulum (ZD) may be misdiagnosed on conventional ultrasound as a thyroid nodule or other lesion. A barium esophagram is usually used to confirm the diagnosis; however, this procedure exposes the patient to radiation. The aim of this study was to evaluate the feasibility of using swallow contrast-enhanced ultrasound (swallow-CEUS) to diagnose ZD. Ten consecutive patients with ZD (7 men and 3 women, aged 67 ± 11 y) were included in the study. In 4 patients, ZD was incidentally found on head and neck ultrasound, and in 6 patients, ZD was suspected because of dysphagia. All lesions could be detected on conventional ultrasound before swallow-CEUS. Ten healthy volunteers (8 men and 2 women, aged 60 ± 12 y) were chosen as a control group. Written informed consent was obtained. With the patient in the sitting or upright position, conventional ultrasound was performed first to image the lesion, then the patient was asked to swallow ultrasound contrast agent (UCA) (2-4 drops of SonoVue diluted with about 200 mL of tap water). Transity of the contrast agent in the esophagus was imaged with CEUS. Retention of the UCA in the diverticulum was monitored for at least 3 min. All patients underwent a barium esophagram as the gold standard. Swallow-CEUS revealed that in all patients (100%), the UCA was transported from the pharynx to the esophagus while the patient swallowed. ZD appeared as a pouch-shaped structure at the posterior pharyngo-esophageal junction that retained UCA longer than 3 min. The barium esophagram confirmed the diagnosis of ZD in all patients. For the 10 volunteers, no abnormal structure (retaining UCA) was detected during or after swallowing of UCA. With the advantages of no radiation and bedside availability, swallow-CEUS may become a method of choice in confirmation of the diagnosis of ZD, especially when ZD is suspected on conventional ultrasound. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier

  9. Comparative study of conventional US, contrast enhanced US and enhanced MR for the follow-up of prostatic radiofrequency ablation.

    Science.gov (United States)

    Feng, Chao; Hu, Bin; Hu, Bing; Chen, Lei; Li, Jia; Huang, Jin

    2017-06-01

    The aim of the present study was to evaluate and compare the effectiveness of different imaging methods during follow-up of prostatic radiofrequency ablation. Prostatic radiofrequency ablation (RFA) was performed in 20 healthy beagle dogs. Various imaging examinations were used to monitor the results of RFA, including conventional ultrasound (US), contrast enhanced ultrasound (CEUS) and enhanced magnetic resonance (MR). Imaging exams were performed at five phases: Immediately following RFA, one week later, one month later, three months later and six months later. The morphology for each imaging test and histological results were recorded and compared in each phase. Based on the actual results from autopsy, the accuracy of those imaging exams was evaluated. The canine prostate gland demonstrated typical coagulative necrosis immediately following RFA. The lesion would develop into stable cyst if no other complications occurred within the six-month follow-up. Regarding the RFA lesion volume measurement and the reflection of pathological changes, conventional US was not able to accurately measure the volume of RFA lesion and missed many more details concerning the RFA-treated area than CEUS and MR during the three months. The results from CEUS exhibited comparable accuracy to those from enhanced MR at each phase. However, there were no significant differences in the results from US, CEUS and MR at six months, which may contribute to the complete formation of lesion cyst. In the early phase, conventional US was not sufficient for evaluating the efficacy of RFA. Enhanced US and MR provided clear images and accurate information. However, CEUS has the advantage of being more economical, using more convenient equipment and faster scanning, thus identifying it as the more feasible choice. Furthermore, no notable advantages were observed among any image examinations in the long-term follow-up.

  10. Diagnostic accuracy of contrast enhanced ultrasound in patients with blunt abdominal trauma presenting to the emergency department: a systematic review and meta-analysis.

    Science.gov (United States)

    Zhang, Zhongheng; Hong, Yucai; Liu, Ning; Chen, Yuhao

    2017-06-30

    We aimed to investigate the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) in evaluating blunt abdominal trauma for patients presenting to the emergency department. Electronic search of Scopus and Pubmed was performed from inception to September 2016. Human studies investigating the diagnostic accuracy of CEUS in identifying abdominal solid organ injuries were included. Risk of bias was assessed using the QUADAS tool. A total of 10 studies were included in the study and 9 of them were included for meta-analysis. The log(DOR) values ranged from 3.80 (95% CI: 2.81-4.79) to 8.52 (95% CI: 4.58-12.47) in component studies. The combined log(DOR) was 6.56 (95% CI: 5.66-7.45). The Cochran's Q was 11.265 (p = 0.793 with 16 degrees of freedom), and the Higgins' I 2 was 0%. The CEUS had a sensitivity of 0.981 (95% CI: 0.868-0.950) and a false positive rate of 0.018 (95% CI: 0.010-0.032) for identifying parenchymal injuries, with an AUC of 0.984. CEUS performed at emergency department had good diagnostic accuracy in identifying abdominal solid organ injuries. CEUS can be recommended in monitoring solid organ injuries, especially for patients managed with non-operative strategy.

  11. Contrast-Enhanced Ultrasound Improves the Pathological Outcomes of US-Guided Core Needle Biopsy That Targets the Viable Area of Anterior Mediastinal Masses

    Directory of Open Access Journals (Sweden)

    Jian-hua Zhou

    2018-01-01

    Full Text Available Based on the option that ultrasound-guided core needle biopsy (US-CNB of the enhanced portion of anterior mediastinal masses (AMMs identified by contrast-enhanced ultrasound (CEUS would harvest viable tissue and benefit the histological diagnoses, a retrospective study was performed to elucidate the correlation between the prebiopsy CEUS and diagnostic yield of AMMs and found that CEUS potentially improved the diagnostic yield of AMMs compared with conventional US with a significant increase in the cellularity of samples. Furthermore, the marginal blood flow signals and absence of necrosis can predict the diagnostic yield of AMM. It was concluded that US-CNB of the viable part of AMMs, as verified by CEUS, was able to harvest sufficient tissue with more cellularity that could be used for ancillary studies and improve the diagnostic yield. And CEUS was recommended to those patients with AMMs undergoing repeated US-CNB, with the absence of marginal blood signals or presence of necrosis.

  12. Quantitative analysis of thyroid tumors vascularity: A comparison between 3-D contrast-enhanced ultrasound and 3-D Power Doppler on benign and malignant thyroid nodules.

    Science.gov (United States)

    Caresio, Cristina; Caballo, Marco; Deandrea, Maurilio; Garberoglio, Roberto; Mormile, Alberto; Rossetto, Ruth; Limone, Paolo; Molinari, Filippo

    2018-05-15

    To perform a comparative quantitative analysis of Power Doppler ultrasound (PDUS) and Contrast-Enhancement ultrasound (CEUS) for the quantification of thyroid nodules vascularity patterns, with the goal of identifying biomarkers correlated with the malignancy of the nodule with both imaging techniques. We propose a novel method to reconstruct the vascular architecture from 3-D PDUS and CEUS images of thyroid nodules, and to automatically extract seven quantitative features related to the morphology and distribution of vascular network. Features include three tortuosity metrics, the number of vascular trees and branches, the vascular volume density, and the main spatial vascularity pattern. Feature extraction was performed on 20 thyroid lesions (ten benign and ten malignant), of which we acquired both PDUS and CEUS. MANOVA (multivariate analysis of variance) was used to differentiate benign and malignant lesions based on the most significant features. The analysis of the extracted features showed a significant difference between the benign and malignant nodules for both PDUS and CEUS techniques for all the features. Furthermore, by using a linear classifier on the significant features identified by the MANOVA, benign nodules could be entirely separated from the malignant ones. Our early results confirm the correlation between the morphology and distribution of blood vessels and the malignancy of the lesion, and also show (at least for the dataset used in this study) a considerable similarity in terms of findings of PDUS and CEUS imaging for thyroid nodules diagnosis and classification. © 2018 American Association of Physicists in Medicine.

  13. Post-traumatic contrast enhancing brain lesion

    International Nuclear Information System (INIS)

    Kim, Dae Jung; Kim, Hyun Sook; Jeong, Min Sun; Kim, Deok Ryeong; Cho, Young Kwon; Choi, Yun Sun

    2014-01-01

    Only a few studies have been reported on the MR contrast enhancement and the apparent diffusion coefficient (ADC) findings of the post-traumatic lesion of the brain. We report a case of the venous ischemia in the left frontal lobe observed in the MRI obtained one day after the incidence of trauma. Considering the presented slight increase in the ADC, the vasogenic edema was thought to be the major mechanism of the venous ischemia and excitotoxic injury. In spite of a slight increase in the ADC, the hyperintensity in the diffusion weighted imaging and contrast-enhanced areas eventually changed into hemorrhagic lesions.

  14. Post-traumatic contrast enhancing brain lesion

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dae Jung; Kim, Hyun Sook; Jeong, Min Sun; Kim, Deok Ryeong; Cho, Young Kwon; Choi, Yun Sun [Eulji Hospital, Eulji University College of Medicine, Seoul (Korea, Republic of)

    2014-10-15

    Only a few studies have been reported on the MR contrast enhancement and the apparent diffusion coefficient (ADC) findings of the post-traumatic lesion of the brain. We report a case of the venous ischemia in the left frontal lobe observed in the MRI obtained one day after the incidence of trauma. Considering the presented slight increase in the ADC, the vasogenic edema was thought to be the major mechanism of the venous ischemia and excitotoxic injury. In spite of a slight increase in the ADC, the hyperintensity in the diffusion weighted imaging and contrast-enhanced areas eventually changed into hemorrhagic lesions.

  15. Characterizing EPR-mediated passive drug targeting using contrast-enhanced functional ultrasound imaging.

    Science.gov (United States)

    Theek, Benjamin; Gremse, Felix; Kunjachan, Sijumon; Fokong, Stanley; Pola, Robert; Pechar, Michal; Deckers, Roel; Storm, Gert; Ehling, Josef; Kiessling, Fabian; Lammers, Twan

    2014-05-28

    The Enhanced Permeability and Retention (EPR) effect is extensively used in drug delivery research. Taking into account that EPR is a highly variable phenomenon, we have here set out to evaluate if contrast-enhanced functional ultrasound (ceUS) imaging can be employed to characterize EPR-mediated passive drug targeting to tumors. Using standard fluorescence molecular tomography (FMT) and two different protocols for hybrid computed tomography-fluorescence molecular tomography (CT-FMT), the tumor accumulation of a ~10 nm-sized near-infrared-fluorophore-labeled polymeric drug carrier (pHPMA-Dy750) was evaluated in CT26 tumor-bearing mice. In the same set of animals, two different ceUS techniques (2D MIOT and 3D B-mode imaging) were employed to assess tumor vascularization. Subsequently, the degree of tumor vascularization was correlated with the degree of EPR-mediated drug targeting. Depending on the optical imaging protocol used, the tumor accumulation of the polymeric drug carrier ranged from 5 to 12% of the injected dose. The degree of tumor vascularization, determined using ceUS, varied from 4 to 11%. For both hybrid CT-FMT protocols, a good correlation between the degree of tumor vascularization and the degree of tumor accumulation was observed, within the case of reconstructed CT-FMT, correlation coefficients of ~0.8 and p-values of EPR, and potentially also to pre-select patients likely to respond to passively tumor-targeted nanomedicine treatments. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Clinical evaluation of contrast-enhanced digital mammography and contrast enhanced tomosynthesis--Comparison to contrast-enhanced breast MRI.

    Science.gov (United States)

    Chou, Chen-Pin; Lewin, John M; Chiang, Chia-Ling; Hung, Bao-Hui; Yang, Tsung-Lung; Huang, Jer-Shyung; Liao, Jia-Bin; Pan, Huay-Ben

    2015-12-01

    To compare the diagnostic accuracy of contrast-enhanced digital mammography (CEDM) and contrast-enhanced tomosynthesis (CET) to dynamic contrast enhanced breast MRI (DCE-MRI) using a multireader-multicase study. Institutional review board approval and informed consents were obtained. Total 185 patients (mean age 51.3) with BI-RADS 4 or 5 lesions were evaluated before biopsy with mammography, tomosynthesis, CEDM, CET and DCE-MRI. Mediolateral-oblique and cranio-caudal views of the target breast CEDM and CET were acquired at 2 and 4 min after contrast agent injection. A mediolateral-oblique view of the non-target breast was taken at 6 min. Each lesion was scored with forced BI-RADS categories by three readers. Each reader interpreted lesions in the following order: mammography, tomosynthesis, CEDM, CET, and DCE-MRI during a single reading session. Histology showed 81 cancers and 144 benign lesions in the study. Of the 81 malignant lesions, 44% (36/81) were invasive and 56% (45/81) were non-invasive. Areas under the ROC curve, averaged for the 3 readers, were as follows: 0.897 for DCE-MRI, 0.892 for CET, 0.878 for CEDM, 0.784 for tomosynthesis and 0.740 for mammography. Significant differences in AUC were found between the group of contrast enhanced modalities (CEDM, CET, DCE-MRI) and the unenhanced modalities (all p0.05). CET and CEDM may be considered as an alternative modality to MRI for following up women with abnormal mammography. All three contrast modalities were superior in accuracy to conventional digital mammography with or without tomosynthesis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. Evaluation of breast lesions by contrast enhanced ultrasound: Qualitative and quantitative analysis

    International Nuclear Information System (INIS)

    Wan Caifeng; Du Jing; Fang Hua; Li Fenghua; Wang Lin

    2012-01-01

    Objective: To evaluate and compare the diagnostic performance of qualitative, quantitative and combined analysis for characterization of breast lesions in contrast enhanced ultrasound (CEUS), with histological results used as the reference standard. Methods: Ninety-one patients with 91 breast lesions BI-RADS 3–5 at US or mammography underwent CEUS. All lesions underwent qualitative and quantitative enhancement evaluation. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance of different analytical method for discrimination between benign and malignant breast lesions. Results: Histopathologic analysis of the 91 lesions revealed 44 benign and 47 malignant. For qualitative analysis, benign and malignant lesions differ significantly in enhancement patterns (p z1 ), 0.768 (A z2 ) and 0.926(A z3 ) respectively. The values of A z1 and A z3 were significantly higher than that for A z2 (p = 0.024 and p = 0.008, respectively). But there was no significant difference between the values of A z1 and A z3 (p = 0.625). Conclusions: The diagnostic performance of qualitative and combined analysis was significantly higher than that for quantitative analysis. Although quantitative analysis has the potential to differentiate benign from malignant lesions, it has not yet improved the final diagnostic accuracy.

  18. MRI and contrast-enhanced ultrasound imaging for evaluation of focal irreversible electroporation treatment: results from a phase I-II study in patients undergoing IRE followed by radical prostatectomy

    International Nuclear Information System (INIS)

    Bos, Willemien van den; Bruin, D.M. de; Randen, A. van; Engelbrecht, M.R.W.; Postema, A.W.; Muller, B.G.; Zondervan, P.J.; Laguna Pes, M.P.; Reijke, T.M. de; Rosette, J.J.M.C.H. de la; Varkarakis, I.M.; Skolarikos, A.; Savci-Heijink, C.D.; Jurhill, R.R.; Wijkstra, H.

    2016-01-01

    Irreversible electroporation (IRE) is an ablative therapy with a low side-effect profile in prostate cancer. The objective was: 1) To compare the volumetric IRE ablation zone on grey-scale transrectal ultrasound (TRUS), contrast-enhanced ultrasound (CEUS) and multiparametric MRI (mpMRI) with histopathology findings; 2) To determine a reliable imaging modality to visualize the IRE ablation effects accurately. A prospective phase I-II study was performed in 16 patients scheduled for radical prostatectomy (RP). IRE of the prostate was performed 4 weeks before RP. Prior to, and 4 weeks after the IRE treatment, imaging was performed by TRUS, CEUS, and mpMRI. 3D-analysis of the ablation volumes on imaging and on H and E-stained whole-mount sections was performed. The volumes were compared and the correlation was calculated. Evaluation of the imaging demonstrated that with T2-weighted MRI, dynamic contrast enhanced (DCE) MRI, and CEUS, effects of IRE are visible. T2MRI and CEUS closely match the volumes on histopathology (Pearson correlation r = 0.88 resp. 0.80). However, IRE is not visible with TRUS. mpMRI and CEUS are appropriate for assessing IRE effects and are the most feasible imaging modalities to visualize IRE ablation zone. The imaging is concordant with results of histopathological examination. (orig.)

  19. Perfusion pattern and time of vascularisation with CEUS increase accuracy in differentiating between benign and malignant tumours in 216 musculoskeletal soft tissue masses

    Energy Technology Data Exchange (ETDEWEB)

    De Marchi, Armanda, E-mail: armanda.demarchi@tiscali.it [Department of Imaging, Azienda Ospedaliera Città della Salute e della Scienza, CTO Hospital, Via Zuretti 29, 10126 Torino (Italy); Prever, Elena Brach del, E-mail: elena.brach@unito.it [Department of OrthopaedicOncology and ReconstructiveSurgery, Azienda Ospedaliero Universitaria Città della Salute e della Scienza, CTO Hospital, Via Zuretti 29, 10126 Torino (Italy); Cavallo, Franco, E-mail: franco.cavallo@unito.it [Department of Public health and Paediatrics, University of Turin, Via Santena 5-bis, 10126 Torino (Italy); Pozza, Simona, E-mail: simona.pozza@tin.it [Department of Imaging, Azienda Ospedaliera Città della Salute e della Scienza, CTO Hospital, Via Zuretti 29, 10126 Torino (Italy); Linari, Alessandra, E-mail: linaralessandra@libero.it [Department of Pathology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza, Regina Margherita Hospital, Piazza Polonia, 10126 Torino (Italy); Lombardo, Paolo, E-mail: pao.lombardo82@gmail.com [Department of DiagnosticImaging and Radiotherapy of the University of Turin, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Via Genova 3, 10126 Torino (Italy); Comandone, Alessandro, E-mail: alessandro.comandone@gradenigo.it [Department of Oncology, Gradenigo Hospital, Corso Regina Margherita, 8/10.10153 Torino (Italy); Piana, Raimondo, E-mail: raimondo.piana@libero.it [Department of OrthopaedicOncology and ReconstructiveSurgery, Azienda Ospedaliero Universitaria Città della Salute e della Scienza, CTO Hospital, Via Zuretti 29, 10126 Torino (Italy); Faletti, Carlo [Department of Imaging, Azienda Ospedaliera Città della Salute e della Scienza, CTO Hospital, Via Zuretti 29, 10126 Torino (Italy)

    2015-01-15

    Introduction: Musculoskeletal Soft Tissue Tumours (STT) are frequent heterogeneous lesions. Guidelines consider a mass larger than 5 cm and deep with respect to the deep fascia potentially malignant. Contrast Enhanced Ultrasound (CEUS) can detect both vascularity and tumour neoangiogenesis. We hypothesised that perfusion patterns and vascularisation time could improve the accuracy of CEUS in discriminating malignant tumours from benign lesions. Materials and methods: 216 STT were studied: 40% benign lesions, 60% malignant tumours, 56% in the lower limbs. Seven CEUS perfusion patterns and three types of vascularisation (arterial-venous uptake, absence of uptake) were applied. Accuracy was evaluated by comparing imaging with the histological diagnosis. Univariate and multivariate analysis, Chi-square test and t-test for independent variables were applied; significance was set at p < 0.05 level, 95% computed CI. Results: CEUS pattern 6 (inhomogeneous perfusion), arterial uptake and location in the lower limb were associated with high risk of malignancy. CEUS pattern has PPV 77%, rapidity of vascularisation PPV 69%; location in the limbs is the most sensitive indicator, but NPV 52%, PPV 65%. The combination of CEUS-pattern and vascularisation has 74% PPV, 60% NPV, 70% sensitivity. No correlation with size and location in relation to the deep fascia was found. Conclusion: US with CEUS qualitative analysis could be an accurate technique to identify potentially malignant STT, for which second line imaging and biopsy are indicated in Referral Centers. Intense inhomogeneous enhancement with avascular areas and rapid vascularisation time could be useful in discriminating benign from malignant SST, overall when the lower limbs are involved.

  20. Dual-energy contrast-enhanced mammography.

    Science.gov (United States)

    Travieso Aja, M M; Rodríguez Rodríguez, M; Alayón Hernández, S; Vega Benítez, V; Luzardo, O P

    2014-01-01

    The degree of vascularization in breast lesions is related to their malignancy. For this reason, functional diagnostic imaging techniques have become important in recent years. Dual-energy contrast-enhanced mammography is a new, apparently promising technique in breast cancer that provides information about the degree of vascularization of the lesion in addition to the morphological information provided by conventional mammography. This article describes the state of the art for dual-energy contrast-enhanced mammography. Based on 15 months' clinical experience, we illustrate this review with clinical cases that allow us to discuss the advantages and limitations of this technique. Copyright © 2014 SERAM. Published by Elsevier Espana. All rights reserved.

  1. Contrast Enhanced Spectral Mammography: A Review.

    Science.gov (United States)

    Patel, Bhavika K; Lobbes, M B I; Lewin, John

    2018-02-01

    Contrast-enhanced spectral mammography (CESM) provides low-energy 2D mammographic images comparable to standard digital mammography and a post-contrast recombined image to assess tumor neovascularity similar to magnetic resonance imaging (MRI). The utilization of CESM in the United States is currently low but could increase rapidly given many potential indications for clinical use. This article discusses historical background and literature review of indications and diagnostic accuracy of CESM to date. CESM is a growing technique for breast cancer detection and diagnosis that has levels of sensitivity and specificity on par with contrast-enhanced breast MRI. Because of its similar performance and ease of implementation, CESM is being adopted for multiple indications previously reserved for MRI, such as problem-solving, disease extent in newly diagnosed patients, and evaluating the treatment response of neoadjuvant chemotherapy. Copyright © 2018 Elsevier Inc. All rights reserved.

  2. Contrast-enhanced harmonic endoscopic ultrasound

    DEFF Research Database (Denmark)

    Săftoiu, A; Dietrich, C F; Vilmann, P

    2012-01-01

    Second-generation intravenous blood-pool ultrasound contrast agents are increasingly used in endoscopic ultrasound (EUS) for characterization of microvascularization, differential diagnosis of benign and malignant focal lesions, and improving staging and guidance of therapeutic procedures. Although...... initially used as Doppler signal enhancers, second-generation microbubble contrast agents are now used with specific contrast harmonic imaging techniques, which benefit from the highly nonlinear behavior of the microbubbles. Contrast-specific modes based on multi-pulse technology are used to perform...... contrast-enhanced harmonic EUS based on a very low mechanical index (0.08 - 0.12). Quantification techniques based on dynamic contrast-enhanced ultrasound have been recommended for perfusion imaging and monitoring of anti-angiogenic treatment, mainly based on time-intensity curve analysis. Most...

  3. A new automated quantification algorithm for the detection and evaluation of focal liver lesions with contrast-enhanced ultrasound.

    Science.gov (United States)

    Gatos, Ilias; Tsantis, Stavros; Spiliopoulos, Stavros; Skouroliakou, Aikaterini; Theotokas, Ioannis; Zoumpoulis, Pavlos; Hazle, John D; Kagadis, George C

    2015-07-01

    Detect and classify focal liver lesions (FLLs) from contrast-enhanced ultrasound (CEUS) imaging by means of an automated quantification algorithm. The proposed algorithm employs a sophisticated segmentation method to detect and contour focal lesions from 52 CEUS video sequences (30 benign and 22 malignant). Lesion detection involves wavelet transform zero crossings utilization as an initialization step to the Markov random field model toward the lesion contour extraction. After FLL detection across frames, time intensity curve (TIC) is computed which provides the contrast agents' behavior at all vascular phases with respect to adjacent parenchyma for each patient. From each TIC, eight features were automatically calculated and employed into the support vector machines (SVMs) classification algorithm in the design of the image analysis model. With regard to FLLs detection accuracy, all lesions detected had an average overlap value of 0.89 ± 0.16 with manual segmentations for all CEUS frame-subsets included in the study. Highest classification accuracy from the SVM model was 90.3%, misdiagnosing three benign and two malignant FLLs with sensitivity and specificity values of 93.1% and 86.9%, respectively. The proposed quantification system that employs FLLs detection and classification algorithms may be of value to physicians as a second opinion tool for avoiding unnecessary invasive procedures.

  4. Contrast-Enhanced Ultrasound in the Diagnosis of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma: Controversy over the ASSLD Guideline

    Directory of Open Access Journals (Sweden)

    Le-Hang Guo

    2015-01-01

    Full Text Available Hepatocellular carcinoma (HCC and intrahepatic cholangiocarcinoma (ICC are both regarded as primary liver cancers, having different biological behaviors and prognoses. Correct differentiation between them is essential for surgical planning and prognosis assessment. In 2005, the American Association for the Study of Liver Diseases (AASLD recommended that noninvasive diagnosis of HCC is achievable by a single dynamic technique (including contrast-enhanced ultrasound (CEUS showing intense arterial uptake followed by washout of contrast in the venous-delayed phases. However, CEUS has been dropped from the diagnostic techniques in the latest AASLD guideline according to the opinion of some authors from Europe that CEUS may offer false positive HCC diagnosis in patients with ICC. Since the update of AASLD guideline has been released, increased attention has been paid to this interesting topic. Remarkable controversy over this issue is present and this removal was not well received in Europe and Asia. This commentary summarized the opinions for the role of CUES in differentiation between HCC and ICC in recent years. It is concluded that prospective studies with strict design and large case series are mandatory to solve the controversies and stratification of ICC in terms of tumor size and liver background is also essential.

  5. Diagnostic accuracy of contrast-enhanced ultrasound in assessing the therapeutic response to radio frequency ablation for liver tumors: systematic review and meta-analysis.

    Science.gov (United States)

    Xuan, Min; Zhou, Fengsheng; Ding, Yan; Zhu, Qiaoying; Dong, Ji; Zhou, Hao; Cheng, Jun; Jiang, Xiao; Wu, Pengxi

    2018-04-01

    To review the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) used to detect residual or recurrent liver tumors after radiofrequency ablation (RFA). This technique uses contrast-enhanced computer tomography or/and contrast-enhanced magnetic resonance imaging as the gold standard of investigation. MEDLINE, EMBASE, and COCHRANE were systematically searched for all potentially eligible studies comparing CEUS with the reference standard that follows RFA. Risk of bias and applicability concerns were addressed by adopting the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Pooled point estimates for sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratios (DOR) with 95% CI were computed before plotting the sROC (summary receiver operating characteristic) curve. Meta-regression and subgroup analysis were used to identify the source of the heterogeneity that was detected. Publication bias was evaluated using Deeks' funnel plot asymmetry test. Ten eligible studies on 1162 lesions that occurred between 2001 and 2016 were included in the final analysis. The quality of the included studies assessed by the QUADAS-2 tool was considered reasonable. The pooled sensitivity and specificity of CEUS in detecting residual or recurrent liver tumors had the following values: 0.90 (95% CI 0.85-0.94) and 1.00 (95% CI 0.99-1.00), respectively. Overall DOR was 420.10 (95% CI 142.30-1240.20). The sources of heterogeneity could not be precisely identified by meta-regression or subgroup analysis. No evidence of publication bias was found. This study confirmed that CEUS exhibits high sensitivity and specificity in assessing therapeutic responses to RFA for liver tumors.

  6. Usefulness of combining gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging and contrast-enhanced ultrasound for diagnosing the macroscopic classification of small hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Tomoki; Aikata, Hiroshi; Hatooka, Masahiro; Morio, Kei; Morio, Reona; Kan, Hiromi; Fujino, Hatsue; Fukuhara, Takayuki; Masaki, Keiichi; Ohno, Atsushi; Naeshiro, Noriaki; Nakahara, Takashi; Honda, Yohji; Murakami, Eisuke; Kawaoka, Tomokazu; Tsuge, Masataka; Hiramatsu, Akira; Imamura, Michio; Kawakami, Yoshiiku; Hyogo, Hideyuki; Takahashi, Shoichi [Hiroshima University Hospital, Department of Gastroenterology and Metabolism, Hiroshima (Japan); Chayama, Kazuaki [Hiroshima University Hospital, Department of Gastroenterology and Metabolism, Hiroshima (Japan); Hiroshima University, Liver Research Project Center, Hiroshima (Japan)

    2015-11-15

    Non-simple nodules in hepatocellular carcinoma (HCC) correlate with poor prognosis. Therefore, we examined the diagnostic ability of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (EOB-MRI) and contrast-enhanced ultrasound (CEUS) for diagnosing the macroscopic classification of small HCCs. A total of 85 surgically resected nodules (≤30 mm) were analyzed. HCCs were pathologically classified as simple nodular (SN) and non-SN. By evaluating hepatobiliary phase (HBP) of EOB-MRI and Kupffer phase of CEUS, the diagnostic abilities of both modalities to correctly distinguish between SN and non-SN were compared. Forty-six nodules were diagnosed as SN and the remaining 39 nodules as non-SN. The area under the ROC curve (AUROCs, 95 % confidence interval) for the diagnosis of non-SN were EOB-MRI, 0.786 (0.682-0.890): CEUS, 0.784 (0.679-0.889), in combination, 0.876 (0.792-0.959). The sensitivity, specificity, and accuracy were 64.1 %, 95.7 %, and 81.2 % in EOB-MRI, 56.4 %, 97.8 %, and 78.8 % in CEUS, and 84.6 %, 95.7 %, and 90.6 % in combination, respectively. High diagnostic ability was obtained when diagnosed in both modalities combined. The sensitivity was especially statistically significant compared to CEUS. Combined diagnosis by EOB-MRI and CEUS can provide high-quality imaging assessment for determining non-SN in small HCCs. (orig.)

  7. Quantitative contrast-enhanced ultrasound evaluation of pathological complete response in patients with locally advanced breast cancer receiving neoadjuvant chemotherapy.

    Science.gov (United States)

    Wan, Cai-Feng; Liu, Xue-Song; Wang, Lin; Zhang, Jie; Lu, Jin-Song; Li, Feng-Hua

    2018-06-01

    To clarify whether the quantitative parameters of contrast-enhanced ultrasound (CEUS) can be used to predict pathological complete response (pCR) in patients with locally advanced breast cancer receiving neoadjuvant chemotherapy (NAC). Fifty-one patients with histologically proved locally advanced breast cancer scheduled for NAC were enrolled. The quantitative data for CEUS and the tumor diameter were collected at baseline and before surgery, and compared with the pathological response. Multiple logistic regression analysis was performed to examine quantitative parameters at CEUS and the tumor diameter to predict the pCR, and receiver operating characteristic (ROC) curve analysis was used as a summary statistic. Multiple logistic regression analysis revealed that PEAK (the maximum intensity of the time-intensity curve during bolus transit), PEAK%, TTP% (time to peak), and diameter% were significant independent predictors of pCR, and the area under the ROC curve was 0.932(Az 1 ), and the sensitivity and specificity to predict pCR were 93.7% and 80.0%. The area under the ROC curve for the quantitative parameters was 0.927(Az 2 ), and the sensitivity and specificity to predict pCR were 81.2% and 94.3%. For diameter%, the area under the ROC curve was 0.786 (Az 3 ), and the sensitivity and specificity to predict pCR were 93.8% and 54.3%. The values of Az 1 and Az 2 were significantly higher than that of Az 3 (P = 0.027 and P = 0.034, respectively). However, there was no significant difference between the values of Az 1 and Az 2 (P = 0.825). Quantitative analysis of tumor blood perfusion with CEUS is superior to diameter% to predict pCR, and can be used as a functional technique to evaluate tumor response to NAC. Copyright © 2018. Published by Elsevier B.V.

  8. Dynamic contrast enhanced ultrasound for therapy monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Hudson, John M. [Department of Medical Biophysics, University of Toronto, Toronto, ON (Canada); Williams, Ross [Imaging Research, Sunnybrook Research Institute, Toronto, ON (Canada); Tremblay-Darveau, Charles; Sheeran, Paul S. [Department of Medical Biophysics, University of Toronto, Toronto, ON (Canada); Milot, Laurent [Department of Medical Imaging, University of Toronto, Toronto, ON (Canada); Bjarnason, Georg A. [Department of Medical Oncology, University of Toronto, and Sunnybrook Odette Cancer Centre, Toronto, ON (Canada); Burns, Peter N., E-mail: burns@sri.utoronto.ca [Department of Medical Biophysics, University of Toronto, Toronto, ON (Canada); Imaging Research, Sunnybrook Research Institute, Toronto, ON (Canada); Department of Medical Imaging, University of Toronto, Toronto, ON (Canada)

    2015-09-15

    Quantitative imaging is a crucial component of the assessment of therapies that target the vasculature of angiogenic or inflamed tissue. Dynamic contrast-enhanced ultrasound (DCE-US) using microbubble contrast offers the advantages of being sensitive to perfusion, non-invasive, cost effective and well suited to repeated use at the bedside. Uniquely, it employs an agent that is truly intravascular. This papers reviews the principles and methodology of DCE-US, especially as applied to anti-angiogenic cancer therapies. Reproducibility is an important attribute of such a monitoring method: results are discussed. More recent technical advances in parametric and 3D DCE-US imaging are also summarised and illustrated.

  9. Contrast-Enhanced Ultrasound in Vascular Surgery

    DEFF Research Database (Denmark)

    Bredahl, Kim; Mestre, Xavier Marti; Coll, Ramon Vila

    2017-01-01

    modalities. Ultrasound has only challenged these methods in assessment of carotid disease, aortic aneurysms, venous insufficiency, and thromboembolism and in surveillance of in situ bypasses. These practice patterns may change with the introduction of second-generation ultrasound contrast agents which...... are easy to use, manageable, and safe. This topical review attempts to summarize and highlight the current evidence and future prospects for contrast-enhanced ultrasound in vascular surgery, with a particular focus on opportunities in carotid and lower limb arteriosclerotic disease and surveillance after...

  10. Osteoblastic Metastases Mimickers on Contrast Enhanced CT

    Directory of Open Access Journals (Sweden)

    Fahad Al-Lhedan

    2017-01-01

    Full Text Available Secondary osseous involvement in lymphoma is more common compared to primary bone lymphoma. The finding of osseous lesion can be incidentally discovered during the course of the disease. However, osseous metastases are infrequently silent. Detection of osseous metastases is crucial for accurate staging and optimal treatment planning of lymphoma. The aim of imaging is to identify the presence and extent of osseous disease and to assess for possible complications such as pathological fracture of the load-bearing bones and cord compression if the lesion is spinal. We are presenting two patients with treated lymphoma who were in complete remission. On routine follow-up contrast enhanced CT, there were new osteoblastic lesions in the spine worrisome for metastases. Additional studies were performed for further evaluation of both of them which did not demonstrate any corresponding suspicious osseous lesion. The patients have a prior history of chronic venous occlusive thrombosis that resulted in collaterals formation. Contrast enhancement of the vertebral body marrow secondary to collaterals formation and venous flow through the vertebral venous plexus can mimic the appearance of spinal osteoblastic metastases.

  11. Morphological rational operator for contrast enhancement.

    Science.gov (United States)

    Peregrina-Barreto, Hayde; Herrera-Navarro, Ana M; Morales-Hernández, Luis A; Terol-Villalobos, Iván R

    2011-03-01

    Contrast enhancement is an important task in image processing that is commonly used as a preprocessing step to improve the images for other tasks such as segmentation. However, some methods for contrast improvement that work well in low-contrast regions affect good contrast regions as well. This occurs due to the fact that some elements may vanish. A method focused on images with different luminance conditions is introduced in the present work. The proposed method is based on morphological transformations by reconstruction and rational operations, which, altogether, allow a more accurate contrast enhancement resulting in regions that are in harmony with their environment. Furthermore, due to the properties of these morphological transformations, the creation of new elements on the image is avoided. The processing is carried out on luminance values in the u'v'Y color space, which avoids the creation of new colors. As a result of the previous considerations, the proposed method keeps the natural color appearance of the image.

  12. Adaptive multiscale processing for contrast enhancement

    Science.gov (United States)

    Laine, Andrew F.; Song, Shuwu; Fan, Jian; Huda, Walter; Honeyman, Janice C.; Steinbach, Barbara G.

    1993-07-01

    This paper introduces a novel approach for accomplishing mammographic feature analysis through overcomplete multiresolution representations. We show that efficient representations may be identified from digital mammograms within a continuum of scale space and used to enhance features of importance to mammography. Choosing analyzing functions that are well localized in both space and frequency, results in a powerful methodology for image analysis. We describe methods of contrast enhancement based on two overcomplete (redundant) multiscale representations: (1) Dyadic wavelet transform (2) (phi) -transform. Mammograms are reconstructed from transform coefficients modified at one or more levels by non-linear, logarithmic and constant scale-space weight functions. Multiscale edges identified within distinct levels of transform space provide a local support for enhancement throughout each decomposition. We demonstrate that features extracted from wavelet spaces can provide an adaptive mechanism for accomplishing local contrast enhancement. We suggest that multiscale detection and local enhancement of singularities may be effectively employed for the visualization of breast pathology without excessive noise amplification.

  13. Quantitative contrast-enhanced optical coherence tomography

    Energy Technology Data Exchange (ETDEWEB)

    Winetraub, Yonatan; SoRelle, Elliott D. [Molecular Imaging Program at Stanford, Stanford University, 299 Campus Drive, Stanford, California 94305 (United States); Bio-X Program, Stanford University, 299 Campus Drive, Stanford, California 94305 (United States); Biophysics Program, Stanford University, 299 Campus Drive, Stanford, California 94305 (United States); Department of Structural Biology, Stanford University, 299 Campus Drive, Stanford, California 94305 (United States); Liba, Orly [Molecular Imaging Program at Stanford, Stanford University, 299 Campus Drive, Stanford, California 94305 (United States); Bio-X Program, Stanford University, 299 Campus Drive, Stanford, California 94305 (United States); Department of Structural Biology, Stanford University, 299 Campus Drive, Stanford, California 94305 (United States); Department of Electrical Engineering, Stanford University, 299 Campus Drive, Stanford, California 94305 (United States); Zerda, Adam de la [Molecular Imaging Program at Stanford, Stanford University, 299 Campus Drive, Stanford, California 94305 (United States); Bio-X Program, Stanford University, 299 Campus Drive, Stanford, California 94305 (United States); Biophysics Program, Stanford University, 299 Campus Drive, Stanford, California 94305 (United States); Department of Structural Biology, Stanford University, 299 Campus Drive, Stanford, California 94305 (United States); Department of Electrical Engineering, Stanford University, 299 Campus Drive, Stanford, California 94305 (United States)

    2016-01-11

    We have developed a model to accurately quantify the signals produced by exogenous scattering agents used for contrast-enhanced Optical Coherence Tomography (OCT). This model predicts distinct concentration-dependent signal trends that arise from the underlying physics of OCT detection. Accordingly, we show that real scattering particles can be described as simplified ideal scatterers with modified scattering intensity and concentration. The relation between OCT signal and particle concentration is approximately linear at concentrations lower than 0.8 particle per imaging voxel. However, at higher concentrations, interference effects cause signal to increase with a square root dependence on the number of particles within a voxel. Finally, high particle concentrations cause enough light attenuation to saturate the detected signal. Predictions were validated by comparison with measured OCT signals from gold nanorods (GNRs) prepared in water at concentrations ranging over five orders of magnitude (50 fM to 5 nM). In addition, we validated that our model accurately predicts the signal responses of GNRs in highly heterogeneous scattering environments including whole blood and living animals. By enabling particle quantification, this work provides a valuable tool for current and future contrast-enhanced in vivo OCT studies. More generally, the model described herein may inform the interpretation of detected signals in modalities that rely on coherence-based detection or are susceptible to interference effects.

  14. Contrast enhancement of mail piece images

    Science.gov (United States)

    Shin, Yong-Chul; Sridhar, Ramalingam; Demjanenko, Victor; Palumbo, Paul W.; Hull, Jonathan J.

    1992-08-01

    A New approach to contrast enhancement of mail piece images is presented. The contrast enhancement is used as a preprocessing step in the real-time address block location (RT-ABL) system. The RT-ABL system processes a stream of mail piece images and locates destination address blocks. Most of the mail pieces (classified into letters) show high contrast between background and foreground. As an extreme case, however, the seasonal greeting cards usually use colored envelopes which results in reduced contrast osured by an error rate by using a linear distributed associative memory (DAM). The DAM is trained to recognize the spectra of three classes of images: with high, medium, and low OCR error rates. The DAM is not forced to make a classification every time. It is allowed to reject as unknown a spectrum presented that does not closely resemble any that has been stored in the DAM. The DAM was fairly accurate with noisy images but conservative (i.e., rejected several text images as unknowns) when there was little ground and foreground degradations without affecting the nondegraded images. This approach provides local enhancement which adapts to local features. In order to simplify the computation of A and (sigma) , dynamic programming technique is used. Implementation details, performance, and the results on test images are presented in this paper.

  15. MRI contrast enhancement using Magnetic Carbon Nanoparticles

    Science.gov (United States)

    Chaudhary, Rakesh P.; Kangasniemi, Kim; Takahashi, Masaya; Mohanty, Samarendra K.; Koymen, Ali R.; Department of Physics, University of Texas at Arlington Team; University of Texas Southwestern Medical Center Team

    2014-03-01

    In recent years, nanotechnology has become one of the most exciting forefront fields in cancer diagnosis and therapeutics such as drug delivery, thermal therapy and detection of cancer. Here, we report development of core (Fe)-shell (carbon) nanoparticles with enhanced magnetic properties for contrast enhancement in MRI imaging. These new classes of magnetic carbon nanoparticles (MCNPs) are synthesized using a bottom-up approach in various organic solvents, using the electric plasma discharge generated in the cavitation field of an ultrasonic horn. Gradient echo MRI images of well-dispersed MCNP-solutions (in tube) were acquired. For T2 measurements, a multi echo spin echo sequence was performed. From the slope of the 1/T2 versus concentration plot, the R2 value for different CMCNP-samples was measured. Since MCNPs were found to be extremely non-reactive, and highly absorbing in NIR regime, development of carbon-based MRI contrast enhancement will allow its simultaneous use in biomedical applications. We aim to localize the MCNPs in targeted tissue regions by external DC magnetic field, followed by MRI imaging and subsequent photothermal therapy.

  16. Contrast enhanced ultrasound of sentinel lymph nodes

    Directory of Open Access Journals (Sweden)

    XinWu Cui

    2013-03-01

    Full Text Available Sentinel lymph nodes are the first lymph nodes in the region that receive lymphatic drainage from a primary tumor. The detection or exclusion of sentinel lymph node micrometastases is critical in the staging of cancer, especially breast cancer and melanoma because it directly affects patient’s prognosis and surgical management. Currently, intraoperative sentinel lymph node biopsies using blue dye and radioisotopes are the method of choice for the detection of sentinel lymph node with high identification rate. In contrast, conventional ultrasound is not capable of detecting sentinel lymph nodes in most cases. Contrast enhanced ultrasound with contrast specific imaging modes has been used for the evaluation and diagnostic work-up of peripherally located suspected lymphadenopathy. The method allows for real-time analysis of all vascular phases and the visualization of intranodal focal “avascular” areas that represent necrosis or deposits of neoplastic cells. In recent years, a number of animal and human studies showed that contrast enhanced ultrasound can be also used for the detection of sentinel lymph node, and may become a potential application in clinical routine. Several contrast agents have been used in those studies, including albumin solution, hydroxyethylated starch, SonoVue®, Sonazoid® and Definity®. This review summarizes the current knowledge about the use of ultrasound techniques in detection and evaluation of sentinel lymph node.

  17. Use of Contrast-Enhanced Ultrasound to Study Relationship between Serum Uric Acid and Renal Microvascular Perfusion in Diabetic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Ling Wang

    2015-01-01

    Full Text Available Purpose. To investigate the relationship between uric acid and renal microvascular perfusion in diabetic kidney disease (DKD using contrast-enhanced ultrasound (CEUS method. Materials and Methods. 79 DKD patients and 26 healthy volunteers were enrolled. Renal function and urine protein markers were tested. DKD patients were subdivided into two groups including a normal serum uric acid (SUA group and a high SUA group. Contrast-enhanced ultrasound (CEUS was performed, and low acoustic power contrast-specific imaging was used for quantitative analysis. Results. Normal controls (NCs had the highest levels of AUC, AUC1, and AUC2. Compared to the normal SUA DKD group, high SUA DKD patients had significantly higher IMAX, AUC, and AUC1 (P<0.05. DKD patients with low urinary uric acid (UUA excretion had significantly higher AUC2 compared to DKD patients with normal UUA (P<0.05. Conclusion. Hyperuricemia in DKD patients was associated with a renal ultrasound image suggestive of microvascular hyperperfusion. The CEUS parameter AUC1 holds promise as an indicator for renal microvascular hyperperfusion, while AUC2 might be a useful indicator of declining glomerular filtration rate in DKD patients with decreased excretion of uric acid.

  18. Fast mutual-information-based contrast enhancement

    Science.gov (United States)

    Cao, Gang; Yu, Lifang; Tian, Huawei; Huang, Xianglin; Wang, Yongbin

    2017-07-01

    Recently, T. Celik proposed an effective image contrast enhancement (CE) method based on spatial mutual information and PageRank (SMIRANK). According to the state-of-the-art evaluation criteria, it achieves the best visual enhancement quality among existing global CE methods. However, SMIRANK runs much slower than the other counterparts, such as histogram equalization (HE) and adaptive gamma correction. Low computational complexity is also required for good CE algorithms. In this paper, we novelly propose a fast SMIRANK algorithm, called FastSMIRANK. It integrates both spatial and gray-level downsampling into the generation of pixel value mapping function. Moreover, the computation of rank vectors is speeded up by replacing PageRank with a simple yet efficient row-based operation of mutual information matrix. Extensive experimental results show that the proposed FastSMIRANK could accelerate the processing speed of SMIRANK by about 20 times, and is even faster than HE. Comparable enhancement quality is preserved simultaneously.

  19. Color-coded perfusion analysis of CEUS for pre-interventional diagnosis of microvascularisation in cases of vascular malformations.

    Science.gov (United States)

    Teusch, V I; Wohlgemuth, W A; Piehler, A P; Jung, E M

    2014-01-01

    Aim of our pilot study was the application of a contrast-enhanced color-coded ultrasound perfusion analysis in patients with vascular malformations to quantify microcirculatory alterations. 28 patients (16 female, 12 male, mean age 24.9 years) with high flow (n = 6) or slow-flow (n = 22) malformations were analyzed before intervention. An experienced examiner performed a color-coded Doppler sonography (CCDS) and a Power Doppler as well as a contrast-enhanced ultrasound after intravenous bolus injection of 1 - 2.4 ml of a second-generation ultrasound contrast medium (SonoVue®, Bracco, Milan). The contrast-enhanced examination was documented as a cine sequence over 60 s. The quantitative analysis based on color-coded contrast-enhanced ultrasound (CEUS) images included percentage peak enhancement (%peak), time to peak (TTP), area under the curve (AUC), and mean transit time (MTT). No side effects occurred after intravenous contrast injection. The mean %peak in arteriovenous malformations was almost twice as high as in slow-flow-malformations. The area under the curve was 4 times higher in arteriovenous malformations compared to the mean value of other malformations. The mean transit time was 1.4 times higher in high-flow-malformations compared to slow-flow-malformations. There was no difference regarding the time to peak between the different malformation types. The comparison between all vascular malformation and surrounding tissue showed statistically significant differences for all analyzed data (%peak, TTP, AUC, MTT; p < 0.01). High-flow and slow-flow vascular malformations had statistically significant differences in %peak (p < 0.01), AUC analysis (p < 0.01), and MTT (p < 0.05). Color-coded perfusion analysis of CEUS seems to be a promising technique for the dynamic assessment of microvasculature in vascular malformations.

  20. Clinical Applications of Contrast-Enhanced Ultrasound in the Pediatric Work-Up of Focal Liver Lesions and Blunt Abdominal Trauma

    DEFF Research Database (Denmark)

    Laugesen, Nicolaj Grønbæk; Nolsoe, Christian Pallson; Rosenberg, Jacob

    2017-01-01

    of CEUS is indeed promising. However, no ultrasound contrast agent manufactured today is registered for pediatric use in Europe. The contrast agent SonoVue(®) has recently been approved by the FDA under the name of Lumason(®) to be used in hepatic investigations in adults and children. This article...... help reduce radiation exposure and use of iodinated contrast agents in pediatrics, thereby potentially reducing complications in routine imaging.......In pediatrics ultrasound has long been viewed more favorably than imaging that exposes patients to radiation and iodinated contrast or requires sedation. It is child-friendly and diagnostic capabilities have been improved with the advent of contrast-enhanced ultrasound (CEUS). The application...

  1. Factors associated with initial incomplete ablation for benign thyroid nodules after radiofrequency ablation: First results of CEUS evaluation.

    Science.gov (United States)

    Zhao, Chong-Ke; Xu, Hui-Xiong; Lu, Feng; Sun, Li-Ping; He, Ya-Ping; Guo, Le-Hang; Li, Xiao-Long; Bo, Xiao-Wan; Yue, Wen-Wen

    2017-01-01

    To assess the factors associated with initial incomplete ablation (ICA) after radiofrequency ablation for benign thyroid nodules (BTNs). 69 BTNs (mean volume 6.35±5.66 ml, range 1.00-25.04 ml) confirmed by fine-needle aspiration cytology (FNAC) in fifty-four patients were treated with ultrasound-guided percutaneous radiofrequency ablation (RFA) and the local treatment efficacy was immediately assessed by intra-procedural contrast-enhanced ultrasound (CEUS). The RFA was performed with a bipolar electrode (CelonProSurge 150-T20, output power: 20 W). CEUS was performed with a second generation contrast agent under low acoustic power (i.e. coded phase inversion, CPI). Characteristics of clinical factors, findings on conventional gray-scale ultrasound, color-Doppler ultrasound, and CEUS were evaluated preoperatively. Factors associated with initial ICA and initial ICA patterns on CEUS were assessed. Volume reduction ratios (VRRs) of ICA nodules were compared with those with complete ablation (CA). The RFA procedures were accomplished with a mean ablation time and mean total energy deposition of 11.13±3.39 min (range, 5.38-22.13 min) and 12612±4466 J (range, 6310-26130 J) respectively. CEUS detected initial ICA in 21 of 69 (30.8%) BTNs and 16 (76.2%) of the 21 BTNs with initial ICA achieved CA after additional RFA, leading to a final CA rate of 92.8% (64/69). The factors associated with initial ICA were predominantly solid nodule, nodule close to danger triangle area, nodule close to carotid artery, and peripheral blood flow on color-Doppler ultrasound (all P 50% at the 6-month follow-up, among which 7 nodules (10.1%) had VRRs of >90%. There were significant differences in VRRs between ICA nodules and CA nodules at the 3- and 6-month follow-up (all P ultrasound. CEUS assists quick treatment response evaluation and facilitates subsequent additional RFA and final CA of the nodules. Nodules with CA achieve a better outcome in terms of VRR in comparison with

  2. Characterisation of focal liver lesions with unenhanced and contrast enhanced low MI real time ultrasound: On-site unblinded versus off-site blinded reading

    International Nuclear Information System (INIS)

    Hohmann, Joachim; Skrok, Jan; Basilico, Raffaella; Jennett, Manfred; Müller, Anja; Wolf, Karl-Jürgen; Albrecht, Thomas

    2012-01-01

    Objective: To compare on-site and blinded off-site reading of baseline ultrasound (US) and contrast enhanced ultrasound (CEUS) for classification and characterisation of focal liver lesions. Materials and methods: 99 patients (57 women and 42 men, age range 18–89 years, mean age: 59 years) with 53 malignant and 46 benign liver lesions were studied with unenhanced US followed by contrast enhanced US after injection of 2.4 ml SonoVue ® (Bracco, Milano, Italy). Image interpretation was performed on-site with clinical information available by consensus of two readers and off-site by two independent blinded readers at two different centers. Comparison of pre and post contrast scans and of the different readers was performed. Reference examinations were histology, intraoperative US, MRI or CT. Results: Sensitivity for malignancy improved from 81/89/66% (on-site/off-site reader 1/2) before to 100/96/96% post contrast administration (p < 0.05, except for reader 1). Specificity improved from 48/48/54% on baseline US to 89/80/76% on CEUS (p < 0.05). Accuracy for specific lesion diagnosis was 62/59/50% pre and 90/77/72% post contrast (p < 0.05). Classification and characterisation post contrast were mildly inferior for off-site reading. Agreement between on-site and off-site readers of unenhanced scans was fair (κ = 0.29–0.39) while it was good for CEUS (κ = 0.63–0.79). Conclusions: CEUS improves classification and characterisation of focal liver lesions and interobserver agreement compared to conventional US. Classification and characterisation post contrast were mildly but statistically significantly better for on-site than for off-site reading.

  3. CONTRAST ENHANCED SPECTRAL MAMMOGRAPHY (CESM (REVIEW

    Directory of Open Access Journals (Sweden)

    N. I. Rozhkova

    2015-01-01

    Full Text Available The problem of early diagnosis of a breast cancer is extremely actual. Growth of incidence at women from 19 to 39 years increased for 34% over the last 10 years. It defines need of acceleration of development and deployment of the latest technologies of identification of the earliest symptoms of diseases. The x-ray mammography is the conducting method among of all radiological methods of diagnostics. Nevertheless a number of restrictions of method reduces its efficiency. The technologies increasing informational content of x-ray mammography – the leading method of screening – due to use of artificial contrasting and advantages of digital technologies are constantly developed. In this review it is described works, in which the authors having clinical experience of application of CESM – contrastenhanced spectral mammography on representative group of women. Positive sides and restrictions of new technology in comparison with mammography, ultrasonography and MRT are shown in this article.

  4. Effect of contrast-enhanced ultrasound on differential diagnosis of intrahepatic cholangiocarcinoma and arterial phase enhanced hepatic inflammatory lesions

    Institute of Scientific and Technical Information of China (English)

    Shanshan Yin; Qiuli Cui; Kun Yan; Wei Yang; Wei Wu; Liping Bao; Minhua Chen

    2017-01-01

    Objective:To investigate differential diagnosis between intrahepatic cholangiocarcinoma (ICC) and arterial phase enhanced hepatic inflammatory lesions in patients without liver cirrhosis using contrast-enhanced ultrasound (CEUS).Methods:ICC and hepatic inflammatory lesions cases with CEUS and pathological diagnosis between Sep 2013 and Oct 2016 were investigated retrospectively.Imaging features of conventional ultrasound and CEUS were analyzed.The parameters of time intensity curve (TIC),including the arrival time,peak intensity (PI) in the lesions,the starting time for washout,and the intensity difference at 3 min (△I3) after contrast agent infection between the lesion and the liver parenchyma,were compared between ICC and hepatic inflammatory lesions.Results:Twenty-five ICC and fifteen inflammatory patients were included in this study.Seventeen ICC (68.0%) and two inflammatory cases (13.3%) showed bile duct dilatation on conventional ultrasound.Using CEUS,three ICC cases (12.0%) were misdiagnosed as inflammatory lesions and three inflammatory lesions (20.0%) as ICC;two ICC (8.0%) and one inflammatory case (6.7%) could not be made definite diagnosis.Washout started at 34.5±3.5 s and 61.5± 12.9 s for ICC and inflammatory lesions respectively (P<0.001).The intensity difference between lesion and liver parenchyma at 3 min after contrast agent injection was 10.8±3.1 dB in ICC and 4.2±2.3 dB in inflammatory group (P<0.00 1).The sensitivity and specificity differentiating ICC and inflammatory lesions were 76% and 87% if the cut-offvalue of the intensity difference was 7.7 dB.Conclusions:Combined with TIC analysis,and particularly with the characteristic of the early-starting and obvious washout in ICC,CEUS can be useful in differential diagnosis between hepatic inflammatory lesions and ICC.

  5. Dynamic contrast enhanced MRI in prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Alonzi, Roberto [Marie Curie Research Wing, Mount Vernon Cancer Centre, Rickmansworth Road, Northwood, Middlesex, HA6 2RN (United Kingdom)], E-mail: robertoalonzi@btinternet.com; Padhani, Anwar R. [Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Rickmansworth Road, Northwood, Middlesex, HA6 2RN (United Kingdom); Synarc Inc. 575 Market Street, San Francisco, CA 94105 (United States)], E-mail: anwar.padhani@paulstrickland-scannercentre.org.uk; Allen, Clare [Department of Imaging, University College Hospital, London, 235 Euston Road, NW1 2BU (United Kingdom)], E-mail: clare.allen@uclh.nhs.uk

    2007-09-15

    Angiogenesis is an integral part of benign prostatic hyperplasia (BPH), is associated with prostatic intraepithelial neoplasia (PIN) and is key to the growth and for metastasis of prostate cancer. Dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) using small molecular weight gadolinium chelates enables non-invasive imaging characterization of tissue vascularity. Depending on the technique used, data reflecting tissue perfusion, microvessel permeability surface area product, and extracellular leakage space can be obtained. Two dynamic MRI techniques (T{sub 2}*-weighted or susceptibility based and T{sub 1}-weighted or relaxivity enhanced methods) for prostate gland evaluations are discussed in this review with reference to biological basis of observations, data acquisition and analysis methods, technical limitations and validation. Established clinical roles of T{sub 1}-weighted imaging evaluations will be discussed including lesion detection and localisation, for tumour staging and for the detection of suspected tumour recurrence. Limitations include inadequate lesion characterisation particularly differentiating prostatitis from cancer, and in distinguishing between BPH and central gland tumours.

  6. Topical contrast-enhanced magnetic resonance dacryocystography

    International Nuclear Information System (INIS)

    Yoshikawa, Takeshi; Sugimura, Kazuro; Hirota, Shozo

    2000-01-01

    The purpose of this study was to evaluate the usefulness of magnetic resonance dacryocystography (MRD) with topical administration of normal saline solution and diluted Gd-DTPA solution for the assessment of lacrimal outflow disorders. Two T2-weighted sequences and two T1-weighted sequences were evaluated in this study. The 1:100 diluted Gd solution was prepared by diluting Gd-DTPA (Magnevist) with normal saline solution. A phantom study using tube phantoms of various diameters filled with normal saline solution and 1:100 diluted Gd solution was performed. A preliminary study was performed in ten normal volunteers Eighteen patients with lacrimal outflow disorders underwent clinical MRD, and 14 also underwent conventional dacryocystography (CDG). MRD images were evaluated and compared with clinical symptoms and CDG images. In all sequences, MRD could visualize the full length of 0.7 to 1.7 mm diameter tube phantoms and could show all of the normal lacrimal sacs and nasolacrimal ducts. In the clinical study, MRD findings were compatible with the symptoms in 14 patients but were not compatible with CDG findings in half of the cases. Topical contrast-enhanced MRD provided a simple, non-invasive means of obtaining detailed morphological and functional information on the lacrimal drainage apparatus. (author)

  7. Contrast enhanced ultrasound in liver imaging

    International Nuclear Information System (INIS)

    Nielsen, Michael Bachmann; Bang, Nanna

    2004-01-01

    Ultrasound contrast agents were originally introduced to enhance the Doppler signals when detecting vessels with low velocity flow or when imaging conditions were sub-optimal. Contrast agents showed additional properties, it was discovered that a parenchymal enhancement phase in the liver followed the enhancement of the blood pool. Contrast agents have made ultrasound scanning more accurate in detection and characterization of focal hepatic lesions and the sensitivity is now comparable with CT and MRI scanning. Further, analysis of the transit time of contrast agent through the liver seems to give information on possible hepatic involvement, not only from focal lesions but also from diffuse benign parenchymal disease. The first ultrasound contrast agents were easily destroyed by the energy from the sound waves but newer agents have proved to last for longer time and hereby enable real-time scanning and make contrast enhancement suitable for interventional procedures such as biopsies and tissue ablation. Also, in monitoring the effect of tumour treatment contrast agents have been useful. A brief overview is given on some possible applications and on different techniques using ultrasound contrast agents in liver imaging. At present, the use of an ultrasound contrast agent that allows real-time scanning with low mechanical index is to be preferred

  8. Contrast-enhanced ultrasound for quantitative assessment of portal pressure in canine liver fibrosis.

    Science.gov (United States)

    Zhai, Lin; Qiu, Lan-Yan; Zu, Yuan; Yan, Yan; Ren, Xiao-Zhuan; Zhao, Jun-Feng; Liu, Yu-Jiang; Liu, Ji-Bin; Qian, Lin-Xue

    2015-04-21

    To explore the feasibility of non-invasive quantitative estimation of portal venous pressure by contrast-enhanced ultrasound (CEUS) in a canine model. Liver fibrosis was established in adult canines (Beagles; n = 14) by subcutaneous injection of carbon tetrachloride (CCl4). CEUS parameters, including the area under the time-intensity curve and intensity at portal/arterial phases (Qp/Qa and Ip/Ia, respectively), were used to quantitatively assess the blood flow ratio of the portal vein/hepatic artery at multiple time points. The free portal venous pressures (FPP) were measured by a multi-channel baroreceptor using a percutaneous approach at baseline and 8, 16, and 24 wk after CCl4 injections in each canine. Liver biopsies were obtained at the end of 8, 16, and 24 wk from each animal, and the stage of the fibrosis was assessed according to the Metavir scoring system. A Pearson correlation test was performed to compare the FPP with Qp/Qa and Ip/Ia. Pathologic examination of 42 biopsies from the 14 canines at weeks 8, 16, and 24 revealed that liver fibrosis was induced by CCl4 and represented various stages of liver fibrosis, including F0 (n = 3), F1 (n = 12), F2 (n = 14), F3 (n = 11), and F4 (n = 2). There were significant differences in the measurements of Qp/Qa (19.85 ± 3.30 vs 10.43 ± 1.21, 9.63 ± 1.03, and 8.77 ± 0.96) and Ip/Ia (1.77 ± 0.37 vs 1.03 ± 0.12, 0.83 ± 0.10, and 0.69 ± 0.13) between control and canine fibrosis at 8, 16, and 24 wk, respectively (all P fibrosis model. Prediction of elevated FPP based on Qp/Qa and Ip/Ia was highly sensitive, as assessed by the area under the receiver operating curve (0.866 and 0.895, respectively). CEUS is a potential method to accurately, but non-invasively, estimate portal venous pressure through measurement of Qp/Qa and Ip/Ia parameters.

  9. Advanced ultrasound applications in the assessment of renal transplants: contrast-enhanced ultrasound, elastography, and B-flow.

    Science.gov (United States)

    Morgan, Tara A; Jha, Priyanka; Poder, Liina; Weinstein, Stefanie

    2018-04-09

    Ultrasound is routinely used as the first imaging exam for evaluation of renal transplants and can identify most major surgical complications and evaluate vascularity with color Doppler. Ultrasound is limited, however, in the detection of parenchymal disease processes and Doppler evaluation is also prone to technical errors. Multiple new ultrasound applications have been developed and are under ongoing investigation which could add additional diagnostic capability to the routine ultrasound exam with minimal additional time, cost, and patient risk. Contrast-enhanced ultrasound (CEUS) can be used off-label in the transplant kidney, and can assist in detection of infection, trauma, and vascular complications. CEUS also can demonstrate perfusion of the transplant assessed quantitatively with generation of time-intensity curves. Future directions of CEUS include monitoring treatment response and microbubble targeted medication delivery. Elastography is an ultrasound application that can detect changes in tissue elasticity, which is useful to diagnose diffuse parenchymal disease, such as fibrosis, otherwise unrecognizable with ultrasound. Elastography has been successfully applied in other organs including the liver, thyroid, and breast; however, it is still under development for use in the transplant kidney. Unique properties of the transplant kidney including its heterogeneity, anatomic location, and other technical factors present challenges in the development of reference standard measurements. Lastly, B-flow imaging is a flow application derived from B-mode. This application can show the true lumen size of a vessel which is useful to depict vascular anatomy and bypasses some of the pitfalls of color Doppler such as demonstration of slow flow.

  10. Contrast-enhanced color Doppler US in breast cancer: Tumoral vascularity correlated with angiogenesis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun A; Yoon, Kwon Ha; Yun, Ki Jung; Lee, Kwang Man; Park, Ki Han; Juhng, Seon Kwan; Won, Jong Jin [Wonkwang University School of Medicine, Seoul (Korea, Republic of)

    2000-12-15

    To evaluate the effects of contrast-enhanced color Doppler ultrasonography (CDUS) on the depiction of vascularity and flow pattern in breast cancer and to determine the relationship between tumoral vascularity and angiogenesis. Twenty-one patients with breast cancer were prospectively evaluated with CDUS before and after injection of the contrast agent (SH U 508A, 2.5g, 300 mg/ml ). The tumoral vascularity was expressed as percentage of color Doppler area, which was measured quantitatively by a computerized program (Ultrasonic Imaging Tool; Soongsil University, Seoul, Korea). The flow pattern (four-patterns; spotty, linear, branching, marginal) of the vascularity was analyzed. After surgery, tumor angiogenesis was assessed by microvessel density. The relationship between the vascularity on CDUS and microvessel density was statistically analyzed. At unenhanced CDUS, tumoral flow signals were detected in 12 lesions (48%); at contrast-enhanced CDUS, 18 lesions (86%). All These 18 lesions showed increased signals, compared with those at unenhanced CDUS. The percentage color Doppler area was 1.86 {+-} 0.48% at unenhanced CDUS and 5.23 {+-} 1.18% at contrast-enhanced CDUS. The flow patterns before contrast injection were spotty pattern in 11 tumors and linear pattern in one; after contrast injection, spotty in 8, linear in 4, branching in 5, and marginal in one. The tumoral vascularity at contrast-enhanced CDUS showed no significant correlation with microvessel density. Contrast-enhanced CDUS seems to be a valuable tool in the depiction of vascularity and characterization of flow pattern in breast cancer. However, tumoral vascularity on CDUS may not reflect tumoral angiogenesis.

  11. Contrast-Enhanced Ultrasound and Near-Infrared Spectroscopy of the Neonatal Bowel: Novel, Bedside, Noninvasive, and Radiation-Free Imaging for Early Detection of Necrotizing Enterocolitis.

    Science.gov (United States)

    Al-Hamad, Suzanne; Hackam, David J; Goldstein, Seth D; Huisman, Thierry A G M; Darge, Kassa; Hwang, Misun

    2018-05-31

    Despite extensive research and improvements in the field of neonatal care, the morbidity and mortality associated with necrotizing enterocolitis (NEC) have remained unchanged over the past three decades. Early detection of ischemia and necrotic bowel is vital in improving morbidity and mortality associated with NEC; however, strategies for predicting and preventing NEC are lacking. Contrast-enhanced ultrasound (CEUS) and near-infrared spectroscopy (NIRS) are novel techniques in pediatrics that have been proven as safe modalities. CEUS has benefits over conventional ultrasound (US) by its improved real-time evaluation of the micro- and macrovascularities of normally and abnormally perfused tissue. US has been implemented as a useful adjunct to X-ray for earlier evaluation of NEC. NIRS is another noninvasive technique that has shown promise in improving early detection of NEC. The purpose of this article is to review the current understanding of changes in bowel perfusion in NEC, discuss the accuracy of abdominal US in detecting NEC, and explain how the use of CEUS and NIRS will enhance the precise and early detection of altered/pathological bowel wall perfusion in the initial development and course of NEC. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  12. Contrast-enhanced ultrasound of focal nodular hyperplasia: a matter of size

    Energy Technology Data Exchange (ETDEWEB)

    Bertin, Caroline [Hopital Beaujon APHP, Radiology Department, Clichy (France); Egels, Sophie; Huynh-Charlier, Isabelle [Hopital Pitie-Salpetriere APHP, Radiology Department, Paris (France); Wagner, Mathilde [Hopital Pitie-Salpetriere APHP, Radiology Department, Paris (France); Universite Paris Diderot, INSERM, UMR 1149, Laboratoire IPMA, Centre de Recherche sur l' Inflammation, Faculte de Medecine X Bichat, Paris (France); Vilgrain, Valerie [Hopital Beaujon APHP, Radiology Department, Clichy (France); Universite Paris Diderot, INSERM, UMR 1149, Laboratoire IPMA, Centre de Recherche sur l' Inflammation, Faculte de Medecine X Bichat, Paris (France); Lucidarme, Olivier [Hopital Pitie-Salpetriere APHP, Radiology Department, Paris (France); Sorbonne Universites, UPMC Univ Paris 06, CNRS UMR 7371, INSERM UMRS 1146, Laboratoire d' Imagerie Biomedicale, Paris (France); Groupe Hospitalier Pitie-Salpetriere - Charles Foix, Service de Radiologie Polyvalente et Oncologique, Paris (France)

    2014-10-15

    To assess the contrast-enhanced ultrasound (CEUS) frequencies of centrifugal enhancement, spoke-wheel sign and central scar in focal nodular hyperplasia (FNH) as a function of lesion size. Ninety-four FNHs were retrospectively reviewed to assess their largest diameter and enhancement pattern, including centrifugal enhancement from one central artery, spoke-wheel sign, diffuse or centripetal enhancement, central scar and late-phase washout. Mean FNH-lesion size was 3.7 ± 2.1 cm. Only 43.6 % of FNHs had centrifugal enhancement, with a spoke-wheel pattern (23.4 %) or without (20.2 %), while 56.4 % showed diffuse or centripetal enhancement. Centrifugal enhancement was observed in 73.9 % of FNHs ≤3.1 cm and 14.6 % of FNHs >3.1 cm (P < 10{sup -4}). Size and frequency of centrifugal enhancement were negatively correlated (r = -0.57, P < 10{sup -4}). The spoke-wheel pattern was also seen more frequently in smaller (37 %) than in larger FNHs (10.4 %) (P < 10{sup -3}). Late-phase washout was described in 5.3 % of FNHs and was not size-dependent. Lesions with a central scar were larger than those without, respectively, 5.7 ± 1.7 and 3.6 ± 2.0 cm (P = 0.012). Typical centrifugal enhancement yielding a confident FNH diagnosis is seen significantly more frequently when the lesion is ≤3.1 cm. (orig.)

  13. Contrast-enhanced computed tomographic colonography in the follow-up of colorectal cancer patients: a feasibility study

    International Nuclear Information System (INIS)

    Laghi, Andrea; Iannaccone, Riccardo; Carbone, Iacopo; Piacentini, Francesca; Passariello, Roberto; Bria, Emilio; Trasatti, Luciana; Lauro, Salvatore; Vecchione, Aldo

    2003-01-01

    The aim of our study was to assess whether contrast-enhanced CT colonography is a feasible alternative to both conventional colonoscopy and liver ultrasonography in the follow-up program of colorectal cancer patients. Thirty-five patients, surgically treated for colorectal cancer, underwent a follow-up program that included physical examination, carcinoembryonic antigen serum assay, conventional colonoscopy, liver ultrasonography, and chest X-ray. For these patients, we added a yearly contrast-enhanced CT colonography. All CT examinations were performed with a high-resolution protocol using a multidetector spiral CT scanner (Siemens, Erlangen, Germany) prior to and after the administration of 130 ml of i.v. contrast material. Images were directly analyzed on a dedicated workstation by two radiologists to determine colonic evaluation, visualization of colonic anastomosis, presence of polyps, and extra-colonic findings. Colonic evaluation was judged as optimal in 91.7% of all colonic segments. All mechanical surgical anastomoses were visualized with CT colonography. There was no evidence of anastomotic recurrence. Seven polyps were detected in five different patients with CT colonography, with two false-positive and no false-negative examinations. Three liver metastases and two basal pulmonary nodules were also identified. Contrast-enhanced CT colonography is a feasible alternative to both conventional colonoscopy and liver ultrasonography in the follow-up of patients operated on for colorectal cancer. (orig.)

  14. Is contrast-enhanced CT indicated in acute head injury

    International Nuclear Information System (INIS)

    Mauser, H.W.; Nieuwenhuizen, O. van; Veiga-Pires, J.A.

    1984-01-01

    The authors discuss the value of intravenous contrast enhancement in CT scanning in acute head injury. In a series of seventy consecutive patients they conclude that no incremental information was obtained by performing contrast-enhanced CT scans in the acute phase of the head injury. (orig.)

  15. A contrast-enhanced ultrasound study of benign and malignant ...

    African Journals Online (AJOL)

    A contrast-enhanced ultrasound study of benign and malignant breast tissue. S Barnard, E Leen, T Cooke, W Angerson. Abstract. Objective. To determine the diagnostic value of haemodynamic contrast-enhanced ultrasound assessment in benign and malignant breast tissue, using histological examination as the reference ...

  16. Contrast-enhanced spectral mammography (CESM) and contrast enhanced MRI (CEMRI): Patient preferences and tolerance.

    Science.gov (United States)

    Hobbs, Max M; Taylor, Donna B; Buzynski, Sebastian; Peake, Rachel E

    2015-06-01

    Contrast-enhanced spectral mammography (CESM) may have similar diagnostic performance to Contrast-enhanced MRI (CEMRI) in the diagnosis and staging of breast cancer. To date, research has focused exclusively on diagnostic performance when comparing these two techniques. Patient experience is also an important factor when comparing and deciding on which of these modalities is preferable. The aim of this study is to compare patient experience of CESM against CEMRI during preoperative breast cancer staging. Forty-nine participants who underwent both CESM and CEMRI, as part of a larger trial, completed a Likert questionnaire about their preference for each modality according to the following criteria: comfort of breast compression, comfort of intravenous (IV) contrast injection, anxiety and overall preference. Participants also reported reasons for preferring one modality to the other. Quantitative data were analysed using a Wilcoxon sign-rank test and chi-squared test. Qualitative data are reported descriptively. A significantly higher overall preference towards CESM was demonstrated (n = 49, P < 0.001), with faster procedure time, greater comfort and lower noise level cited as the commonest reasons. Participants also reported significantly lower rates of anxiety during CESM compared with CEMRI (n = 36, P = 0.009). A significantly higher rate of comfort was reported during CEMRI for measures of breast compression (n = 49, P = 0.001) and the sensation of IV contrast injection (n = 49, P = 0.003). Our data suggest that overall, patients prefer the experience of CESM to CEMRI, adding support for the role of CESM as a possible alternative to CEMRI for breast cancer staging. © 2015 The Royal Australian and New Zealand College of Radiologists.

  17. Contrast-enhanced spectral mammography (CESM) and contrast enhanced MRI (CEMRI): Patient preferences and tolerance

    International Nuclear Information System (INIS)

    Hobbs, Max; Buzynski, Sebastian; Taylor, Donna B.; Peake, Rachel E.

    2015-01-01

    Contrast-enhanced spectral mammography (CESM) may have similar diagnostic performance to Contrast-enhanced MRI (CEMRI) in the diagnosis and staging of breast cancer. To date, research has focused exclusively on diagnostic performance when comparing these two techniques. Patient experience is also an important factor when comparing and deciding on which of these modalities is preferable. The aim of this study is to compare patient experience of CESM against CEMRI during preoperative breast cancer staging. Forty-nine participants who underwent both CESM and CEMRI, as part of a larger trial, completed a Likert questionnaire about their preference for each modality according to the following criteria: comfort of breast compression, comfort of intravenous (IV) contrast injection, anxiety and overall preference. Participants also reported reasons for preferring one modality to the other. Quantitative data were analysed using a Wilcoxon sign-rank test and chi-squared test. Qualitative data are reported descriptively. A significantly higher overall preference towards CESM was demonstrated (n = 49, P < 0.001), with faster procedure time, greater comfort and lower noise level cited as the commonest reasons. Participants also reported significantly lower rates of anxiety during CESM compared with CEMRI (n = 36, P = 0.009). A significantly higher rate of comfort was reported during CEMRI for measures of breast compression (n = 49, P = 0.001) and the sensation of IV contrast injection (n = 49, P = 0.003). Our data suggest that overall, patients prefer the experience of CESM to CEMRI, adding support for the role of CESM as a possible alternative to CEMRI for breast cancer staging.

  18. Contrast-Enhanced Ultrasound with VEGFR2-Targeted Microbubbles for Monitoring Regorafenib Therapy Effects in Experimental Colorectal Adenocarcinomas in Rats with DCE-MRI and Immunohistochemical Validation.

    Directory of Open Access Journals (Sweden)

    Ralf Stefan Eschbach

    Full Text Available To investigate contrast-enhanced ultrasound (CEUS with VEGFR2-targeted microbubbles for monitoring therapy effects of regorafenib on experimental colon carcinomas in rats with correlation to dynamic contrast-enhanced MRI (DCE-MRI and immunohistochemistry.Human colorectal adenocarcinoma xenografts (HT-29 were implanted subcutaneously in n = 21 (n = 11 therapy group; n = 10 control group female athymic nude rats (Hsd: RH-Foxn1rnu. Animals were imaged at baseline and after a one-week daily treatment with regorafenib or a placebo (10 mg/kg bodyweight, using CEUS with VEGFR2-targeted microbubbles and DCE-MRI. In CEUS tumor perfusion was assessed during an early vascular phase (wash-in area under the curve = WiAUC and VEGFR2-specific binding during a late molecular phase (signal intensity after 8 (SI8min and 10 minutes (SI10min, using a conventional 15L8 linear transducer (transmit frequency 7 MHz, dynamic range 80 dB, depth 25 mm. In DCE-MRI functional parameters plasma flow (PF and plasma volume (PV were quantified. For validation purposes, CEUS parameters were correlated with DCE-MRI parameters and immunohistochemical VEGFR2, CD31, Ki-67 and TUNEL stainings.CEUS perfusion parameter WiAUC decreased significantly (116,989 ± 77,048 a.u. to 30,076 ± 27,095a.u.; p = 0.005 under therapy with no significant changes (133,932 ± 65,960 a.u. to 84,316 ± 74,144 a.u.; p = 0.093 in the control group. In the therapy group, the amount of bound microbubbles in the late phase was significantly lower in the therapy than in the control group on day 7 (SI8min: 283 ± 191 vs. 802 ± 460 a.u.; p = 0.006; SI10min: 226 ± 149 vs. 645 ± 461 a.u.; p = 0.009. PF and PV decreased significantly (PF: 147 ± 58 mL/100 mL/min to 71 ± 15 mL/100 mL/min; p = 0.003; PV: 13 ± 3% to 9 ± 4%; p = 0.040 in the therapy group. Immunohistochemistry revealed significantly fewer VEGFR2 (7.2 ± 1.8 vs. 17.8 ± 4.6; p < 0.001, CD31 (8.1 ± 3.0 vs. 20.8 ± 5.7; p < 0.001 and Ki-67 (318.7

  19. Comparison of transient arterial occlusion and muscle exercise provocation for assessment of perfusion reserve in skeletal muscle with real-time contrast-enhanced ultrasound

    International Nuclear Information System (INIS)

    Krix, Martin; Krakowski-Roosen, Holger; Armarteifio, Erick; Fuerstenberger, Susanne; Delorme, Stefan; Kauczor, Hans-Ulrich; Weber, Marc-Andre

    2011-01-01

    Objective: Contrast-enhanced ultrasound (CEUS) is able to quantify muscle perfusion and changes in perfusion due to muscle exercise in real-time. However, reliable measurement of standardized muscle exercise is difficult to perform in clinical examinations. We compared perfusion reserve assessed by CEUS after transient arterial occlusion and exercise to find the most suitable measurement for clinical application. Methods: Contrast pulse sequencing (7 MHz) during continuous IV infusion of SonoVue (4.8 mL/300 s) was used in 8 healthy volunteers to monitor muscle perfusion of the gastrocnemius muscle during transient (1 min) arterial occlusion produced by a thigh cuff of a venous occlusion plethysmograph. Isometric muscle exercise (50% of individual maximum strength for 20 s) was subsequently performed during the same examination, and several CEUS parameters obtained from ultrasound-signal-intensity-time curves and its calculation errors were compared. Results: The mean maximum local blood volume after occlusion was 13.9 [∼mL] (range, 4.5-28.8 [∼mL]), and similar values were measured after sub-maximum exercise 13.8 [∼mL], (range, 4.6-22.2 [∼mL]. The areas under the curve during reperfusion vs. recovery were also similar (515.2 ± 257.5 compared to 482.2 ± 187.5 [∼mL s]) with a strong correlation (r = 0.65), as were the times to maximum (15.3 s vs. 15.9 s), with a significantly smaller variation for the occlusion method (±2.1 s vs. ±9.0 s, p = 0.03). The mean errors for all calculated CEUS parameters were lower for the occlusion method than for the exercise test. Conclusions: CEUS muscle perfusion measurements can be easily performed after transient arterial occlusion. It delivers data which are comparable to CEUS measurements after muscle exercise but with a higher robustness. This method can be easily applied in clinical examination of patients with e.g. PAOD or diabetic microvessel diseases to assess perfusion reserve.

  20. Evaluation on changes of early renal function in patients with diabetic nephropathy with contrast-enhanced ultrasound and its clinical significance

    International Nuclear Information System (INIS)

    Guo Xinmin; Jin Hong; Pan Liwen; Chen Hui; Liu Wei; Quan Xianyue

    2013-01-01

    Objective: To quantitatively assess the parameter alteration of renal blood flow in patients with diabetic nephropathy (DN) with the contrast-enhanced ultrasound (CEUS), and to evaluate value of the technique in diagnosis of early renal function changes of DN patients. Methods: 40 diabetic patients were equally divided into two group according to Mogensen's staging criteria: normal albuminuria group (group Ⅰ) and early DN group (group Ⅱ); and 15 cases of healthy volunteers were used as control group (N group) (n=15). All subjects were performed renal CEUS perfusion imaging, and QontraXt image analysis software was applied to select the region of interest (ROI) in the renal cortex. Then the time intensity curve (TIC) and kidney blood perfusion parameters were collected. Results: The renal blood perfusion was clearly shown in real time CEUS; compared with N group, the time to peak (TTP), regional blood volume (RBV), and mean transit time (MTT) of the patients in group Ⅰ were increased, there were significant differences (P<0.05); but there were no significant differences of derived peak intensity (DPI) and regional blood flow (RBF) between two groups (P>0.05). Compared with group Ⅰ and N group, the RBV, TTP and MTT of the patients were increased, the DPI and RBF were reduced in group Ⅱ, there were significant differences (P<0.05). Conclusion: The CEUS technical analysis can be used in evaluating renal abnormality of the DN patients in early period by showing the changes of renal perfusion parameters. (authors)

  1. Contrast-enhanced MR angiography in Leriche's syndrome

    International Nuclear Information System (INIS)

    Link, J.; Steffens, J.C.; Brossmann, J.; Heller, M.; Loose, R.

    1998-01-01

    Purpose: To determine the usefulness of contrast-enhanced MR angiography for the diagnosis of Leriche's syndrome. Material and methods: Leriche's syndrome was seen in 7 patients via DSA. In [dition, contrast-enhanced MR angiography was performed (T R 7.8 ms/T E 2.1 ms, flip angle 30 , slab thickness 116 mm, slice thickness 1.82 mm, 64 partitions, FOV 500x438 mm, matrix 224x512). Results: Diagnosis of Leriche's syndrome was possible by contrast-enhanced MR angiography in each case. Visualisation of the femoral arteries was not possible in two patients by intraarterial DSA, in three other patients there was an insufficient contrast in the femoral arteries with DSA. Contrast-enhanced MR angiography revealed good visualisation of the femoral arteries in these patients. In [dition, contrast-enhanced MR angiography allowed complete visualisation of the patent lower limb arteries. In intraarterial DSA visualisation of the lower limb arteries was achieved reached in only one patient, but was incomplete. Conclusion: Contrast-enhanced MR angiography yielded the correct diagnosis of Leriche's syndrome in all 7 patients. Contrast-enhanced MR angiography was superior to DSA in the assessment of the distal run-off vessels in five of seven patients. (orig.) [de

  2. Potential Cost Savings of Contrast-Enhanced Digital Mammography.

    Science.gov (United States)

    Patel, Bhavika K; Gray, Richard J; Pockaj, Barbara A

    2017-06-01

    The purpose of this article is to discuss whether the sensitivity and specificity of contrast-enhanced digital mammography (CEDM) render it a viable diagnostic alternative to breast MRI. That CEDM couples low-energy images (comparable to the diagnostic quality of standard mammography) and subtracted contrast-enhanced mammograms make it a cost-effective modality and a realistic substitute for the more costly breast MRI.

  3. Dual-energy contrast-enhanced spectral mammography (CESM).

    Science.gov (United States)

    Daniaux, Martin; De Zordo, Tobias; Santner, Wolfram; Amort, Birgit; Koppelstätter, Florian; Jaschke, Werner; Dromain, Clarisse; Oberaigner, Willi; Hubalek, Michael; Marth, Christian

    2015-10-01

    Dual-energy contrast-enhanced mammography is one of the latest developments in breast care. Imaging with contrast agents in breast cancer was already known from previous magnetic resonance imaging and computed tomography studies. However, high costs, limited availability-or high radiation dose-led to the development of contrast-enhanced spectral mammography (CESM). We reviewed the current literature, present our experience, discuss the advantages and drawbacks of CESM and look at the future of this innovative technique.

  4. Contrast enhanced MR findings of lesions associated with radial scar: correlation with histopathology

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Jee Woo; Cha, Eun Suk; Choi, Hyun Joo; Seo, Young Jin [College of Medicine, The Catholic University of Korea, Suwon (Korea, Republic of)

    2007-01-15

    To evaluate the contrast-enhanced MR findings of lesions associated with a radial scar and to compare the MR findings with the histopathology results. From Mar. 2001 to Sep. 2005, 8 patients with a surgically proven radial scar who had undergone MRI, mammography, and ultrasonography were enrolled in this study. The morphological findings and dynamic enhancement pattern of the time-intensity curve were retrospectively reviewed using noncontrast and contrast-enhanced MRI. Mammography and ultrasonography were also analyzed according to the BI-RADS category and correlated with the histopathological diagnosis. The age of the patients ranged from 42 to 53 years (mean, 47 years). Five patients presented with a left breast lesion and the others presented with a right breast lesion. The histopathological diagnosis associated with the radial scar were fibrocystic changes (n = 1) adenosis (n = 2), atypical ductal hyperplasia (n = 2), lobular carcinoma in situ (n = 1), ductal carcinoma in situ (n = 1), and invasive ductal carcinoma (n = 1). In all patients, architectural distortion without microcalcification was observed with mammography. Irregular shaped hypoechoic lesions with an indistinct, spiculated, or angular margin was observed in all patients with ultrasonography. Posterior shadowing was observed in 4 cases. MR enhancement revealed two cases with foci enhancement (adenosis and fibrocystic change), five cases with non-mass-like focal enhancement (fibrocystic change, atypical ductal hyperplasia, lobular carcinoma in situ, ductal carcinoma in situ, invasive ductal carcinoma), and one irregular homogeneous mass enhancement (atypical ducal hyperplasia). The time-signal intensity curves are as follows: persistent type (n = 2), adenosis, and fibrocystic changes, respectively; plateu type (n = 4) one adenosis, two atypical ductal hyperplasia, and one ductal carcinoma in situ; and washout type (n = 2), lobular carcinoma in situ, and invasive ductal carcinoma, respectively

  5. Contrast enhanced MR findings of lesions associated with radial scar: correlation with histopathology

    International Nuclear Information System (INIS)

    Chung, Jee Woo; Cha, Eun Suk; Choi, Hyun Joo; Seo, Young Jin

    2007-01-01

    To evaluate the contrast-enhanced MR findings of lesions associated with a radial scar and to compare the MR findings with the histopathology results. From Mar. 2001 to Sep. 2005, 8 patients with a surgically proven radial scar who had undergone MRI, mammography, and ultrasonography were enrolled in this study. The morphological findings and dynamic enhancement pattern of the time-intensity curve were retrospectively reviewed using noncontrast and contrast-enhanced MRI. Mammography and ultrasonography were also analyzed according to the BI-RADS category and correlated with the histopathological diagnosis. The age of the patients ranged from 42 to 53 years (mean, 47 years). Five patients presented with a left breast lesion and the others presented with a right breast lesion. The histopathological diagnosis associated with the radial scar were fibrocystic changes (n = 1) adenosis (n = 2), atypical ductal hyperplasia (n = 2), lobular carcinoma in situ (n = 1), ductal carcinoma in situ (n = 1), and invasive ductal carcinoma (n = 1). In all patients, architectural distortion without microcalcification was observed with mammography. Irregular shaped hypoechoic lesions with an indistinct, spiculated, or angular margin was observed in all patients with ultrasonography. Posterior shadowing was observed in 4 cases. MR enhancement revealed two cases with foci enhancement (adenosis and fibrocystic change), five cases with non-mass-like focal enhancement (fibrocystic change, atypical ductal hyperplasia, lobular carcinoma in situ, ductal carcinoma in situ, invasive ductal carcinoma), and one irregular homogeneous mass enhancement (atypical ducal hyperplasia). The time-signal intensity curves are as follows: persistent type (n = 2), adenosis, and fibrocystic changes, respectively; plateu type (n = 4) one adenosis, two atypical ductal hyperplasia, and one ductal carcinoma in situ; and washout type (n = 2), lobular carcinoma in situ, and invasive ductal carcinoma, respectively

  6. Evaluation of sacroiliitis: contrast-enhanced MRI with subtraction technique

    Energy Technology Data Exchange (ETDEWEB)

    Algin, Oktay; Gokalp, Gokhan; Baran, Bulent; Ocakoglu, Gokhan; Yazici, Zeynep [Uludag University, Medical Faculty, Department of Radiology, Gorukle, Bursa (Turkey)

    2009-10-15

    The purpose of the study was to investigate the diagnostic value of contrast-enhanced MRI using the subtraction technique in the detection of active sacroiliitis. Magnetic resonance imaging was performed in 8 asymptomatic volunteers and 50 patients with clinically suspected active sacroiliitis. On precontrast MR images, T1-weighted spin-echo images with and without fat saturation (T1WFS and T1W), STIR and 3D-FLASH images with fat saturation were obtained in the semicoronal plane using a 1.5 Tesla imager. Postcontrast MRI was performed using the same T1WFS sequence as before contrast injection for all volunteers and patients. Postcontrast images were subtracted from fat-suppressed precontrast images. Enhancement within the joint space and bone marrow was considered to demonstrate active sacroiliitis. In 50 patients (100 sacroiliac joints [SIJs]), 40 (76 SIJs) were considered to have active sacroiliitis based on MR images. Bone marrow edema was present in 33 patients (62 SIJs) on STIR images. Routine MRI allowed identification of contrast enhancement in SIJs on postcontrast T1WFS images in 31 patients (49 SIJs). Contrast enhancement was observed in 40 patients (76 SIJs) who were examined by MRI using the subtraction technique. Contrast enhancement was significantly more conspicuous on subtraction images than on non-subtracted postcontrast T1WFS images (Mann-Whitney U test, p<0.001). Contrast-enhanced MRI with subtraction technique may be useful for early detection of active sacroiliitis. (orig.)

  7. Contrast-enhanced CISS imaging of cerebellopontine angle tumors

    Energy Technology Data Exchange (ETDEWEB)

    Tozaki, Mitsuhiro; Toyoda, Keiko; Hata, Yuichi; Fukuda, Yasushi; Fukuda, Kunihiko [Jikei Univ., Tokyo (Japan). School of Medicine; Katano, Shuichi

    1999-10-01

    Our purpose of this study was to evaluate the clinical usefulness of contrast-enhanced CISS-3DFT MR imaging for the diagnosis of CP angle tumors. CISS-3DFT MR imaging is expected for screening procedure of acoustic schwannoma because of excellent spatial resolution. Recently, we discovered contrast enhancement effect on CISS sequence in spite of heavily T{sub 2}-weighted images. Fourteen patients with CP angle tumors were performed on a 1.0 T MR unit. Transaxial CISS-3DFT MRI was obtained both before and after intravenous injections of Gd-DTPA. Multiplanar reconstructions (MPRs) were performed in all cases. Contrast enhancement effect of CP angle tumors, and the relationship between tumors and the adjacent cranial nerves were evaluated. Contrast enhancement effect of the tumors was present in all cases in spite of heavily T{sub 2}-weighted images of CISS sequences. In the internal auditory canal, relationship between the tumors and the cranial nerves was demonstrated in 6 cases (6/9). In the cerebellopontine cistern, all cases were demonstrated (11/11). Contrast-enhanced CISS-3DFT MR imaging with a good contrast resolution and an excellent spatial resolution is useful for the diagnosis of CP angle tumors. (author)

  8. Assessment of peripheral skeletal muscle microperfusion in a porcine model of peripheral arterial stenosis by steady-state contrast-enhanced ultrasound and Doppler flow measurement.

    Science.gov (United States)

    Naehle, Claas P; Steinberg, Verena A; Schild, Hans; Mommertz, Gottfried

    2015-05-01

    Noninvasive measurement of peripheral muscle microperfusion could potentially improve diagnosis, management, and treatment of peripheral arterial disease (PAD) and thus improve patient care. Contrast-enhanced ultrasound (CEUS) as a noninvasive diagnostic tool allows quantification of muscle perfusion. Increasing data on bolus technique CEUS reflecting microperfusion are becoming available, but only limited data on steady-state CEUS for assessment of muscle microperfusion are available. Therefore, the aim of this study was to evaluate steady-state CEUS for assessment of peripheral muscle microperfusion in a PAD animal model. In a porcine animal model, peripheral muscle microperfusion was quantified by steady-state CEUS replenishment kinetics (mean transit time [mTT] and wash-in rate [WiR]) of the biceps femoris muscle during intravenous steady-state infusion of INN-sulfur hexafluoride (SonoVue; Bracco, Geneva, Switzerland). In addition, macroperfusion was quantified at the external femoral artery with a Doppler flow probe. Peripheral muscle microperfusion and Doppler flow measurements were performed bilaterally at rest and under adenosine stress (70 μg/kg body weight) before and after unilateral creation of a moderate external iliac artery stenosis. All measurements could be performed completely in 10 pigs. Compared with baseline measurements, peripheral muscle microperfusion decreased significantly during adenosine stress (rest vs adenosine stress: mTT, 7.8 ± 3.3 vs 21.2 ± 17.8 s, P = .0006; WiR, 58.4 ± 38.1 vs 25.3 ± 15.6 arbitrary units [a.u.]/s, P flow, 122.3 ± 31.4 vs 83.6 ± 28.1 mL/min, P = .0067) and after stenosis creation (no stenosis vs stenosis: mTT, 8.1 ± 3.1 vs 29.2 ± 18.0 s, P = .0469; WiR, 53.0 ± 22.7 vs 13.6 ± 8.4 a.u./s, P = .0156; Doppler flow, 124.2 ± 41.8 vs 65.9 ± 40.0 mL/min, P = .0313). After stenosis creation, adenosine stress led to a further significant decrease of peripheral muscle microperfusion but had no effect on

  9. Value of contrast-enhanced ultrasound in differential diagnosis of single metastatic liver cancer and solitary necrotic nodule of the liver

    Directory of Open Access Journals (Sweden)

    LI Jing

    2016-07-01

    Full Text Available Objective To investigate the value of contrast-enhanced ultrasound (CEUS in the differential diagnosis of single metastatic hepatic carcinoma (MHC and solitary necrotic nodule of the liver (SNNL. MethodsA retrospective analysis was performed for 12 patients with single MHC and 16 patients with SNNL who showed circular enhancement in arterial phase on CEUS. Age, size of lesion, and findings of two-dimensional gray-scale ultrasound and CEUS were compared between the two groups. The two-independent-samples t-test was used for comparison between groups, and the paired t-test was used for comparison within each group. ResultsThe MHC group had a significantly higher mean age than the SNNL group (60.2±11.3 years vs 41.0±9.1 years, t=4.970, P<0.001. The mean diameter of lesion was 2.86±1.22 cm in the MHC group and 2.97±0.96 cm in the SNNL group, and showed no significant difference between the two groups (t=-0.269, P=0.790. In the MHC group, the lesions had complex and uneven echoes and blurred boundaries, while in the SNNL group, most lesions were in the right lobe and were hypoechoic with clear boundaries. No blood flow signals were detected on CDFI in these two groups. Both groups had circular enhancement around the lesions in arterial phase on CEUS, and the mean thickness showed a significant difference between the MHC group and the SNNL group (5.00±1.69 mm vs 2.37±0.87 mm, t=5.374, P<0001. In the MHC group, the area in lesions without enhancement in delayed phase was significantly larger than that in arterial phase (t=-4.508, P=0001, while in the SNNL group, the area in lesions without enhancement showed no significant difference between delayed phase and arterial phase (t=-0.449, P=0.660. ConclusionThe thickness of circular enhancement in arterial phase on CEUS and the presence or absence of the enlargement in the area without enhancement contributes to the differential diagnosis of single MHC and SNNL.

  10. Role of Contrast-enhanced Ultrasound in the Evaluation of Inflammatory Arthritis

    Directory of Open Access Journals (Sweden)

    Chen-Yang Zhao

    2017-01-01

    Conclusions: CEUS may be a new choice for the rheumatologists to evaluate inflammatory arthritis, because of its low price, ability to provide dynamic pictures, and high sensitivity to angiogenesis. It can also be applied in disease classification and therapeutic monitoring. More studies about CEUS need to be done to set up the diagnostic standards.

  11. Centrifugal (inside-out) enhancement of liver hemangiomas: A possible atypical appearance on contrast-enhanced US

    International Nuclear Information System (INIS)

    Bartolotta, Tommaso Vincenzo; Taibbi, Adele; Galia, Massimo; Lo Re, Giuseppe; La Grutta, Ludovico; Grassi, Roberto; Midiri, Massimo

    2007-01-01

    Objective: To report the prevalence and to describe the atypical centrifugal (inside-out) appearance of contrast-enhancement of liver hemangiomas on contrast-enhanced sonography. Materials and methods: Baseline and SonoVue-enhanced ultrasonography of 92 patients with 158 liver hemangiomas - considered atypical at grey-scale examination and confirmed by computed tomography, magnetic resonance imaging and ultrasound follow-up - were reviewed in consensus by two experienced radiologists, who evaluated baseline echogenicity and the dynamic enhancement pattern of each lesion looking for the presence of central enhancing foci in the arterial phase followed by a centrifugal (inside-out) enhancement in the portal-venous and late phases. Results: After administration of SonoVue, 12/158 hemangiomas (7.6%) (size range: 1-7 cm; mean: 3.2 cm) in seven patients (5 women, 2 men; age range: 34-71 years, mean: 50.8 years) showed a central enhancing focus in the arterial phase followed by a centrifugal enhancement in the portal-venous and late phases. In all cases centrifugal enhancement was incomplete at contrast-enhanced sonography, whereas computed tomography and/or magnetic resonance imaging were able to depict a complete and homogeneous fill-in. Conclusion: Radiologist should be aware that centrifugal (inside-out) appearance on contrast-enhanced sonography is a rare but possible feature of liver hemangioma

  12. Centrifugal (inside-out) enhancement of liver hemangiomas: A possible atypical appearance on contrast-enhanced US

    Energy Technology Data Exchange (ETDEWEB)

    Bartolotta, Tommaso Vincenzo [Department of Radiology, University of Palermo, Via Del Vespro 127, 90127 Palermo (Italy)], E-mail: tv.bartolotta@unipa.it; Taibbi, Adele [Department of Radiology, University of Palermo, Via Del Vespro 127, 90127 Palermo (Italy)], E-mail: taibbi_adele@yahoo.it; Galia, Massimo [Department of Radiology, University of Palermo, Via Del Vespro 127, 90127 Palermo (Italy)], E-mail: mgalia@yahoo.com; Lo Re, Giuseppe [Department of Radiology, University of Palermo, Via Del Vespro 127, 90127 Palermo (Italy)], E-mail: giuseppe.lore12@tin.it; La Grutta, Ludovico [Department of Radiology, University of Palermo, Via Del Vespro 127, 90127 Palermo (Italy)], E-mail: lagrutta@mbox.infcom.it; Grassi, Roberto [Institute of Radiology, Second University of Naples, Piazza Miraglia, 80138 Naples (Italy)], E-mail: roberto.grassi@libero.it; Midiri, Massimo [Department of Radiology, University of Palermo, Via Del Vespro 127, 90127 Palermo (Italy)], E-mail: mmidiri@hotmail.com

    2007-12-15

    Objective: To report the prevalence and to describe the atypical centrifugal (inside-out) appearance of contrast-enhancement of liver hemangiomas on contrast-enhanced sonography. Materials and methods: Baseline and SonoVue-enhanced ultrasonography of 92 patients with 158 liver hemangiomas - considered atypical at grey-scale examination and confirmed by computed tomography, magnetic resonance imaging and ultrasound follow-up - were reviewed in consensus by two experienced radiologists, who evaluated baseline echogenicity and the dynamic enhancement pattern of each lesion looking for the presence of central enhancing foci in the arterial phase followed by a centrifugal (inside-out) enhancement in the portal-venous and late phases. Results: After administration of SonoVue, 12/158 hemangiomas (7.6%) (size range: 1-7 cm; mean: 3.2 cm) in seven patients (5 women, 2 men; age range: 34-71 years, mean: 50.8 years) showed a central enhancing focus in the arterial phase followed by a centrifugal enhancement in the portal-venous and late phases. In all cases centrifugal enhancement was incomplete at contrast-enhanced sonography, whereas computed tomography and/or magnetic resonance imaging were able to depict a complete and homogeneous fill-in. Conclusion: Radiologist should be aware that centrifugal (inside-out) appearance on contrast-enhanced sonography is a rare but possible feature of liver hemangioma.

  13. Ultrasonography of the canine pancreas

    Directory of Open Access Journals (Sweden)

    Michelle L Avante

    2018-01-01

    Full Text Available This study describes the ultrasonographic techniques currently used in the evaluation of the canine pancreas. Ultrasonography was the first method to enable direct visualization of the pancreas in humans and it has been subsequently applied to animals. Currently, it is the method of choice for pancreatic evaluation and is essential as a diagnostic tool in the detection of abnormalities, especially tumors. Innovative equipment technology has led to the emergence of techniques complementary to B-mode ultrasound; such as Doppler, elastography, and contrast-enhanced ultrasonography, which have enabled more accurate diagnosis. Doppler provides information on vascular architecture and the hemodynamic aspect of blood vessels in multiple organs. ARFI elastography provides detailed images of the alterations detected by conventional examination (qualitative method and assists in differentiating between benign and malignant processes (quantitative method. Microbubble contrast agents determine parameters related to homogeneous and heterogeneous filling of organs with microbubbles, mainly nodular areas, thus defining high and low intensity patterns.

  14. Ileal Crohn disease: mural microvascularity quantified with contrast-enhanced US correlates with disease activity.

    Science.gov (United States)

    De Franco, Antonio; Di Veronica, Alessandra; Armuzzi, Alessandro; Roberto, Italia; Marzo, Manuela; De Pascalis, Barbara; De Vitis, Italo; Papa, Alfredo; Bock, Enrico; Danza, Francesco M; Bonomo, Lorenzo; Guidi, Luisa

    2012-02-01

    To quantitatively assess microvascular activation in the thickened ileal walls of patients with Crohn disease (CD) by using contrast-enhanced ultrasonography (US) and evaluate its correlation with widely used indexes of CD activity. This prospective study was approved by the ethics committee, and written informed consent was obtained from all patients. The authors examined 54 consecutively enrolled patients (mean age, 35.29 years; age range, 18-69 years; 39 men, 15 women) with endoscopically confirmed CD of the terminal ileum. Ileal wall segments thicker than 3 mm were examined with low-mechanical-index contrast-enhanced US and a second-generation US contrast agent. The authors analyzed software-plotted time-enhancement intensity curves to determine the maximum peak intensity (MPI) and wash-in slope coefficient (β) and evaluated their correlation with (a) the composite index of CD activity (CICDA), (b) the CD activity index (CDAI), and (c) the simplified endoscopic score for CD (SES-CD, evaluated in 37 patients) for the terminal ileum. Statistical analysis was performed with the Mann-Whitney test, Spearman rank test, and receiver operating characteristic (ROC) analysis. MPI and β coefficients were significantly increased in the 36 patients with a CICDA indicative of active disease (P<.0001 for both), the 33 patients with a CDAI of at least 150 (P<.032 and P<.0074, respectively), and the 26 patients with an SES-CD of at least 1 (P<.0001 and P<.002, respectively). ROC analysis revealed accurate identification (compared with CICDA) of active CD with an MPI threshold of 24 video intensity (VI) (sensitivity, 97%; specificity, 83%) and a β coefficient of 4.5 VI/sec (sensitivity, 86%; specificity, 83%). Contrast-enhanced US of the ileal wall is a promising method for objective, reproducible assessment of disease activity in patients with ileal CD. © RSNA, 2011

  15. The value of contrast-enhanced laparoscopic ultrasound during robotic-assisted surgery for primary colorectal cancer

    DEFF Research Database (Denmark)

    Ellebaek, Signe Bremholm; Fristrup, Claus Wilki; Pless, Torsten

    2018-01-01

    AIM: The aim of this study was to assess the potential clinical value of contrast enhanced laparoscopic ultrasonography (CE-LUS) as a screening modality for liver metastases during robotic assisted surgery for primary colorectal cancer (CRC). METHOD: A prospective, descriptive (feasibility) study...... including 50 consecutive patients scheduled for robotic assisted surgery for primary CRC. CE-LUS was performed by 2 experienced specialists. Only patients without metastatic disease were included. Follow-up was obtained with contrast-enhanced CT imaging at 3 and 12 months postoperatively. RESULTS: Fifty......-up revealed no liver metastasis in any of the patients. CONCLUSION: CE-LUS did not increase the detection rate of occult liver metastasis during robotic assisted primary CRC surgery. The use of CE-LUS as a screening modality for detection of liver metastasis cannot be recommended based on this study...

  16. A Novel Contrast Enhancement Technique on Palm Bone Images

    Directory of Open Access Journals (Sweden)

    Yung-Tsang Chang

    2014-09-01

    Full Text Available Contrast enhancement plays a fundamental role in image processing. Many histogram-based techniques are widely used for contrast enhancement of given images, due to their simple function and effectiveness. However, the conventional histogram equalization (HE methods result in excessive contrast enhancement, which causes natural looking and satisfactory results for a variety of low contrast images. To solve such problems, a novel multi-histogram equalization technique is proposed to enhance the contrast of the palm bone X-ray radiographs in this paper. For images, the mean-variance analysis method is employed to partition the histogram of the original grey scale image into multiple sub-histograms. These histograms are independently equalized. By using this mean-variance partition method, a proposed multi-histogram equalization technique is employed to achieve the contrast enhancement of the palm bone X-ray radiographs. Experimental results show that the multi-histogram equalization technique achieves a lower average absolute mean brightness error (AMBE value. The multi-histogram equalization technique simultaneously preserved the mean brightness and enhanced the local contrast of the original image.

  17. Reproducibility of contrast-enhanced transrectal ultrasound of the prostate

    NARCIS (Netherlands)

    Sedelaar, J. P.; Goossen, T. E.; Wijkstra, H.; de la Rosette, J. J.

    2001-01-01

    Transrectal three-dimensional (3-D) contrast-enhanced power Doppler ultrasound (US) is a novel technique for studying possible prostate malignancy. Before studies can be performed to investigate the clinical validity of the technique, reproducibility of the contrast US studies must be proven.

  18. A two-stage multi-view learning framework based computer-aided diagnosis of liver tumors with contrast enhanced ultrasound images.

    Science.gov (United States)

    Guo, Le-Hang; Wang, Dan; Qian, Yi-Yi; Zheng, Xiao; Zhao, Chong-Ke; Li, Xiao-Long; Bo, Xiao-Wan; Yue, Wen-Wen; Zhang, Qi; Shi, Jun; Xu, Hui-Xiong

    2018-04-04

    With the fast development of artificial intelligence techniques, we proposed a novel two-stage multi-view learning framework for the contrast-enhanced ultrasound (CEUS) based computer-aided diagnosis for liver tumors, which adopted only three typical CEUS images selected from the arterial phase, portal venous phase and late phase. In the first stage, the deep canonical correlation analysis (DCCA) was performed on three image pairs between the arterial and portal venous phases, arterial and delayed phases, and portal venous and delayed phases respectively, which then generated total six-view features. While in the second stage, these multi-view features were then fed to a multiple kernel learning (MKL) based classifier to further promote the diagnosis result. Two MKL classification algorithms were evaluated in this MKL-based classification framework. We evaluated proposed DCCA-MKL framework on 93 lesions (47 malignant cancers vs. 46 benign tumors). The proposed DCCA-MKL framework achieved the mean classification accuracy, sensitivity, specificity, Youden index, false positive rate, and false negative rate of 90.41 ± 5.80%, 93.56 ± 5.90%, 86.89 ± 9.38%, 79.44 ± 11.83%, 13.11 ± 9.38% and 6.44 ± 5.90%, respectively, by soft margin MKL classifier. The experimental results indicate that the proposed DCCA-MKL framework achieves best performance for discriminating benign liver tumors from malignant liver cancers. Moreover, it is also proved that the three-phase CEUS image based CAD is feasible for liver tumors with the proposed DCCA-MKL framework.

  19. Acoustic Radiation Force Impulse Elastography for Efficacy Evaluation after Hepatocellular Carcinoma Radiofrequency Ablation: A Comparative Study with Contrast-Enhanced Ultrasound

    Directory of Open Access Journals (Sweden)

    Xiaohong Xu

    2014-01-01

    Full Text Available Aim. To explore acoustic radiation force impulse (ARFI elastography in assessing residual tumors of hepatocellular carcinoma (HCC after radiofrequency ablation (RFA. Materials and Methods. There were 83 HCC lesions among 72 patients. All patients were examined with ARFI, contrast enhanced ultrasound (CEUS, and CT or MRI. Tumor brightness on virtual touch tissue imaging (VTI and shear wave velocity (SWV were assessed before and approximately one month after RFA. Results. There were 14 residual tumors after RFA. VTI showed that all the tumors were darker after RFA. VTI was not able to distinguish the ablated lesions and the residual tumors. 13 residual tumor lesions were detected by CEUS. All completely ablated nodules had SWV demonstration of x.xx., while with those residual nodules, 6 tumors had x.xx measurement and 8 tumors had measurable SWV. nine lesions with residual tumors occurred in cirrhosis subjects and 5 lesions with residual tumors occurred in fibrosis subjects; there was no residual tumor in the normal liver subjects. Conclusion. VTI technique cannot demonstrate residual tumor post RFA. While SWV measurement of less than x.xx is likely associated with residual tumors, measurement of less than x.xx cannot exclude residual tumors. Liver cirrhosis is associated with decreased chance of a complete ablation.

  20. Acoustic Radiation Force Impulse Elastography for Efficacy Evaluation after Hepatocellular Carcinoma Radiofrequency Ablation: A Comparative Study with Contrast-Enhanced Ultrasound

    Science.gov (United States)

    Xu, Xiaohong; Luo, Liangping; Chen, Jiexin; Wang, Jiexin; Zhou, Honglian; Li, Mingyi; Jin, Zhanqiang; Chen, Nianping; Miao, Huilai; Lin, Manzhou; Dai, Wei; Ahuja, Anil T.; Wang, Yi-Xiang J.

    2014-01-01

    Aim. To explore acoustic radiation force impulse (ARFI) elastography in assessing residual tumors of hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA). Materials and Methods. There were 83 HCC lesions among 72 patients. All patients were examined with ARFI, contrast enhanced ultrasound (CEUS), and CT or MRI. Tumor brightness on virtual touch tissue imaging (VTI) and shear wave velocity (SWV) were assessed before and approximately one month after RFA. Results. There were 14 residual tumors after RFA. VTI showed that all the tumors were darker after RFA. VTI was not able to distinguish the ablated lesions and the residual tumors. 13 residual tumor lesions were detected by CEUS. All completely ablated nodules had SWV demonstration of x.xx., while with those residual nodules, 6 tumors had x.xx measurement and 8 tumors had measurable SWV. nine lesions with residual tumors occurred in cirrhosis subjects and 5 lesions with residual tumors occurred in fibrosis subjects; there was no residual tumor in the normal liver subjects. Conclusion. VTI technique cannot demonstrate residual tumor post RFA. While SWV measurement of less than x.xx is likely associated with residual tumors, measurement of less than x.xx cannot exclude residual tumors. Liver cirrhosis is associated with decreased chance of a complete ablation. PMID:24895624

  1. Ultrasonographic contrast-enhanced study of sicca syndrome

    International Nuclear Information System (INIS)

    Giuseppetti, Gian Marco; Argalia, Giulio; Salera, Diego; Ranaldi, Roberto; Danieli, Giovanna; Cappelli, Marida

    2005-01-01

    Objective: To assess the ability of US contrast-enhanced time-intensity curves to depict the changes connected with sicca syndrome, a fairly common condition that is often associated with autoimmune disorders such as Sjogren's syndrome or other diseases. Diagnostic criteria are complex and controversial and although no single test can be considered the gold standard, salivary gland scintigraphy and biopsy are reliable diagnostic methods. Materials and methods: Sixty consecutive patients with sicca syndrome, 40 of whom had primary (n = 23) or secondary (n = 17) Sjogren's syndrome and 20 had non-Sjogren's sicca syndrome, selected according to European Community Study Group diagnostic criteria for Sjogren's syndrome and subjected to contrast-enhanced US imaging of the parotids using a second-generation contrast agent with analysis of time-intensity curves at rest and during salivary stimulation, Tc99m salivary gland scintigraphy and labial gland biopsy. Results: In the 40 Sjogren's patients, US enhancement values were significantly lower (P < 0.0001 and P < 0.00003, respectively) than in the 20 non-Sjogren's patients both at rest and during stimulation. In the 23 subjects with the primary syndrome, values during stimulation were significantly lower than in the 17 subjects with the secondary syndrome (P < 0.0006), whereas at rest differences were not significant. Contrast-enhanced US imaging allowed to discriminate Sjogren's from non-Sjogren's sicca patients with 87.5% sensitivity, 85% specificity and 86.7% accuracy and the primary from the secondary syndrome with 78.2% sensitivity, 70.5% specificity and 75% accuracy. Interestingly, in eight patients with the primary syndrome, i.e. those with the more severe gland involvement, enhancement values were lower during stimulation than at rest. Conclusion: Preliminary results indicate that contrast-enhanced US imaging can provide useful information on sicca characterisation and severity

  2. Ultrasonographic contrast-enhanced study of sicca syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Giuseppetti, Gian Marco [Institute of Radiology, University School of Medicine, Umberto I Hospital, Via Conca 1, Ancona (Italy)]. E-mail: gm.giuseppetti@ao-umbertoprimo.marche.it; Argalia, Giulio [Institute of Radiology, University School of Medicine, Umberto I Hospital, Via Conca 1, Ancona (Italy); Salera, Diego [Institute of Radiology, University School of Medicine, Umberto I Hospital, Via Conca 1, Ancona (Italy); Ranaldi, Roberto [Institute of Pathological Anatomy and Histopathology, University School of Medicine, Umberto I Hospital, Ancona (Italy); Danieli, Giovanna [Institute of Internal Medicine, University School of Medicine, Umberto I Hospital, Ancona (Italy); Cappelli, Marida [Institute of Internal Medicine, University School of Medicine, Umberto I Hospital, Ancona (Italy)

    2005-05-01

    Objective: To assess the ability of US contrast-enhanced time-intensity curves to depict the changes connected with sicca syndrome, a fairly common condition that is often associated with autoimmune disorders such as Sjogren's syndrome or other diseases. Diagnostic criteria are complex and controversial and although no single test can be considered the gold standard, salivary gland scintigraphy and biopsy are reliable diagnostic methods. Materials and methods: Sixty consecutive patients with sicca syndrome, 40 of whom had primary (n = 23) or secondary (n = 17) Sjogren's syndrome and 20 had non-Sjogren's sicca syndrome, selected according to European Community Study Group diagnostic criteria for Sjogren's syndrome and subjected to contrast-enhanced US imaging of the parotids using a second-generation contrast agent with analysis of time-intensity curves at rest and during salivary stimulation, Tc99m salivary gland scintigraphy and labial gland biopsy. Results: In the 40 Sjogren's patients, US enhancement values were significantly lower (P < 0.0001 and P < 0.00003, respectively) than in the 20 non-Sjogren's patients both at rest and during stimulation. In the 23 subjects with the primary syndrome, values during stimulation were significantly lower than in the 17 subjects with the secondary syndrome (P < 0.0006), whereas at rest differences were not significant. Contrast-enhanced US imaging allowed to discriminate Sjogren's from non-Sjogren's sicca patients with 87.5% sensitivity, 85% specificity and 86.7% accuracy and the primary from the secondary syndrome with 78.2% sensitivity, 70.5% specificity and 75% accuracy. Interestingly, in eight patients with the primary syndrome, i.e. those with the more severe gland involvement, enhancement values were lower during stimulation than at rest. Conclusion: Preliminary results indicate that contrast-enhanced US imaging can provide useful information on sicca characterisation and

  3. Algorithms for contrast enhancement of electronic portal images

    International Nuclear Information System (INIS)

    Díez, S.; Sánchez, S.

    2015-01-01

    An implementation of two new automatized image processing algorithms for contrast enhancement of portal images is presented as suitable tools which facilitate the setup verification and visualization of patients during radiotherapy treatments. In the first algorithm, called Automatic Segmentation and Histogram Stretching (ASHS), the portal image is automatically segmented in two sub-images delimited by the conformed treatment beam: one image consisting of the imaged patient obtained directly from the radiation treatment field, and the second one is composed of the imaged patient outside it. By segmenting the original image, a histogram stretching can be independently performed and improved in both regions. The second algorithm involves a two-step process. In the first step, a Normalization to Local Mean (NLM), an inverse restoration filter is applied by dividing pixel by pixel a portal image by its blurred version. In the second step, named Lineally Combined Local Histogram Equalization (LCLHE), the contrast of the original image is strongly improved by a Local Contrast Enhancement (LCE) algorithm, revealing the anatomical structures of patients. The output image is lineally combined with a portal image of the patient. Finally the output images of the previous algorithms (NLM and LCLHE) are lineally combined, once again, in order to obtain a contrast enhanced image. These two algorithms have been tested on several portal images with great results. - Highlights: • Two Algorithms are implemented to improve the contrast of Electronic Portal Images. • The multi-leaf and conformed beam are automatically segmented into Portal Images. • Hidden anatomical and bony structures in portal images are revealed. • The task related to the patient setup verification is facilitated by the contrast enhancement then achieved.

  4. Contrast enhancement of the gyri in herpes simplex encephalitis

    International Nuclear Information System (INIS)

    Schumacher, K.A.; Langer, M.; Langer, R.

    1982-01-01

    A case of herpes simplex encephalitis was examined by computer tomography. Both cerebral hemispheres showed contrast enhancement of the gyri. The cause of this is considered. The increased contrast medium accumulation in the affected areas is probably due to the marked vascular proliferation which can be demonstrated anatomically, and to the rapid escape of contrast from the capillaries into the interstitial spaces. The findings of other authors, which differ somewhat, are discussed. (orig.) [de

  5. Color and Contrast Enhancement by Controlled Piecewise Affine Histogram Equalization

    Directory of Open Access Journals (Sweden)

    Jose-Luis Lisani

    2012-10-01

    Full Text Available This paper presents a simple contrast enhancement algorithm based on histogram equalization (HE. The proposed algorithm performs a piecewise affine transform of the intensity levels of a digital image such that the new cumulative distribution function will be approximately uniform (as with HE, but where the stretching of the range is locally controlled to avoid brutal noise enhancement. We call this algorithm Piecewise Affine Equalization (PAE. Several experiments show that, in general, the new algorithm improves HE results.

  6. Sequential contrast-enhanced MR imaging of the penis.

    Science.gov (United States)

    Kaneko, K; De Mouy, E H; Lee, B E

    1994-04-01

    To determine the enhancement patterns of the penis at magnetic resonance (MR) imaging. Sequential contrast material-enhanced MR images of the penis in a flaccid state were obtained in 16 volunteers (12 with normal penile function and four with erectile dysfunction). Subjects with normal erectile function showed gradual and centrifugal enhancement of the corpora cavernosa, while those with erectile dysfunction showed poor enhancement with abnormal progression. Sequential contrast-enhanced MR imaging provides additional morphologic information for the evaluation of erectile dysfunction.

  7. Newly Diagnosed Breast Cancer: Comparison of Contrast-enhanced Spectral Mammography and Breast MR Imaging in the Evaluation of Extent of Disease.

    Science.gov (United States)

    Lee-Felker, Stephanie A; Tekchandani, Leena; Thomas, Mariam; Gupta, Esha; Andrews-Tang, Denise; Roth, Antoinette; Sayre, James; Rahbar, Guita

    2017-11-01

    Purpose To compare the diagnostic performances of contrast material-enhanced spectral mammography and breast magnetic resonance (MR) imaging in the detection of index and secondary cancers in women with newly diagnosed breast cancer by using histologic or imaging follow-up as the standard of reference. Materials and Methods This institutional review board-approved, HIPAA-compliant, retrospective study included 52 women who underwent breast MR imaging and contrast-enhanced spectral mammography for newly diagnosed unilateral breast cancer between March 2014 and October 2015. Of those 52 patients, 46 were referred for contrast-enhanced spectral mammography and targeted ultrasonography because they had additional suspicious lesions at MR imaging. In six of the 52 patients, breast cancer had been diagnosed at an outside institution. These patients were referred for contrast-enhanced spectral mammography and targeted US as part of diagnostic imaging. Images from contrast-enhanced spectral mammography were analyzed by two fellowship-trained breast imagers with 2.5 years of experience with contrast-enhanced spectral mammography. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value were calculated for both imaging modalities and compared by using the Bennett statistic. Results Fifty-two women with 120 breast lesions were included for analysis (mean age, 50 years; range, 29-73 years). Contrast-enhanced spectral mammography had similar sensitivity to MR imaging (94% [66 of 70 lesions] vs 99% [69 of 70 lesions]), a significantly higher PPV than MR imaging (93% [66 of 71 lesions] vs 60% [69 of 115 lesions]), and fewer false-positive findings than MR imaging (five vs 45) (P contrast-enhanced spectral mammography depicted 11 of the 11 secondary cancers (100%) and MR imaging depicted 10 (91%). Conclusion Contrast-enhanced spectral mammography is potentially as sensitive as MR imaging in the evaluation of extent of disease in newly diagnosed

  8. Contrast-enhanced ultrasound for extrahepatic lesions: preliminary experience

    Energy Technology Data Exchange (ETDEWEB)

    Thorelius, Lars E-mail: lars@thorelius.com

    2004-06-01

    Ultrasound imaging (US) is a convenient, inexpensive and non-invasive investigation. Its use is limited by low sensitivity in the detection of a number of parenchymal lesions, especially those produced by trauma, such as infarctions. Contrast enhancement with SonoVue{sup [reg]} improves the sensitivity of ultrasound in the detection and characterization of focal liver lesions to such an extent, that it may replace computed tomography (CT) and magnetic resonance imaging (MRI). Preliminary experience suggests that SonoVue-enhanced sonography may be useful in the detection of lesions in which blood flow is severely reduced as compared to surrounding parenchyma, such as infarctions, lacerations, hematomas, necrotic tissue and non-vascular cysts, especially in the spleen, kidney and pancreas. This technique can also rule out occlusion of the superior mesenteric, splenic and portal veins, and dilation of the biliary tree. Clinical trials comparing contrast-enhanced sonography with contrast-enhanced computed tomography are warranted to establish the role of this inexpensive and non-invasive technique in the routine work-up of patients with abdominal trauma or presenting with sudden flank pain.

  9. Facial nerve palsy: Evaluation by contrast-enhanced MR imaging

    International Nuclear Information System (INIS)

    Kinoshita, T.; Ishii, K.; Okitsu, T.; Okudera, T.; Ogawa, T.

    2001-01-01

    AIM: The purpose of this study was to investigate the value of contrast-enhanced magnetic resonance (MR) imaging in patients with peripheral facial nerve palsy. MATERIALS AND METHODS: MR imaging was performed in 147 patients with facial nerve palsy, using a 1.0 T unit. All of 147 patients were evaluated by contrast-enhanced MR imaging and the pattern of enhancement was compared with that in 300 control subjects evaluated for suspected acoustic neurinoma. RESULTS: The intrameatal and labyrinthine segments of the normal facial nerve did not show enhancement, whereas enhancement of the distal intrameatal segment and the labyrinthine segment was respectively found in 67% and 43% of patients with Bell's palsy. The geniculate ganglion or the tympanic-mastoid segment was enhanced in 21% of normal controls versus 91% of patients with Bell's palsy. Abnormal enhancement of the non-paralyzed facial nerve was found in a patient with bilateral temporal bone fracture. CONCLUSION: Enhancement of the distal intrameatal and labyrinthine segments is specific for facial nerve palsy. Contrast-enhanced MR imaging can reveal inflammatory facial nerve lesions and traumatic nerve injury, including clinically silent damage in trauma. Kinoshita T. et al. (2001)

  10. Facial nerve palsy: Evaluation by contrast-enhanced MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kinoshita, T.; Ishii, K.; Okitsu, T.; Okudera, T.; Ogawa, T

    2001-11-01

    AIM: The purpose of this study was to investigate the value of contrast-enhanced magnetic resonance (MR) imaging in patients with peripheral facial nerve palsy. MATERIALS AND METHODS: MR imaging was performed in 147 patients with facial nerve palsy, using a 1.0 T unit. All of 147 patients were evaluated by contrast-enhanced MR imaging and the pattern of enhancement was compared with that in 300 control subjects evaluated for suspected acoustic neurinoma. RESULTS: The intrameatal and labyrinthine segments of the normal facial nerve did not show enhancement, whereas enhancement of the distal intrameatal segment and the labyrinthine segment was respectively found in 67% and 43% of patients with Bell's palsy. The geniculate ganglion or the tympanic-mastoid segment was enhanced in 21% of normal controls versus 91% of patients with Bell's palsy. Abnormal enhancement of the non-paralyzed facial nerve was found in a patient with bilateral temporal bone fracture. CONCLUSION: Enhancement of the distal intrameatal and labyrinthine segments is specific for facial nerve palsy. Contrast-enhanced MR imaging can reveal inflammatory facial nerve lesions and traumatic nerve injury, including clinically silent damage in trauma. Kinoshita T. et al. (2001)

  11. Contrast enhancement pattern in MR imaging of acute cerebral infarction

    International Nuclear Information System (INIS)

    Kim, Jong Deok; Cho, Mee Young; Lee, Chae Guk; Song, Dong Hoon

    1994-01-01

    To present the enhancement pattern of acute cerebral or cerebellar cortical infarctions aged 1-3 days on MR. Contrast-enhanced MR images of 26 patients with acute cerebral or cerebellar ischemic events were retrospectively reviewed. MR was performed within 3 days after ictus. Contrast enhancement in the area of infarction was observed in 61.5% (16/26) on MR. Of these 50% (13/26) showed non-parenchymal enhancement (NPE) representing either vascular or leptomeningeal enhancement, 7.7% (2/26) showed parenchymal enhancement (PE), and 2.8% (1/26) showed both NPE and PE. The earliest enhancement was seen in images obtained 12 hours after the onset of symptoms and appeared as NPE. One patient showed NPE without apparent high signal intensity at the corresponding area on T2-weighted images. In 38.5% (10/26), there was no enhancement. Contrast-enhanced MR imaging may be needed in acute ischemic infarction, because NPE may be seen as the earliest MR finding of acute cortical infraction aged 1-3 days

  12. Visual Contrast Enhancement Algorithm Based on Histogram Equalization

    Directory of Open Access Journals (Sweden)

    Chih-Chung Ting

    2015-07-01

    Full Text Available Image enhancement techniques primarily improve the contrast of an image to lend it a better appearance. One of the popular enhancement methods is histogram equalization (HE because of its simplicity and effectiveness. However, it is rarely applied to consumer electronics products because it can cause excessive contrast enhancement and feature loss problems. These problems make the images processed by HE look unnatural and introduce unwanted artifacts in them. In this study, a visual contrast enhancement algorithm (VCEA based on HE is proposed. VCEA considers the requirements of the human visual perception in order to address the drawbacks of HE. It effectively solves the excessive contrast enhancement problem by adjusting the spaces between two adjacent gray values of the HE histogram. In addition, VCEA reduces the effects of the feature loss problem by using the obtained spaces. Furthermore, VCEA enhances the detailed textures of an image to generate an enhanced image with better visual quality. Experimental results show that images obtained by applying VCEA have higher contrast and are more suited to human visual perception than those processed by HE and other HE-based methods.

  13. Contrast Enhancement Algorithm Based on Gap Adjustment for Histogram Equalization

    Directory of Open Access Journals (Sweden)

    Chung-Cheng Chiu

    2016-06-01

    Full Text Available Image enhancement methods have been widely used to improve the visual effects of images. Owing to its simplicity and effectiveness histogram equalization (HE is one of the methods used for enhancing image contrast. However, HE may result in over-enhancement and feature loss problems that lead to unnatural look and loss of details in the processed images. Researchers have proposed various HE-based methods to solve the over-enhancement problem; however, they have largely ignored the feature loss problem. Therefore, a contrast enhancement algorithm based on gap adjustment for histogram equalization (CegaHE is proposed. It refers to a visual contrast enhancement algorithm based on histogram equalization (VCEA, which generates visually pleasing enhanced images, and improves the enhancement effects of VCEA. CegaHE adjusts the gaps between two gray values based on the adjustment equation, which takes the properties of human visual perception into consideration, to solve the over-enhancement problem. Besides, it also alleviates the feature loss problem and further enhances the textures in the dark regions of the images to improve the quality of the processed images for human visual perception. Experimental results demonstrate that CegaHE is a reliable method for contrast enhancement and that it significantly outperforms VCEA and other methods.

  14. Effects of computed tomography contrast medium factors on contrast enhancement

    International Nuclear Information System (INIS)

    Terasawa, Kazuaki; Hatcho, Atsushi; Okuda, Itsuko

    2011-01-01

    The various nonionic iodinated contrast media used in contrast computed tomography (CT) studies differ in terms of their composition, characteristics, and iodine concentration (mgI/ml), as well as the volume injected (ml). Compared with ionic iodinated contrast media, nonionic iodinated contrast media are low-osmolar agents, with different agents having different osmotic pressures. Using a custom-made phantom incorporating a semipermeable membrane, the osmotic flow rate (hounsfield unit (HU)/s) could easily be measured based on the observed increase in CT numbers, and the relationship between the osmotic pressure and the osmotic flow rate could be obtained (r 2 =0.84). In addition, taking the effects of patient size into consideration, the levels of contrast enhancement in the abdominal aorta (AA) and inferior vena cava (IVC) were compared among four types of CT contrast medium. The results showed differences in contrast enhancement in the IVC during the equilibrium phase depending on the type of contrast medium used. It was found that the factors responsible for the differences observed in enhancement in the IVC were the osmotic flow rate and the volume of the blood flow pathways in the circulatory system. It is therefore considered that the reproducibility of contrast enhancement is likely to be reduced in the examination of parenchymal organs, in which scanning must be performed during the equilibrium phase, even if the amount of iodine injected per unit body weight (mgI/kg) is maintained at a specified level. (author)

  15. Contrast Enhancement Algorithm Based on Gap Adjustment for Histogram Equalization

    Science.gov (United States)

    Chiu, Chung-Cheng; Ting, Chih-Chung

    2016-01-01

    Image enhancement methods have been widely used to improve the visual effects of images. Owing to its simplicity and effectiveness histogram equalization (HE) is one of the methods used for enhancing image contrast. However, HE may result in over-enhancement and feature loss problems that lead to unnatural look and loss of details in the processed images. Researchers have proposed various HE-based methods to solve the over-enhancement problem; however, they have largely ignored the feature loss problem. Therefore, a contrast enhancement algorithm based on gap adjustment for histogram equalization (CegaHE) is proposed. It refers to a visual contrast enhancement algorithm based on histogram equalization (VCEA), which generates visually pleasing enhanced images, and improves the enhancement effects of VCEA. CegaHE adjusts the gaps between two gray values based on the adjustment equation, which takes the properties of human visual perception into consideration, to solve the over-enhancement problem. Besides, it also alleviates the feature loss problem and further enhances the textures in the dark regions of the images to improve the quality of the processed images for human visual perception. Experimental results demonstrate that CegaHE is a reliable method for contrast enhancement and that it significantly outperforms VCEA and other methods. PMID:27338412

  16. Visual Contrast Enhancement Algorithm Based on Histogram Equalization

    Science.gov (United States)

    Ting, Chih-Chung; Wu, Bing-Fei; Chung, Meng-Liang; Chiu, Chung-Cheng; Wu, Ya-Ching

    2015-01-01

    Image enhancement techniques primarily improve the contrast of an image to lend it a better appearance. One of the popular enhancement methods is histogram equalization (HE) because of its simplicity and effectiveness. However, it is rarely applied to consumer electronics products because it can cause excessive contrast enhancement and feature loss problems. These problems make the images processed by HE look unnatural and introduce unwanted artifacts in them. In this study, a visual contrast enhancement algorithm (VCEA) based on HE is proposed. VCEA considers the requirements of the human visual perception in order to address the drawbacks of HE. It effectively solves the excessive contrast enhancement problem by adjusting the spaces between two adjacent gray values of the HE histogram. In addition, VCEA reduces the effects of the feature loss problem by using the obtained spaces. Furthermore, VCEA enhances the detailed textures of an image to generate an enhanced image with better visual quality. Experimental results show that images obtained by applying VCEA have higher contrast and are more suited to human visual perception than those processed by HE and other HE-based methods. PMID:26184219

  17. Cranial CT revisited: do we really need contrast enhancement?

    International Nuclear Information System (INIS)

    Demaerel, P.; Buelens, C.; Wilms, G.; Baert, A.L.

    1998-01-01

    The aim of this study was to define guidelines for intravenous contrast administration in cranial CT, as currently there are no recent guidelines based on a large series of patients. In 1900 consecutive patients (1480 adults and 420 children) pre- and post-contrast scan was analysed in order to assess the contribution of contrast enhancement to the diagnosis. The findings were grouped according to whether abnormalities were seen on the pre- and/or post-contrast scan, or whether no abnormalities were seen at all. Sensitivity, specificity, positive predictive value, negative predictive value and accurracy of a pre-contrast scan were used to determine validity. Intravenous contrast enhancement only contributes to the diagnosis if a suspicious abnormality is seen on the unenhanced scan or in the appropriate clinical setting (33.6 %). In the remaining patients (65.6 %) there is no diagnostic contribution, except for a small number of abnormalities (0.8 %). These are often anatomical variants and have no therapeutic impact. The number of contrast-enhanced cranial CT examinations can significantly be reduced by using four general guidelines for contrast administration resulting in considerable cost savings without affecting the quality of service to the patient. These guidelines are defined by the clinical findings/presentation or by the findings on the unenhanced scan. The number of contrast-related complications will be reduced, which may have medicolegal implications. These guidelines can be applied in any radiology department. (orig.) (orig.)

  18. Contrast enhancement pattern in MR imaging of acute cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Deok; Cho, Mee Young; Lee, Chae Guk; Song, Dong Hoon [Inje University College of Medicine, Pusan (Korea, Republic of)

    1994-08-15

    To present the enhancement pattern of acute cerebral or cerebellar cortical infarctions aged 1-3 days on MR. Contrast-enhanced MR images of 26 patients with acute cerebral or cerebellar ischemic events were retrospectively reviewed. MR was performed within 3 days after ictus. Contrast enhancement in the area of infarction was observed in 61.5% (16/26) on MR. Of these 50% (13/26) showed non-parenchymal enhancement (NPE) representing either vascular or leptomeningeal enhancement, 7.7% (2/26) showed parenchymal enhancement (PE), and 2.8% (1/26) showed both NPE and PE. The earliest enhancement was seen in images obtained 12 hours after the onset of symptoms and appeared as NPE. One patient showed NPE without apparent high signal intensity at the corresponding area on T2-weighted images. In 38.5% (10/26), there was no enhancement. Contrast-enhanced MR imaging may be needed in acute ischemic infarction, because NPE may be seen as the earliest MR finding of acute cortical infraction aged 1-3 days.

  19. Applications of contrast enhanced CT through external jugular access

    International Nuclear Information System (INIS)

    Xu Qiaolan; Zou Wenxing; Chen Meixia; Xie Hongbo

    2005-01-01

    Objective: A retrospective analysis and evaluation for the effects of contrast enhanced computed tomography through external jugular access. Methods: 1250 cases (male 692 and female 558) underwent CT contrast enhanced examination were retrospectively reviewed from May, 2002 to Oct, 2002. The patients aged from 12 to 86 years, averagely 49 years. Contrast agent (Ultravist) was given through an intravenous catheter placed in the cubital vein. Precise injection rates were ensured by a power injector (Medrad MCT310, USA). Excellent enhancement was achieved with this protocol in most of the patients, while external jugular access was established in 96 cases because it was unable to setup a cubital venous access. Results: Good enhancement were acquired when 96 cases of contrast agent injected through external jugular vein. And the external jugular access was setup successfully with a single puncture. Conclusion: It is a common occasion when patient undergoing contrast enhanced CT scan is in poor conditions: debility, cachexia, or with complication of chemotherapy or radiation therapy, which often results in invalidity of cabital venous access, and consequently, making bolus injection impossible. The external jugular vein is a large and central blood vessel, which is easy to setup an access. In our experience, an external jugular access should be recommended as a substitution if the cubital venous access is not available. (authors)

  20. Applications of contrast enhanced CT through external jugular access

    Energy Technology Data Exchange (ETDEWEB)

    Qiaolan, Xu; Wenxing, Zou; Meixia, Chen; Hongbo, Xie [The First Affiliated Hospital of Sun Yat-sen University, Guangzhou (China). Dept. of Radiology

    2005-09-15

    Objective: A retrospective analysis and evaluation for the effects of contrast enhanced computed tomography through external jugular access. Methods: 1250 cases (male 692 and female 558) underwent CT contrast enhanced examination were retrospectively reviewed from May, 2002 to Oct, 2002. The patients aged from 12 to 86 years, averagely 49 years. Contrast agent (Ultravist) was given through an intravenous catheter placed in the cubital vein. Precise injection rates were ensured by a power injector (Medrad MCT310, USA). Excellent enhancement was achieved with this protocol in most of the patients, while external jugular access was established in 96 cases because it was unable to setup a cubital venous access. Results: Good enhancement were acquired when 96 cases of contrast agent injected through external jugular vein. And the external jugular access was setup successfully with a single puncture. Conclusion: It is a common occasion when patient undergoing contrast enhanced CT scan is in poor conditions: debility, cachexia, or with complication of chemotherapy or radiation therapy, which often results in invalidity of cabital venous access, and consequently, making bolus injection impossible. The external jugular vein is a large and central blood vessel, which is easy to setup an access. In our experience, an external jugular access should be recommended as a substitution if the cubital venous access is not available. (authors)

  1. Comparison of Oral Contrast-Enhanced Transabdominal Ultrasound Imaging With Transverse Contrast-Enhanced Computed Tomography in Preoperative Tumor Staging of Advanced Gastric Carcinoma.

    Science.gov (United States)

    He, Xuemei; Sun, Jing; Huang, Xiaoling; Zeng, Chun; Ge, Yinggang; Zhang, Jun; Wu, Jingxian

    2017-12-01

    This study assessed the diagnostic performance of transabdominal oral contrast-enhanced ultrasound (US) imaging for preoperative tumor staging of advanced gastric carcinoma by comparing it with transverse contrast-enhanced computed tomography (CT). This retrospective study included 42 patients with advanced gastric cancer who underwent laparoscopy, radical surgery, or palliative surgery because of serious complications and had a body mass index of less than 25 kg/m 2 . A cereal-based oral contrast agent was used for transabdominal oral contrast-enhanced US. Retrospective analyses were conducted using preoperative tumor staging data acquired by either transabdominal oral contrast-enhanced US or transverse contrast-enhanced CT. Both contrast-enhanced US and contrast-enhanced CT examinations were reviewed by 2 experienced radiologists independently for preoperative tumor staging according to the seventh edition of the TNM classification. The accuracy, sensitivity, and specificity were calculated by comparing the results of contrast-enhanced US and contrast-enhanced CT with pathologic findings. The overall accuracies of the imaging modalities were compared by the McNemar test. No significant difference was noted in the overall accuracy of transabdominal oral contrast-enhanced US (86% [36 of 42]) and transverse contrast-enhanced CT (83% [35 of 42] P > .999). For stage T2 to T4 gastric cancer, the accuracies of transabdominal oral contrast-enhanced US were 88%, 86%, and 98%, respectively, and those of transverse contrast-enhanced CT were 93%, 83%, and 90%. The overall accuracy of transabdominal oral contrast-enhanced US was comparable with that of transverse contrast-enhanced CT for preoperative tumor staging of advanced gastric cancer. © 2017 by the American Institute of Ultrasound in Medicine.

  2. Medial tibial pain: a dynamic contrast-enhanced MRI study.

    Science.gov (United States)

    Mattila, K T; Komu, M E; Dahlström, S; Koskinen, S K; Heikkilä, J

    1999-09-01

    The purpose of this study was to compare the sensitivity of different magnetic resonance imaging (MRI) sequences to depict periosteal edema in patients with medial tibial pain. Additionally, we evaluated the ability of dynamic contrast-enhanced imaging (DCES) to depict possible temporal alterations in muscular perfusion within compartments of the leg. Fifteen patients with medial tibial pain were examined with MRI. T1-, T2-weighted, proton density axial images and dynamic and static phase post-contrast images were compared in ability to depict periosteal edema. STIR was used in seven cases to depict bone marrow edema. Images were analyzed to detect signs of compartment edema. Region-of-interest measurements in compartments were performed during DCES and compared with controls. In detecting periosteal edema, post-contrast T1-weighted images were better than spin echo T2-weighted and proton density images or STIR images, but STIR depicted the bone marrow edema best. DCES best demonstrated the gradually enhancing periostitis. Four subjects with severe periosteal edema had visually detectable pathologic enhancement during DCES in the deep posterior compartment of the leg. Percentage enhancement in the deep posterior compartment of the leg was greater in patients than in controls. The fast enhancement phase in the deep posterior compartment began slightly slower in patients than in controls, but it continued longer. We believe that periosteal edema in bone stress reaction can cause impairment of venous flow in the deep posterior compartment. MRI can depict both these conditions. In patients with medial tibial pain, MR imaging protocol should include axial STIR images (to depict bone pathology) with T1-weighted axial pre and post-contrast images, and dynamic contrast enhanced imaging to show periosteal edema and abnormal contrast enhancement within a compartment.

  3. Contrast-enhanced Spectral Mammography: Technique, Indications, and Clinical Applications.

    Science.gov (United States)

    Bhimani, Chandni; Matta, Danielle; Roth, Robyn G; Liao, Lydia; Tinney, Elizabeth; Brill, Kristin; Germaine, Pauline

    2017-01-01

    Contrast-enhanced spectral mammography (CESM) combines the benefits of full field digital mammography with the concept of tumor angiogenesis. Technique and practical applications of CESM are discussed. An overview of the technique is followed by a demonstration of practical applications of CESM in our practice. We have successfully implemented CESM into our practice as a screening, diagnostic, staging, and treatment response tool. It is important to understand the technique of CESM and how to incorporate it into practice. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  4. Fundamentals of quantitative dynamic contrast-enhanced MR imaging.

    Science.gov (United States)

    Paldino, Michael J; Barboriak, Daniel P

    2009-05-01

    Quantitative analysis of dynamic contrast-enhanced MR imaging (DCE-MR imaging) has the power to provide information regarding physiologic characteristics of the microvasculature and is, therefore, of great potential value to the practice of oncology. In particular, these techniques could have a significant impact on the development of novel anticancer therapies as a promising biomarker of drug activity. Standardization of DCE-MR imaging acquisition and analysis to provide more reproducible measures of tumor vessel physiology is of crucial importance to realize this potential. The purpose of this article is to review the pathophysiologic basis and technical aspects of DCE-MR imaging techniques.

  5. A prolapsed cervical disc with diffuse contrast enhancement on CT

    International Nuclear Information System (INIS)

    Goto, Jun; Shinpo, Tomoyuki; Inoue, Kiyoharu; Shigeno, Taku; Ochiai, Chikayuki

    1985-01-01

    A 48-year-old woman with the C5/6 disc herniation was reported. She had noticed vague pains in the left shoulder a half year earlier. Neurological examination showed left lower cervical radicular pains and incomplete Brown-Sequard syndrome of the same side. The disc herniation was diagnosed by myelography and discography. On the CT examination, surprisingly, the prolapsed disc was homogenously enhanced after the administration of intravenous contrast medium. The vertebral angiography showed increased vascularity behind the C5/6 intervertebral space. At operation, a prolapsed nucleus pulposus with proliferated connective tissue was found and curetted. The etiology of contrast enhancement was discussed. (author)

  6. Fuzzy Logic-Based Histogram Equalization for Image Contrast Enhancement

    Directory of Open Access Journals (Sweden)

    V. Magudeeswaran

    2013-01-01

    Full Text Available Fuzzy logic-based histogram equalization (FHE is proposed for image contrast enhancement. The FHE consists of two stages. First, fuzzy histogram is computed based on fuzzy set theory to handle the inexactness of gray level values in a better way compared to classical crisp histograms. In the second stage, the fuzzy histogram is divided into two subhistograms based on the median value of the original image and then equalizes them independently to preserve image brightness. The qualitative and quantitative analyses of proposed FHE algorithm are evaluated using two well-known parameters like average information contents (AIC and natural image quality evaluator (NIQE index for various images. From the qualitative and quantitative measures, it is interesting to see that this proposed method provides optimum results by giving better contrast enhancement and preserving the local information of the original image. Experimental result shows that the proposed method can effectively and significantly eliminate washed-out appearance and adverse artifacts induced by several existing methods. The proposed method has been tested using several images and gives better visual quality as compared to the conventional methods.

  7. Morphological rational multi-scale algorithm for color contrast enhancement

    Science.gov (United States)

    Peregrina-Barreto, Hayde; Terol-Villalobos, Iván R.

    2010-01-01

    Contrast enhancement main goal consists on improving the image visual appearance but also it is used for providing a transformed image in order to segment it. In mathematical morphology several works have been derived from the framework theory for contrast enhancement proposed by Meyer and Serra. However, when working with images with a wide range of scene brightness, as for example when strong highlights and deep shadows appear in the same image, the proposed morphological methods do not allow the enhancement. In this work, a rational multi-scale method, which uses a class of morphological connected filters called filters by reconstruction, is proposed. Granulometry is used by finding the more accurate scales for filters and with the aim of avoiding the use of other little significant scales. The CIE-u'v'Y' space was used to introduce our results since it takes into account the Weber's Law and by avoiding the creation of new colors it permits to modify the luminance values without affecting the hue. The luminance component ('Y) is enhanced separately using the proposed method, next it is used for enhancing the chromatic components (u', v') by means of the center of gravity law of color mixing.

  8. Characteristics of hypertrophic cardiomyopathy on delayed contrast-enhanced MRI

    International Nuclear Information System (INIS)

    Yan Chaowu; Zhao Shihua; Li Hua; Jiang Shiliang; Lu Minjie; Zhang Yan; Wei Yunqing; Ling Jian; Fang Wei

    2010-01-01

    Objective: To analyze the characteristics of hypertrophic cardiomyopathy (HCM) on delayed contrast-enhanced cardiac magnetic resonance imaging (CMRI). Methods: All patients underwent delayed contrast-enhanced CMRI. The left ventricle was divided into 9 segments to assess the location, extent and function of the hypertrophic segments. The t test was applied for the statistics. Results: Of 154 patients, delayed enhancement of' hypertrophic segment was found in 95 cases and non-delayed enhancement in 59 cases. The thickness and number of hypertrophic segment in patients with delayed enhancement were larger than those with non-delayed enhancement [(24.8±5.5) mm vs (20.4± 3.8) mm, t=3.82, P<0.05; (3.3±1.9) vs (2.4±1.7), t=2.26, P<0.05], and the age was younger [(46.0±15.2) years vs (55.0±11.9) years, t=-3.67, P<0.05]. The diffuse enhancement was found in 62 patients, and confluent enhancement in 33 patients. Confluent enhancement was found in all 14 patients after the alcohol ablation procedure. Conclusion: The age, thickness and number of hypertrophic segments in patients with delayed enhancement are different from those with non-delayed enhancement. (authors)

  9. [Pancreatic ultrasonography].

    Science.gov (United States)

    Fernández-Rodríguez, T; Segura-Grau, A; Rodríguez-Lorenzo, A; Segura-Cabral, J M

    2015-04-01

    Despite the recent technological advances in imaging, abdominal ultrasonography continues to be the first diagnostic test indicated in patients with a suspicion of pancreatic disease, due to its safety, accessibility and low cost. It is an essential technique in the study of inflammatory processes, since it not only assesses changes in pancreatic parenchyma, but also gives an indication of the origin (bile or alcoholic). It is also essential in the detection and tracing of possible complications as well as being used as a guide in diagnostic and therapeutic punctures. It is also the first technique used in the study of pancreatic tumors, detecting them with a sensitivity of around 70% and a specificity of 90%. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  10. Breast Dynamic Contrast Enhanced MRI: Fibrocystic Changes Presenting as a Non-mass Enhancement Mimicking Malignancy.

    Science.gov (United States)

    Milosevic, Zorica C; Nadrljanski, Mirjan M; Milovanovic, Zorka M; Gusic, Nina Z; Vucicevic, Slavko S; Radulovic, Olga S

    2017-06-01

    We aimed to analyse the morphokinetic features of breast fibrocystic changes (nonproliferative lesions, proliferative lesions without atypia and proliferative lesions with atypia) presenting as a non-mass enhancement (NME)in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) examination. Forty-six patients with histologically proven fibrocystic changes (FCCs) were retrospectively reviewed, according to Breast Imaging Reporting and Data System (BI-RADS) lexicon. Prior to DCE-MRI examination, a unilateral breast lesion suspicious of malignancy was detected clinically, on mammography or breast ultrasonography. The predominant features of FCCs presenting as NME in DCE-MRI examination were: unilateral regional or diffuse distribution (in 35 patients or 76.1%), heterogeneous or clumped internal pattern of enhancement (in 36 patients or 78.3%), plateau time-intensity curve (in 25 patients or 54.3%), moderate or fast wash-in (in 31 patients or 67.4%).Nonproliferative lesions were found in 11 patients (24%), proliferative lesions without atypia in 29 patients (63%) and lesions with atypia in six patients (13%), without statistically significant difference of morphokinetic features, except of the association of clustered microcysts with proliferative dysplasia without atypia. FCCs presenting as NME in DCE-MRI examination have several morphokinetic features suspicious of malignancy, therefore requiring biopsy (BI-RADS 4). Nonproliferative lesions, proliferative lesions without atypia and proliferative lesions with atypia predominantly share the same predefined DCE-MRI morphokinetic features.

  11. A comparison of region-based and pixel-based CEUS kinetics parameters in the assessment of arthritis

    Science.gov (United States)

    Grisan, E.; Raffeiner, B.; Coran, A.; Rizzo, G.; Ciprian, L.; Stramare, R.

    2014-03-01

    Inflammatory rheumatic diseases are leading causes of disability and constitute a frequent medical disorder, leading to inability to work, high comorbidity and increased mortality. The gold-standard for diagnosing and differentiating arthritis is based on patient conditions and radiographic findings, as joint erosions or decalcification. However, early signs of arthritis are joint effusion, hypervascularization and synovial hypertrophy. In particular, vascularization has been shown to correlate with arthritis' destructive behavior, more than clinical assessment. Contrast Enhanced Ultrasound (CEUS) examination of the small joints is emerging as a sensitive tool for assessing vascularization and disease activity. The evaluation of perfusion pattern rely on subjective semi-quantitative scales, that are able to capture the macroscopic degree of vascularization, but are unable to detect the subtler differences in kinetics perfusion parameters that might lead to a deeper understanding of disease progression and a better management of patients. Quantitative assessment is mostly performed by means of the Qontrast software package, that requires the user to define a region of interest, whose mean intensity curve is fitted with an exponential function. We show that using a more physiologically motivated perfusion curve, and by estimating the kinetics parameters separately pixel per pixel, the quantitative information gathered is able to differentiate more effectively different perfusion patterns. In particular, we will show that a pixel-based analysis is able to provide significant markers differentiating rheumatoid arthritis from simil-rheumatoid psoriatic arthritis, that have non-significant differences in clinical evaluation (DAS28), serological markers, or region-based parameters.

  12. Image contrast enhancement based on a local standard deviation model

    International Nuclear Information System (INIS)

    Chang, Dah-Chung; Wu, Wen-Rong

    1996-01-01

    The adaptive contrast enhancement (ACE) algorithm is a widely used image enhancement method, which needs a contrast gain to adjust high frequency components of an image. In the literature, the gain is usually inversely proportional to the local standard deviation (LSD) or is a constant. But these cause two problems in practical applications, i.e., noise overenhancement and ringing artifact. In this paper a new gain is developed based on Hunt's Gaussian image model to prevent the two defects. The new gain is a nonlinear function of LSD and has the desired characteristic emphasizing the LSD regions in which details are concentrated. We have applied the new ACE algorithm to chest x-ray images and the simulations show the effectiveness of the proposed algorithm

  13. CT angiography. Abdominal CT using intravenous aortography for contrast enhancement

    Energy Technology Data Exchange (ETDEWEB)

    Nagai, J; Nakauma, Y; Egawa, J; Kawamura, M [Teikyo Univ., Tokyo (Japan). Faculty of Medicine

    1980-04-01

    To obtain imaging effects close to those of abdominal aortography and investigate a technique with little invasion to patients, intravenous aortography was applied to contrast enhancement (CE) in abdominal CT, and its usefulness was discussed. Intravenous aortography could clearly visualize lesions with rich neovascularity such as hepatocellular carcinoma and renal cell carcinoma. Differing from a drip infusion method, this method has complexities in its technique that contrast medium is injected at once, blood circulation time which is represented by the time between the injection and the time when the patients feel bitterness (10 - 12 seconds) must be measured before CE, and scanning begins 2 seconds before the patients feel bitterness. However, the invasion to patients due to this method is slight, and the capacity of this method to visualize neovascularity is superior to CE by a drip infusion method. Therefore, qualitative diagnosis by CT will be improved by using this method together with a drip infusion method.

  14. Magnetic iron oxide for contrast-enhanced MR imaging

    International Nuclear Information System (INIS)

    Fahlvik, A.K.

    1991-05-01

    The main objective of this experimental work has been to study the biological fate and the contrast enhancing potential of a model preparation of magnetic iron oxide (MSM) after intravenous injection to rodents. This was achieved by: Studying in vitro contrast efficacy of various magnetic iron oxide preparations by relaxation analysis. Studying in vivo contrast efficacy of MSM by relaxation analysis and NMR imaging. Studying the biodistribution and bioelimination of MSM in independent experiments using relaxation analysis, radioactivity studies and histological techniques. Studying interactions of MSM with target cells and target organelles using ex vivo techniques. Based on the presented experimental study, the MSM model preparation of magnetic iron oxide seems to fulfill basic requirements of NMR contrast agents: efficient proton relaxation, specific in vivo distribution, and biological tolerance. 177 refs., 5 figs., 2 tabs

  15. Research on Wavelet-Based Algorithm for Image Contrast Enhancement

    Institute of Scientific and Technical Information of China (English)

    Wu Ying-qian; Du Pei-jun; Shi Peng-fei

    2004-01-01

    A novel wavelet-based algorithm for image enhancement is proposed in the paper. On the basis of multiscale analysis, the proposed algorithm solves efficiently the problem of noise over-enhancement, which commonly occurs in the traditional methods for contrast enhancement. The decomposed coefficients at same scales are processed by a nonlinear method, and the coefficients at different scales are enhanced in different degree. During the procedure, the method takes full advantage of the properties of Human visual system so as to achieve better performance. The simulations demonstrate that these characters of the proposed approach enable it to fully enhance the content in images, to efficiently alleviate the enhancement of noise and to achieve much better enhancement effect than the traditional approaches.

  16. Contrast-enhanced breast MRI: factors affecting sensitivity and specificity

    Energy Technology Data Exchange (ETDEWEB)

    Piccoli, C.W. [Department of Radiology, Jefferson Medical College, Thomas Jefferson University Hospital, 132 South 10th Street, 7th floor, Philadelphia, PA 19107-5244 (United States)

    1997-12-31

    Contrast-enhanced MRI (CE-MRI) of the breast has been investigated for over 10 years. The reports of sensitivity for cancer detection have generally been greater than 90 %. However, estimates of specificity have varied greatly. Differing results are due to differences in study populations, technical methods and criteria for interpretation. Early and marked signal rise, detected using dynamic imaging technique following contrast administration, is the MRI hallmark of cancer. However, some malignant lesions may enhance slowly or minimally, and a variety of benign lesions may enhance rapidly with marked signal intensity. High resolution techniques generally requiring longer acquisition times are more likely to depict the slowly enhancing malignancies at the cost of a decrease in specificity due to lack of temporal resolution. This disadvantage may be offset by the improved visualization of lesion morphology with high resolution images. This report reviews the methods and results of the leading investigators of breast MRI. (orig.) With 3 figs., 70 refs.

  17. Contrast-enhanced breast MRI: factors affecting sensitivity and specificity

    International Nuclear Information System (INIS)

    Piccoli, C.W.

    1997-01-01

    Contrast-enhanced MRI (CE-MRI) of the breast has been investigated for over 10 years. The reports of sensitivity for cancer detection have generally been greater than 90 %. However, estimates of specificity have varied greatly. Differing results are due to differences in study populations, technical methods and criteria for interpretation. Early and marked signal rise, detected using dynamic imaging technique following contrast administration, is the MRI hallmark of cancer. However, some malignant lesions may enhance slowly or minimally, and a variety of benign lesions may enhance rapidly with marked signal intensity. High resolution techniques generally requiring longer acquisition times are more likely to depict the slowly enhancing malignancies at the cost of a decrease in specificity due to lack of temporal resolution. This disadvantage may be offset by the improved visualization of lesion morphology with high resolution images. This report reviews the methods and results of the leading investigators of breast MRI. (orig.)

  18. Contrast enhancement of cranial lesions in computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Lewander, R; Bergstroem, M; Bergvall, U [Kungliga Karolinska Mediko-Kirurgiska Inst., Stockholm (Sweden)

    1978-01-01

    The time course of enhancement in apparently normal brain tissue, edema and focal lesions during 30 to 60 min after intravenous injection of vascular contrast medium was evaluated in a series of 41 pateints with differnt intracranial lesions. The attenuation of apparently normal unenhanced brain tissue varied with the level of the scan, mainly an effect of beam hardening. Different types of enhancement response are discussed in terms of a 3-compartment model. The differential diagnostic potential of contrast enhancement in the early phase needs further evaluation using instruments with short scanning time, while the late phase of enhancement must be recorded with the use of a reliable head fixation to provide reproducibility of repeat measurements.

  19. Quantitative contrast-enhanced mammography for contrast medium kinetics studies

    Science.gov (United States)

    Arvanitis, C. D.; Speller, R.

    2009-10-01

    Quantitative contrast-enhanced mammography, based on a dual-energy approach, aims to extract quantitative and temporal information of the tumour enhancement after administration of iodinated vascular contrast media. Simulations using analytical expressions and optimization of critical parameters essential for the development of quantitative contrast-enhanced mammography are presented. The procedure has been experimentally evaluated using a tissue-equivalent phantom and an amorphous silicon active matrix flat panel imager. The x-ray beams were produced by a tungsten target tube and spectrally shaped using readily available materials. Measurement of iodine projected thickness in mg cm-2 has been performed. The effect of beam hardening does not introduce nonlinearities in the measurement of iodine projected thickness for values of thicknesses found in clinical investigations. However, scattered radiation introduces significant deviations from slope equal to unity when compared with the actual iodine projected thickness. Scatter correction before the analysis of the dual-energy images provides accurate iodine projected thickness measurements. At 10% of the exposure used in clinical mammography, signal-to-noise ratios in excess of 5 were achieved for iodine projected thicknesses less than 3 mg cm-2 within a 4 cm thick phantom. For the extraction of temporal information, a limited number of low-dose images were used with the phantom incorporating a flow of iodinated contrast medium. The results suggest that spatial and temporal information of iodinated contrast media can be used to indirectly measure the tumour microvessel density and determine its uptake and washout from breast tumours. The proposed method can significantly improve tumour detection in dense breasts. Its application to perform in situ x-ray biopsy and assessment of the oncolytic effect of anticancer agents is foreseeable.

  20. Adaptive radiotherapy based on contrast enhanced cone beam CT imaging

    International Nuclear Information System (INIS)

    Soevik, Aaste; Skogmo, Hege K.; Roedal, Jan; Lervaag, Christoffer; Eilertsen, Karsten; Malinen, Eirik

    2010-01-01

    Cone beam CT (CBCT) imaging has become an integral part of radiation therapy, with images typically used for offline or online patient setup corrections based on bony anatomy co-registration. Ideally, the co-registration should be based on tumor localization. However, soft tissue contrast in CBCT images may be limited. In the present work, contrast enhanced CBCT (CECBCT) images were used for tumor visualization and treatment adaptation. Material and methods. A spontaneous canine maxillary tumor was subjected to repeated cone beam CT imaging during fractionated radiotherapy (10 fractions in total). At five of the treatment fractions, CECBCT images, employing an iodinated contrast agent, were acquired, as well as pre-contrast CBCT images. The tumor was clearly visible in post-contrast minus pre-contrast subtraction images, and these contrast images were used to delineate gross tumor volumes. IMRT dose plans were subsequently generated. Four different strategies were explored: 1) fully adapted planning based on each CECBCT image series, 2) planning based on images acquired at the first treatment fraction and patient repositioning following bony anatomy co-registration, 3) as for 2), but with patient repositioning based on co-registering contrast images, and 4) a strategy with no patient repositioning or treatment adaptation. The equivalent uniform dose (EUD) and tumor control probability (TCP) calculations to estimate treatment outcome for each strategy. Results. Similar translation vectors were found when bony anatomy and contrast enhancement co-registration were compared. Strategy 1 gave EUDs closest to the prescription dose and the highest TCP. Strategies 2 and 3 gave EUDs and TCPs close to that of strategy 1, with strategy 3 being slightly better than strategy 2. Even greater benefits from strategies 1 and 3 are expected with increasing tumor movement or deformation during treatment. The non-adaptive strategy 4 was clearly inferior to all three adaptive strategies

  1. Dynamic Contrast-Enhanced MRI of Cervical Cancers: Temporal Percentile Screening of Contrast Enhancement Identifies Parameters for Prediction of Chemoradioresistance

    International Nuclear Information System (INIS)

    Andersen, Erlend K.F.; Hole, Knut Håkon; Lund, Kjersti V.; Sundfør, Kolbein; Kristensen, Gunnar B.; Lyng, Heidi; Malinen, Eirik

    2012-01-01

    Purpose: To systematically screen the tumor contrast enhancement of locally advanced cervical cancers to assess the prognostic value of two descriptive parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Methods and Materials: This study included a prospectively collected cohort of 81 patients who underwent DCE-MRI with gadopentetate dimeglumine before chemoradiotherapy. The following descriptive DCE-MRI parameters were extracted voxel by voxel and presented as histograms for each time point in the dynamic series: normalized relative signal increase (nRSI) and normalized area under the curve (nAUC). The first to 100th percentiles of the histograms were included in a log-rank survival test, resulting in p value and relative risk maps of all percentile–time intervals for each DCE-MRI parameter. The maps were used to evaluate the robustness of the individual percentile–time pairs and to construct prognostic parameters. Clinical endpoints were locoregional control and progression-free survival. The study was approved by the institutional ethics committee. Results: The p value maps of nRSI and nAUC showed a large continuous region of percentile–time pairs that were significantly associated with locoregional control (p < 0.05). These parameters had prognostic impact independent of tumor stage, volume, and lymph node status on multivariate analysis. Only a small percentile–time interval of nRSI was associated with progression-free survival. Conclusions: The percentile–time screening identified DCE-MRI parameters that predict long-term locoregional control after chemoradiotherapy of cervical cancer.

  2. Contrast-enhanced fluorodeoxyglucose positron emission tomography/contrast-enhanced computed tomography in mediastinal T-cell lymphoma with superior vena cava syndrome

    International Nuclear Information System (INIS)

    Santhosh, Sampath; Gorla, Arun Kumar Reddy; Bhattacharya, Anish; Varma, Subhash Chander; Mittal, Bhagwant Rai

    2016-01-01

    Positron emission tomography-computed tomography (PET/CT) is a routine investigation for the staging of lymphomas. Contrast-enhanced computed tomography is mandatory whenever parenchymal lesions, especially in the liver and spleen are suspected. We report a rare case of primary mediastinal T-cell lymphoma evaluated with contrast-enhanced PET/CT that showed features of superior vena cava syndrome

  3. Recent advances in contrast-enhanced magnetic resonance angiography

    International Nuclear Information System (INIS)

    Meaney, J.F.M.; Goyen, M.

    2007-01-01

    Magnetic resonance angiography (MRA) provides a means of visualizing vascular structures noninvasively and is increasingly replacing conventional X-ray angiography in routine use. Contrast-enhanced MRA (CE-MRA), in which gadolinium contrast agents are used to shorten the T1 relaxation, offers increased resolution and higher signal-to-noise ratio compared with earlier flow-dependent [time-of-flight (TOF) or phase-contrast (PC)] techniques. Currently available contrast agents differ in their ability to lower T1 values, and hence the choice of contrast agent is an important consideration in the successful use of CE-MRA. Gadofosveset trisodium (Vasovist, Bayer Schering Pharma AG, Berlin, Germany) is the first of a new class of intravascular contrast agents. This agent is extensively (approximately 85%) and reversibly bound to human serum albumin and is retained within the vasculature thus allowing steady-state imaging to be perform-ed. An additional benefit is that gado0fosveset offers higher relaxivity compared with other contrast agents, thus giving a lower blood T1 values which also makes it ideal for first-pass imaging. Clinical trials have consistently shown that gadofosveset enhanced MRA is more sensitive, specific and accurate than time-of-flight MRA, gives fewer uninterpretable scans and affords greater diagnostic confidence. Intravascular contrast agents such as gadofosveset, therefore, offer the potential for improved vascular imaging. (orig.)

  4. Abnormal contrast enhancement after the removal of meningioma

    Energy Technology Data Exchange (ETDEWEB)

    Soutsu, M; Hashimoto, T; Yamaguchi, Y; Sekino, H; Nakamura, N [Jikei Univ., Tokyo (Japan). School of Medicine

    1980-12-01

    Since the introduction of Computerized Tomography (CT) in August, 1976, we have had experience with 20 patients with meningioma. In 10 patients out of the 20, the tumors were removed totally and examined by contrast-enhanced CT pre- and postoperatively. In spite of the total removal of the tumor, however, 5 patients showed an unexpected abnormal enhancement at the operated site after the infusion of a contrast material. These changes were relatively intense, so it was suspected that there were residual tumors. Comparing these 5 cases with the remaining 5 that had no postoperative enhancement, the former cases were shown by operative and angiographical findings to have more adhesion and connecting vessels between tumor and cortex. Since such a postoperative abnormal enhancement is seen along the corticotomy or retracted area after operations for and aneurysm or another lesion, damaged brain tissue was though to be the probable reason for this enhancement. Moreover, the circulatory change caused by cutting the connecting vessels between tumor and cortex was considered to be another reason for the enhancement. This mechanism was also considered to be one reason for the post-meningioma syndrome by El-Banhawy. These postoperative enhancements decreased in density and became obscure within 4 or 8 weeks. Any reappearance of such changes after that period should be examined, carefully to determine whether or not it marks a recurrent tumor.

  5. High-dose contrast-enhanced MRI in multiple sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Koudriavtseva, T. [Department of Neurosciences, University of Rome ``La Sapienza`` Rome (Italy); Pozzilli, C. [Department of Neurosciences, University of Rome ``La Sapienza`` Rome (Italy); Di Biasi, C. [MR Unit, Clinica Medica 1, University of Rome ``La Sapienza``, Rome (Italy); Iannilli, M. [MR Unit, Clinica Medica 1, University of Rome ``La Sapienza``, Rome (Italy); Trasimeni, G. [MR Unit, Clinica Medica 1, University of Rome ``La Sapienza``, Rome (Italy); Gasperini, C. [Department of Neurosciences, University of Rome ``La Sapienza`` Rome (Italy); Argentino, C. [Department of Neurosciences, University of Rome ``La Sapienza`` Rome (Italy); Gualdi, G.F. [MR Unit, Clinica Medica 1, University of Rome ``La Sapienza``, Rome (Italy)

    1996-05-01

    Contrast-enhanced MRI is effective for assessing disease activity in multiple sclerosis (MS) and may provide an outcome measure for testing the efficacy of treatment in clinical trials. To compare the sensitivity of high-dose gadolinium-HP-DO3A with that of a standard dose of gadolinium-DTPA, we studied 16 patients with relapsing-remitting MS in the acute phase of the disease. Each underwent two MRI examinations within at most 48 h. The initial MRI study was with a standard dose of gadolinium-DTPA (0.1 mmol/kg), and the second one an experimental dose of gadolinium-HP-DO3A (0.3 mmol/kg). No adverse effects were attributed to the contrast media. The high-dose study revealed more enhancing lesions than the standard-dose study (56 vs 38). This difference was found to be more relevant for infratentorial and small lesions. Furthermore, with the higher dose, there was a marked qualitative improvement in the visibility and delineation of the lesions. (orig.). With 4 figs., 2 tabs.

  6. Influence of hyperosmotic agent (glycerol) in contrast enhancement

    International Nuclear Information System (INIS)

    Moriyama, Takashi; Suzuki, Shigeharu; Nakaoka, Tsutomu

    1981-01-01

    For getting a better contrast enhancement (CE) of computed tomography (CT) in brain tumors, we tried to increase the extravascular iodine concentration. A vailing ourselves of the period of returning water following intravenously administered glycerol, a drip injection of the contrast medium gave a better CE effect than the usual CE. In two benign gliomas, CE with glycerol was much better than CE without glycerol, and in two malignant gliomas and two metastatic tumors, CE with glycerol was better, but not so much better as with the benign tumors. In general, the CE effect in primary brain tumors showed a decreasing pattern, whereas in metastatic brain tumors the best time was 60 minutes after the injection of the contrast material (increasing and decreasing pattern), suggesting an increase in the extravascular iodine and a severe failure of the blood brain barrier. Two cystic malignant gliomas allowed the intravenously injected contrast medium to enter the cysts. It appears that the contrast medium passes through and/or is secreted from the wall of the cyst. (author)

  7. Comparison between breast MRI and contrast-enhanced spectral mammography.

    Science.gov (United States)

    Łuczyńska, Elżbieta; Heinze-Paluchowska, Sylwia; Hendrick, Edward; Dyczek, Sonia; Ryś, Janusz; Herman, Krzysztof; Blecharz, Paweł; Jakubowicz, Jerzy

    2015-05-12

    The main goal of this study was to compare contrast-enhanced spectral mammography (CESM) and breast magnetic resonance imaging (MRI) with histopathological results and to compare the sensitivity, accuracy, and positive and negative predictive values for both imaging modalities. After ethics approval, CESM and MRI examinations were performed in 102 patients who had suspicious lesions described in conventional mammography. All visible lesions were evaluated independently by 2 experienced radiologists using BI-RADS classifications (scale 1-5). Dimensions of lesions measured with each modality were compared to postoperative histopathology results. There were 102 patients entered into CESM/MRI studies and 118 lesions were identified by the combination of CESM and breast MRI. Histopathology confirmed that 81 of 118 lesions were malignant and 37 were benign. Of the 81 malignant lesions, 72 were invasive cancers and 9 were in situ cancers. Sensitivity was 100% with CESM and 93% with breast MRI. Accuracy was 79% with CESM and 73% with breast MRI. ROC curve areas based on BI-RADS were 0.83 for CESM and 0.84 for breast MRI. Lesion size estimates on CESM and breast MRI were similar, both slightly larger than those from histopathology. Our results indicate that CESM has the potential to be a valuable diagnostic method that enables accurate detection of malignant breast lesions, has high negative predictive value, and a false-positive rate similar to that of breast MRI.

  8. Challenges in contrast-enhanced spectral mammography interpretation: artefacts lexicon.

    Science.gov (United States)

    Yagil, Y; Shalmon, A; Rundstein, A; Servadio, Y; Halshtok, O; Gotlieb, M; Sklair-Levy, M

    2016-05-01

    To review and describe commonly encountered artefacts in contrast-enhanced spectral mammography (CESM). This retrospective study included 200 women who underwent CESM examinations for screening and diagnostic purposes. Analysis was performed on the image data sets of these women, comprising of a total of 774 subtracted images. Images were reviewed with focus on the presence of four artefacts: rim ("breast within breast"), ripple (black and white lines), axillary line, and skin-line enhancement (skin-line highlighting). Statistical cross-correlation and association with acquisition parameters (tube current, tube voltage, compression force, breast thickness, paddle size) was compared using Fisher's exact test and t-test. The rim artefact was highly common (97-99%) in every projection. The ripple artefact was increasingly more common on the oblique projections (80-82%) and found to be associated with higher breast thickness values. The axillary line artefact was detected only on oblique projections (63%) and associated with the use of a small compression paddle. The skin-line enhancement artefact was seen in 19-46% of projections. None of the artefacts interfered with image interpretation. Two main artefacts commonly seen on CESM are rim and ripple artefacts. They do not hamper with image interpretation. It is important to be aware of them and prevent misinterpretation of these artefacts as real breast pathology. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  9. Contrast-enhanced spectral mammography in patients with MRI contraindications.

    Science.gov (United States)

    Richter, Vivien; Hatterman, Valerie; Preibsch, Heike; Bahrs, Sonja D; Hahn, Markus; Nikolaou, Konstantin; Wiesinger, Benjamin

    2017-01-01

    Background Contrast-enhanced spectral mammography (CESM) is a novel breast imaging technique providing comparable diagnostic accuracy to breast magnetic resonance imaging (MRI). Purpose To show that CESM in patients with MRI contraindications is feasible, accurate, and useful as a problem-solving tool, and to highlight its limitations. Material and Methods A total of 118 patients with MRI contraindications were examined by CESM. Histology was obtained in 94 lesions and used as gold standard for diagnostic accuracy calculations. Imaging data were reviewed retrospectively for feasibility, accuracy, and technical problems. The diagnostic yield of CESM as a problem-solving tool and for therapy response evaluation was reviewed separately. Results CESM was more accurate than mammography (MG) for lesion categorization (r = 0.731, P < 0.0001 vs. r = 0.279, P = 0.006) and for lesion size estimation (r = 0.738 vs. r = 0.689, P < 0.0001). Negative predictive value of CESM was significantly higher than of MG (85.71% vs. 30.77%, P < 0.0001). When used for problem-solving, CESM changed patient management in 2/8 (25%) cases. Superposition artifacts and timing problems affected diagnostic utility in 3/118 (2.5%) patients. Conclusion CESM is a feasible and accurate alternative for patients with MRI contraindications, but it is necessary to be aware of the method's technical limitations.

  10. Contrast enhancement in the craniopharyngioma cyst wall caused by irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Eldevik, O.P.; Gabrielsen, T.O.; Altinok, D. [Univ. of Michigan Medical Center, Ann Arbor, MI (United States). Div. of Neuroradiology

    1998-03-01

    Purpose: To report the occurrence, degree, frequency, and duration of contrast enhancement in the craniopharyngioma cyst wall as caused by irradiation. Material and Methods: Eight patients with cystic craniopharyngiomas had comparable CT or MR studies before and after either external irradiation of the cyst (n=5) or {sup 32}P instillation into the cyst (n=3). Results: A minimal to marked increase in cyst-wall enhancement was seen at 66-157 days after {sup 32}P instillation in 3/3 cases and at 112-495 days after external irradiation in 3/5 cases. The increased enhancement was always associated with a variable interim increase in the thickness of the enhanced cyst wall. Conclusion: CT or MR imaging after the irradiation of cystic craniopharyngiomas usually demonstrated an increase in thickness and enhancement in the cyst wall. Such changes may be due to the irradiation alone and do not necessarily represent infection or increased neoplastic activity. The timing is uncertain as to the earliest possible development of such changes and their maximum duration, but they were seen as early as 66 days post-irradiation and as late as 495 days post-irradiation. (orig.).

  11. Contrast enhancement in the craniopharyngioma cyst wall caused by irradiation

    International Nuclear Information System (INIS)

    Eldevik, O.P.; Gabrielsen, T.O.; Altinok, D.

    1998-01-01

    Purpose: To report the occurrence, degree, frequency, and duration of contrast enhancement in the craniopharyngioma cyst wall as caused by irradiation. Material and Methods: Eight patients with cystic craniopharyngiomas had comparable CT or MR studies before and after either external irradiation of the cyst (n=5) or 32 P instillation into the cyst (n=3). Results: A minimal to marked increase in cyst-wall enhancement was seen at 66-157 days after 32 P instillation in 3/3 cases and at 112-495 days after external irradiation in 3/5 cases. The increased enhancement was always associated with a variable interim increase in the thickness of the enhanced cyst wall. Conclusion: CT or MR imaging after the irradiation of cystic craniopharyngiomas usually demonstrated an increase in thickness and enhancement in the cyst wall. Such changes may be due to the irradiation alone and do not necessarily represent infection or increased neoplastic activity. The timing is uncertain as to the earliest possible development of such changes and their maximum duration, but they were seen as early as 66 days post-irradiation and as late as 495 days post-irradiation. (orig.)

  12. Radiochromic film dosimetry of contrast-enhanced radiotherapy (CERT)

    International Nuclear Information System (INIS)

    Morris, Kevin N; Weil, Michael D; Malzbender, Rainer

    2006-01-01

    Contrast-enhanced radiotherapy (CERT) employs elevated concentrations of high-Z contrast media in targets to dramatically increase the absorbed dose of radiation relative to the surrounding tissues. However, it is difficult to measure the dose enhancement with routine clinical instruments because the photoelectrons and Auger electrons produced by the interaction of kilovoltage x-rays with the contrast agent travel extremely short distances. We have developed a technique utilizing unlaminated radiochromic film to measure the maximum dose enhancement factor attainable in solutions of contrast agent with iodine concentrations ranging from 0% to 37% (w/v). The films were also used to simultaneously measure the dose enhancement and beam attenuation through solutions containing 0%, 5% and 10% iodine (w/v). These depth-dose measurements were made in phantoms representing 3 cm targets located 0 and 4.8 cm deep in acrylic. Higher concentrations of contrast yielded greater dose enhancement and target-to-surface dose ratios, but caused more rapid attenuation of the beam as it traversed the target. The dose distribution across the entire target could be improved by employing multiple beams. These results, using concentrations of contrast that are clinically achievable by intratumoural injection, illustrate the potential of CERT for the specific delivery of high doses of radiation to targets at depth

  13. Cumulative phase delay imaging for contrast-enhanced ultrasound tomography

    International Nuclear Information System (INIS)

    Demi, Libertario; Van Sloun, Ruud J G; Wijkstra, Hessel; Mischi, Massimo

    2015-01-01

    Standard dynamic-contrast enhanced ultrasound (DCE-US) imaging detects and estimates ultrasound-contrast-agent (UCA) concentration based on the amplitude of the nonlinear (harmonic) components generated during ultrasound (US) propagation through UCAs. However, harmonic components generation is not specific to UCAs, as it also occurs for US propagating through tissue. Moreover, nonlinear artifacts affect standard DCE-US imaging, causing contrast to tissue ratio reduction, and resulting in possible misclassification of tissue and misinterpretation of UCA concentration. Furthermore, no contrast-specific modality exists for DCE-US tomography; in particular speed-of-sound changes due to UCAs are well within those caused by different tissue types. Recently, a new marker for UCAs has been introduced. A cumulative phase delay (CPD) between the second harmonic and fundamental component is in fact observable for US propagating through UCAs, and is absent in tissue. In this paper, tomographic US images based on CPD are for the first time presented and compared to speed-of-sound US tomography. Results show the applicability of this marker for contrast specific US imaging, with cumulative phase delay imaging (CPDI) showing superior capabilities in detecting and localizing UCA, as compared to speed-of-sound US tomography. Cavities (filled with UCA) which were down to 1 mm in diameter were clearly detectable. Moreover, CPDI is free of the above mentioned nonlinear artifacts. These results open important possibilities to DCE-US tomography, with potential applications to breast imaging for cancer localization. (fast track communication)

  14. High-dose contrast-enhanced MRI in multiple sclerosis

    International Nuclear Information System (INIS)

    Koudriavtseva, T.; Pozzilli, C.; Di Biasi, C.; Iannilli, M.; Trasimeni, G.; Gasperini, C.; Argentino, C.; Gualdi, G.F.

    1996-01-01

    Contrast-enhanced MRI is effective for assessing disease activity in multiple sclerosis (MS) and may provide an outcome measure for testing the efficacy of treatment in clinical trials. To compare the sensitivity of high-dose gadolinium-HP-DO3A with that of a standard dose of gadolinium-DTPA, we studied 16 patients with relapsing-remitting MS in the acute phase of the disease. Each underwent two MRI examinations within at most 48 h. The initial MRI study was with a standard dose of gadolinium-DTPA (0.1 mmol/kg), and the second one an experimental dose of gadolinium-HP-DO3A (0.3 mmol/kg). No adverse effects were attributed to the contrast media. The high-dose study revealed more enhancing lesions than the standard-dose study (56 vs 38). This difference was found to be more relevant for infratentorial and small lesions. Furthermore, with the higher dose, there was a marked qualitative improvement in the visibility and delineation of the lesions. (orig.). With 4 figs., 2 tabs

  15. Image fusion for dynamic contrast enhanced magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Leach Martin O

    2004-10-01

    Full Text Available Abstract Background Multivariate imaging techniques such as dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI have been shown to provide valuable information for medical diagnosis. Even though these techniques provide new information, integrating and evaluating the much wider range of information is a challenging task for the human observer. This task may be assisted with the use of image fusion algorithms. Methods In this paper, image fusion based on Kernel Principal Component Analysis (KPCA is proposed for the first time. It is demonstrated that a priori knowledge about the data domain can be easily incorporated into the parametrisation of the KPCA, leading to task-oriented visualisations of the multivariate data. The results of the fusion process are compared with those of the well-known and established standard linear Principal Component Analysis (PCA by means of temporal sequences of 3D MRI volumes from six patients who took part in a breast cancer screening study. Results The PCA and KPCA algorithms are able to integrate information from a sequence of MRI volumes into informative gray value or colour images. By incorporating a priori knowledge, the fusion process can be automated and optimised in order to visualise suspicious lesions with high contrast to normal tissue. Conclusion Our machine learning based image fusion approach maps the full signal space of a temporal DCE-MRI sequence to a single meaningful visualisation with good tissue/lesion contrast and thus supports the radiologist during manual image evaluation.

  16. Differentiation of focal liver lesions by contrast-enhanced MRI

    International Nuclear Information System (INIS)

    Heintz, P.; Ehrenheim, C.

    1989-01-01

    47 patients with liver tumours (haemangioma, focal nodular hyperplasia, hepatocellular carcinoma) underwent MRI of the liver before and after i.v. injection of 0.2 ml./kg. gadolinium-DTPA in addition to other imaging methods. The demarcation of focal nodular hyperplasia is not influenced by use of the contrast agent as it almost behaves like surrounding normal liver tissue, thus only indirectly facilitating its identification. With regard to liver haemangiomas that show the most intensive uptake of gadolinium-DTPA, the contrast enhanced image does not reach to contrast and sensitivity of a native T 2 -weighted SE image, especially in cases of small haemangiomas. The contrast agent is helpful, however, in the recognition of large cavernous haemangiomas that are partially fibrotic or thrombotic. Emphasis is given to the contrast agent in hepatomas: gadolinium-DTPA presents a pattern of uptake and distribution frequently found in hepatocellular carcinoma providing additional information on the delineation of internal tumour details. (orig.) [de

  17. Quantitative imaging by pixel-based contrast-enhanced ultrasound reveals a linear relationship between synovial vascular perfusion and the recruitment of pathogenic IL-17A-F+IL-23+ CD161+ CD4+ T helper cells in psoriatic arthritis joints.

    Science.gov (United States)

    Fiocco, Ugo; Stramare, Roberto; Martini, Veronica; Coran, Alessandro; Caso, Francesco; Costa, Luisa; Felicetti, Mara; Rizzo, Gaia; Tonietto, Matteo; Scanu, Anna; Oliviero, Francesca; Raffeiner, Bernd; Vezzù, Maristella; Lunardi, Francesca; Scarpa, Raffaele; Sacerdoti, David; Rubaltelli, Leopoldo; Punzi, Leonardo; Doria, Andrea; Grisan, Enrico

    2017-02-01

    To develop quantitative imaging biomarkers of synovial tissue perfusion by pixel-based contrast-enhanced ultrasound (CEUS), we studied the relationship between CEUS synovial vascular perfusion and the frequencies of pathogenic T helper (Th)-17 cells in psoriatic arthritis (PsA) joints. Eight consecutive patients with PsA were enrolled in this study. Gray scale CEUS evaluation was performed on the same joint immediately after joint aspiration, by automatic assessment perfusion data, using a new quantification approach of pixel-based analysis and the gamma-variate model. The set of perfusional parameters considered by the time intensity curve includes the maximum value (peak) of the signal intensity curve, the blood volume index or area under the curve, (BVI, AUC) and the contrast mean transit time (MTT). The direct ex vivo analysis of the frequencies of SF IL17A-F + CD161 + IL23 + CD4 + T cells subsets were quantified by fluorescence-activated cell sorter (FACS). In cross-sectional analyses, when tested for multiple comparison setting, a false discovery rate at 10%, a common pattern of correlations between CEUS Peak, AUC (BVI) and MTT parameters with the IL17A-F + IL23 + - IL17A-F + CD161 + - and IL17A-F + CD161 + IL23 + CD4 + T cells subsets, as well as lack of correlation between both peak and AUC values and both CD4 + T and CD4 + IL23 + T cells, was observed. The pixel-based CEUS assessment is a truly measure synovial inflammation, as a useful tool to develop quantitative imaging biomarker for monitoring target therapeutics in PsA.

  18. Contrast-enhanced fast fluid-attenuated inversion recovery MR imaging in patients with brain tumors

    International Nuclear Information System (INIS)

    Kim, Chan Kyo; Na, Dong Gyu; Ryoo, Wook Jae; Byun Hong Sik; Yoon, Hye Kyung; Kim, Jong hyun

    2000-01-01

    To assess the feasibility of contrast-enhanced fast fluid-attenuated inversion recovery (fast FLAIR) MR imaging in patients with brain tumors. This study involved 31 patients with pathologically proven brain tumors and nine with clinically diagnosed metastases. In all patients, T2-weighted, fast FLAIR, images were visual contrast-enhanced T1-weighted MR images were obtained. Contrast-enhanced fast FLAIR images were visually compared with other MR sequences in terms of tumor conspicuity. In order to distinguish tumor and surrounding edema, contrast-enhanced fast FLAIR images were compared with fast FLAIR and T2-weighted images. The tumor-to- white matter contrast-to-noise ratios (CNRs), as demonstrated by T2-weighted, fast FLAIR, contrast-enhanced fast FLAIR and contrast-enhanced T1-weighted imaging, were quantitatively assessed and compared. For the visual assessment of tumor conspicuity, contrast-enhanced fast FLAIR image imaging superior to fast FLAIR in 60% of cases (24/40), and superior to T2-weighted in 70% (28/40). Contrast-enhanced fast FLAIR imaging was inferior to contrast-enhanced T1-weighted in 58% of cases (23/40). For distinguishing between tumor and surrounding edema, contrast-enhanced fast FLAIR imaging was superior to fast FLAIR or T2-weighted in 22 of 27 tumors with peritumoral edema (81%). Quantitatively, CNR was the highest on contrast-enhanced fast FLAIR image and the lowest on fast FLAIR. For the detection of leptomeningeal metastases, contrast-enhanced fast FLAIR was partially superior to contrast-enhanced T1-weighted imaging in two of three high-grade gliomas. Although contrast-enhanced fast FLAIR imaging should not be seen as a replacement for conventional modalities, it provides additional informaton for assessment of the extent of glial cell tumors and leptomeningeal metastases in patients with brain tumors. (author)

  19. The usefulness of contrast-enhanced sonography in the differential diagnostic of adrenal tumors

    International Nuclear Information System (INIS)

    Slonina, J.; Nienartowicz, E.; Malczewska, J.; Moron, K.; Kumar Agrawal, A.

    2006-01-01

    Introduction: The occurrence of gland tumors causes significant clinical problem. Non hormone-secreting tumors provide the most complicated diagnostic difficulties. The application of contrast-enhanced sonography could improve the vessels visualization and point out characteristic features of benign and malignant changes. The authors believe that this new method make possible the differential adrenal tumor diagnostic process more precise and increase the specificity of ultrasonography in the recognition of benign and malignant tumors. The aim of this study was to define the usefulness of contrasting agent Levovist in differential diagnostics of adrenal tumors and its influence on sensitivity and specificity of ultrasound examination and to establish patients qualification criteria for surgical procedures. Material and methods: Ultrasound examinations were made with the use of digital devise by GE Voluson 740, probe 4.6 MHz with Doppler options and volumetric probe 3D according to the following protocol: 26 patients with recognized adrenal tumor were qualified for the examination. Patients in the first stage of tumor vascularisation had Doppler examination with color (CD) and power Doppler (PD). Three-dimensional ultrasonography was used to improve visualization of vascularisation. In the final phase of the examination the patients were administrated of Levovist in the recommended by the producer dose: 2,5 g in the concentration of 400 mg/l. Results: 26 cases of adrenal gland tumours were subjected to analysis. In standard ultrasonographic examination focal changes in 25 patients were hipoechogenic focuses and in one case the focus was hyperechogenic. Heterogeneity of focuses was observed in 16 cases. In Doppler examination with color (CD) and power Doppler (PD) vascular blood flow was revealed within 12. After using contrasting agent Levovist vascular blood flow was achieved in 4 additional cases, which constituted 61% . Conclusions: 1. 3D ultrasound could be

  20. The forgotten organ: Contrast enhanced sonography of the spleen

    International Nuclear Information System (INIS)

    Goerg, Christian

    2007-01-01

    Objective: Ultrasound contrast agents in conjunction with contrast specific imaging techniques, are increasingly accepted in clinical use for diagnostic imaging in several organs. Contrast enhanced sonography (CES) of second-generation contrast media have shown a spleen-specific uptake of the microbubble contrast agent. The aim of this review is to illustrate indications for the use of CES in patients with suspected (peri-)splenic pathology. Methods: This review based on the experience of transcutaneous CES in 200 patients with (peri-)splenic pathology diagnosed by B-mode sonography at an internal medicine center. CES studies were performed with a contrast-devoted unit (Acuson, Sequoia, Siemens medical solution) that had contrast-specific, continuous-mode software. A low mechanical index was used. A sulfur hexafluoride-based microbubble contrast medium (Sonovue, Bracco SpA, Milan, Italy) was injected. Results: On our experience, there are several clinical conditions which may show an diagnostic advantage of CES in comparison to B-mode US. CES should be performed to investigate: (1) the perisplenic tumor to diagnose or exclude accessory spleen, (2) the small-sized spleen to diagnose functional asplenia/hyposplenia, (3) the inhomogenous spleen of unknown cause to diagnose focal lesions within the spleen, (4) the incidentally found hypoechoic splenic tumor to diagnose high vascular splenic hemangioma, (5) focal lesions suspect for splenic abscess, hematoma, infarction to confirme diagnosis, and (6) patients with abdominal trauma to diagnose or exclude splenic injuriy. Conclusion: CES is of diagnostic value in several clinical circumstances to diagnose accessory spleen, functional asplenia, small-sized splenic involvement, high vascular splenic hemangioma, and vascular splenic pathology like splenic infarction, splenic abscess, and splenic laceration

  1. The forgotten organ: Contrast enhanced sonography of the spleen

    Energy Technology Data Exchange (ETDEWEB)

    Goerg, Christian [Medizinische Universitaetsklinik, Baldingerstrasse, 35043 Marburg/Lahn (Germany)], E-mail: goergc@med.uni-marburg.de

    2007-11-15

    Objective: Ultrasound contrast agents in conjunction with contrast specific imaging techniques, are increasingly accepted in clinical use for diagnostic imaging in several organs. Contrast enhanced sonography (CES) of second-generation contrast media have shown a spleen-specific uptake of the microbubble contrast agent. The aim of this review is to illustrate indications for the use of CES in patients with suspected (peri-)splenic pathology. Methods: This review based on the experience of transcutaneous CES in 200 patients with (peri-)splenic pathology diagnosed by B-mode sonography at an internal medicine center. CES studies were performed with a contrast-devoted unit (Acuson, Sequoia, Siemens medical solution) that had contrast-specific, continuous-mode software. A low mechanical index was used. A sulfur hexafluoride-based microbubble contrast medium (Sonovue, Bracco SpA, Milan, Italy) was injected. Results: On our experience, there are several clinical conditions which may show an diagnostic advantage of CES in comparison to B-mode US. CES should be performed to investigate: (1) the perisplenic tumor to diagnose or exclude accessory spleen, (2) the small-sized spleen to diagnose functional asplenia/hyposplenia, (3) the inhomogenous spleen of unknown cause to diagnose focal lesions within the spleen, (4) the incidentally found hypoechoic splenic tumor to diagnose high vascular splenic hemangioma, (5) focal lesions suspect for splenic abscess, hematoma, infarction to confirme diagnosis, and (6) patients with abdominal trauma to diagnose or exclude splenic injuriy. Conclusion: CES is of diagnostic value in several clinical circumstances to diagnose accessory spleen, functional asplenia, small-sized splenic involvement, high vascular splenic hemangioma, and vascular splenic pathology like splenic infarction, splenic abscess, and splenic laceration.

  2. Polycystic ovary syndrome: dynamic contrast-enhanced ovary MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Erdem, C. Zuhal E-mail: sunarerdem@yahoo.com; Bayar, Ulku; Erdem, L. Oktay; Barut, Aykut; Gundogdu, Sadi; Kaya, Erdal

    2004-07-01

    Objective: to determine the enhancement behaviour of the ovaries in women with polycystic ovary syndrome (PCOS) by dynamic contrast-enhanced magnetic resonance (DCE-MR) imaging and to compare these data with those of normal ovulating controls. Method: 24 women with PCOS and 12 controls underwent DCE-MR imaging. Dynamic images were acquired before and after injection of a contrast bolus at 30 s and the min of 1, 2, 3, 4 and 5. On postprocessing examination: (i) the ovarian volumes; (ii) the signal intensity value of each ovary per dynamic study; (iii) early-phase enhancement rate; (iv) time to peak enhancement (T{sub p}); and (v) percentage of washout of 5th min were determined. Data of the ovaries of the women with PCOS and controls were compared with Mann-Whitney U-test. Results: the mean values of T{sub p} were found to be significantly lower in women with PCOS than in controls (p<0.05). On the other hand, the mean values of ovarian volume, the early-phase enhancement rate, and percentage of washout of 5th min of ovaries were significantly higher in PCOS patients (p<0.05). Examination of the mean signal intensity-time curve revealed the ovaries in women with PCOS showed a faster and greater enhancement and wash-out. Conclusion: the enhancement behaviour of ovaries of women with PCOS may be significantly different from those of control subjects on DCE-MR imaging examination. In our experience, it is a valuable modality to highlight the vascularization changes in ovarian stroma with PCOS. We believe that improved DCE-MR imaging techniques may also provide us additional parameters in the diagnosis and treatment strategies of PCOS.

  3. Usefulness of contrast enhanced cardiac computed tomography in myocardial infarction

    International Nuclear Information System (INIS)

    Morooka, Nobuhiro; Yamada, Zenju; Watanabe, Shigeru

    1982-01-01

    Contrast enhanced cardiac computed tomography (CECT) was performed in 33 patients with transmural myocardial infarction. The anterior wall thickness assessed by CECT was well correlated with that by left ventriculography in RAO projection. When the septal wall thickness was compared between ECG gated and non-gated CECT images, the septal wall thickness by non-gated CECT showed a close coincidence with the diastolic wall thickness by ECG gated CECT. In all patients, the thickness of the septal, anterior and postero-lateral walls was measured. The mean wall thickness in patients of antero-septal infarction was 9.0 +- 1.9 mm for the septal wall, 6.3 +- 1.3 mm for the anterior wall, and 10.0 +- 2.1 mm for the postero-lateral wall. In patients of infero-lateral infarction, the mean wall thickness was 12.2 +- 1.7 mm for the septal wall, 10.8 +- 1.6 mm for the anterior wall and 8.9 +- 1.2 mm for the postero-lateral wall. A filling defect was revealed in the infarcted area when CECT was performed in patients with acute myocardial infarction within 1 week from the onset, and late enhancement was demonstrated by plain CT performed 10 min later. Left ventricular aneurysms were noted in 16 of 23 patients of anteroseptal infarction, and 8 of these 16 had mural thrombi in the left ventricle. Coronary artery calcification was found in 11 of 33 myocardial infarction patients. In patients with aortocoronary bypass graft, the sequential scan (dynamic scan) was shown to be a useful non-invasive method because it showed whether the graft was patent or not. (J.P.N.)

  4. Contrast-enhanced peripheral MRA. Technique and contrast agents

    International Nuclear Information System (INIS)

    Nielsen, Yousef W.; Thomsen, Henrik S.

    2012-01-01

    In the last decade contrast-enhanced magnetic resonance angiography (CE-MRA) has gained wide acceptance as a valuable tool in the diagnostic work-up of patients with peripheral arterial disease. This review presents current concepts in peripheral CE-MRA with emphasis on MRI technique and contrast agents. Peripheral CE-MRA is defined as an MR angiogram of the arteries from the aortic bifurcation to the feet. Advantages of CE-MRA include minimal invasiveness and lack of ionizing radiation. The basic technique employed for peripheral CE-MRA is the bolus-chase method. With this method a paramagnetic MRI contrast agent is injected intravenously and T1-weighted images are acquired in the subsequent arterial first-pass phase. In order to achieve high quality MR angiograms without interfering venous contamination or artifacts, a number of factors need to be taken into account. This includes magnetic field strength of the MRI system, receiver coil configuration, use of parallel imaging, contrast bolus timing technique, and k-space filling strategies. Furthermore, it is possible to optimize peripheral CE-MRA using venous compression techniques, hybrid scan protocols, time-resolved imaging, and steady-state MRA. Gadolinium(Gd)-based contrast agents are used for CE-MRA of the peripheral arteries. Extracellular Gd agents have a pharmacokinetic profile similar to iodinated contrast media. Accordingly, these agents are employed for first-pass MRA. Blood-pool Gd-based agents are characterized by prolonged intravascular stay, due to macromolecular structure or protein binding. These agents can be used for first-pass, as well as steady-state MRA. Some Gd-based contrast agents with low thermodynamic stability have been linked to development of nephrogenic systemic fibrosis in patients with severe renal insufficiency. Using optimized technique and a stable MRI contrast agent, peripheral CE-MRA is a safe procedure with diagnostic accuracy close to that of conventional catheter X

  5. TMJ disorders and pain: Assessment by contrast-enhanced MRI

    International Nuclear Information System (INIS)

    Farina, Davide; Bodin, Christiane; Gandolfi, Silvia; De Gasperi, Werner; Borghesi, Andrea; Maroldi, Roberto

    2009-01-01

    Though magnetic resonance (MRI) is a widely accepted standard for the assessment of patients with temporomandibular joint (TMJ) disorders, efforts to correlate symptoms to MRI findings have often given controversial results. Aim of this study was to investigate the correlation between TMJ pain and findings of contrast-enhanced MRI. Thirty-eight consecutive patients with TMJ dysfunction syndrome (study group) were examined with MRI. Protocol included T2 turbo spin-echo sequence, T1 spin-echo sequence, and T2 gradient-echo (acquired with closed jaw, at intermediate and maximal opening). Post-contrast phase was obtained through a fat sat 3D T1 gradient-echo sequence (VIBE). Post-contrast findings in the study group were matched with those obtained in a control group of 33 patients submitted to MRI of the paranasal sinuses. Statistically significant difference was found between condylar medullary bone enhancement in painful TMJ, in painless TMJ and control group. In addition the average thickness of joint soft tissue enhancement in painful TMJ was superior to painless TMJ (p < 0.0001) and to control group. On multivariate logistic regression analysis, the odds ratio that a painful TMJ showed disk displacement, osteoarthrosis, effusion and JST enhancement were 3.05, 3.18, 1.2 and 11.36, respectively. Though not histologically proven, TMJ enhancement could reflect the presence of inflammation in painful joints. Furthermore, the administration of contrast could be of help for the assessment of patients with orofacial pain, particularly when clinical exploration is insufficient to ascribe the pain to TMJ.

  6. TMJ disorders and pain: Assessment by contrast-enhanced MRI

    Energy Technology Data Exchange (ETDEWEB)

    Farina, Davide [Department of Radiology (School of Medicine), University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia (Italy); Bodin, Christiane [Division of Gnathology (School of Dentistry), University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia (Italy); Gandolfi, Silvia [Department of Radiology (School of Medicine), University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia (Italy); De Gasperi, Werner [Division of Gnathology (School of Dentistry), University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia (Italy); Borghesi, Andrea; Maroldi, Roberto [Department of Radiology (School of Medicine), University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia (Italy)

    2009-04-15

    Though magnetic resonance (MRI) is a widely accepted standard for the assessment of patients with temporomandibular joint (TMJ) disorders, efforts to correlate symptoms to MRI findings have often given controversial results. Aim of this study was to investigate the correlation between TMJ pain and findings of contrast-enhanced MRI. Thirty-eight consecutive patients with TMJ dysfunction syndrome (study group) were examined with MRI. Protocol included T2 turbo spin-echo sequence, T1 spin-echo sequence, and T2 gradient-echo (acquired with closed jaw, at intermediate and maximal opening). Post-contrast phase was obtained through a fat sat 3D T1 gradient-echo sequence (VIBE). Post-contrast findings in the study group were matched with those obtained in a control group of 33 patients submitted to MRI of the paranasal sinuses. Statistically significant difference was found between condylar medullary bone enhancement in painful TMJ, in painless TMJ and control group. In addition the average thickness of joint soft tissue enhancement in painful TMJ was superior to painless TMJ (p < 0.0001) and to control group. On multivariate logistic regression analysis, the odds ratio that a painful TMJ showed disk displacement, osteoarthrosis, effusion and JST enhancement were 3.05, 3.18, 1.2 and 11.36, respectively. Though not histologically proven, TMJ enhancement could reflect the presence of inflammation in painful joints. Furthermore, the administration of contrast could be of help for the assessment of patients with orofacial pain, particularly when clinical exploration is insufficient to ascribe the pain to TMJ.

  7. Dynamic contrast-enhanced MRI evaluation of cerebral cavernous malformations.

    Science.gov (United States)

    Hart, Blaine L; Taheri, Saeid; Rosenberg, Gary A; Morrison, Leslie A

    2013-10-01

    The aim of this study is to quantitatively evaluate the behavior of CNS cavernous malformations (CCMs) using a dynamic contrast-enhanced MRI (DCEMRI) technique sensitive for slow transfer rates of gadolinium. The prospective study was approved by the institutional review board and was HIPPA compliant. Written informed consent was obtained from 14 subjects with familial CCMs (4 men and 10 women, ages 22-76 years, mean 48.1 years). Following routine anatomic MRI of the brain, DCEMRI was performed for six slices, using T1 mapping with partial inversion recovery (TAPIR) to calculate T1 values, following administration of 0.025 mmol/kg gadolinium DTPA. The transfer rate (Ki) was calculated using the Patlak model, and Ki within CCMs was compared to normal-appearing white matter as well as to 17 normal control subjects previously studied. All subjects had typical MRI appearance of CCMs. Thirty-nine CCMs were studied using DCEMRI. Ki was low or normal in 12 lesions and elevated from 1.4 to 12 times higher than background in the remaining 27 lesions. Ki ranged from 2.1E-6 to 9.63E-4 min(-1), mean 3.55E-4. Normal-appearing white matter in the CCM patients had a mean Ki of 1.57E-4, not statistically different from mean WM Ki of 1.47E-4 in controls. TAPIR-based DCEMRI technique permits quantifiable assessment of CCMs in vivo and reveals considerable differences not seen with conventional MRI. Potential applications include correlation with biologic behavior such as lesion growth or hemorrage, and measurement of drug effects.

  8. Polycystic ovary syndrome: dynamic contrast-enhanced ovary MR imaging

    International Nuclear Information System (INIS)

    Erdem, C. Zuhal; Bayar, Ulku; Erdem, L. Oktay; Barut, Aykut; Gundogdu, Sadi; Kaya, Erdal

    2004-01-01

    Objective: to determine the enhancement behaviour of the ovaries in women with polycystic ovary syndrome (PCOS) by dynamic contrast-enhanced magnetic resonance (DCE-MR) imaging and to compare these data with those of normal ovulating controls. Method: 24 women with PCOS and 12 controls underwent DCE-MR imaging. Dynamic images were acquired before and after injection of a contrast bolus at 30 s and the min of 1, 2, 3, 4 and 5. On postprocessing examination: (i) the ovarian volumes; (ii) the signal intensity value of each ovary per dynamic study; (iii) early-phase enhancement rate; (iv) time to peak enhancement (T p ); and (v) percentage of washout of 5th min were determined. Data of the ovaries of the women with PCOS and controls were compared with Mann-Whitney U-test. Results: the mean values of T p were found to be significantly lower in women with PCOS than in controls (p<0.05). On the other hand, the mean values of ovarian volume, the early-phase enhancement rate, and percentage of washout of 5th min of ovaries were significantly higher in PCOS patients (p<0.05). Examination of the mean signal intensity-time curve revealed the ovaries in women with PCOS showed a faster and greater enhancement and wash-out. Conclusion: the enhancement behaviour of ovaries of women with PCOS may be significantly different from those of control subjects on DCE-MR imaging examination. In our experience, it is a valuable modality to highlight the vascularization changes in ovarian stroma with PCOS. We believe that improved DCE-MR imaging techniques may also provide us additional parameters in the diagnosis and treatment strategies of PCOS

  9. Patterns of contrast enhancement in the brain and meninges.

    Science.gov (United States)

    Smirniotopoulos, James G; Murphy, Frances M; Rushing, Elizabeth J; Rees, John H; Schroeder, Jason W

    2007-01-01

    Contrast material enhancement for cross-sectional imaging has been used since the mid 1970s for computed tomography and the mid 1980s for magnetic resonance imaging. Knowledge of the patterns and mechanisms of contrast enhancement facilitate radiologic differential diagnosis. Brain and spinal cord enhancement is related to both intravascular and extravascular contrast material. Extraaxial enhancing lesions include primary neoplasms (meningioma), granulomatous disease (sarcoid), and metastases (which often manifest as mass lesions). Linear pachymeningeal (dura-arachnoid) enhancement occurs after surgery and with spontaneous intracranial hypotension. Leptomeningeal (pia-arachnoid) enhancement is present in meningitis and meningoencephalitis. Superficial gyral enhancement is seen after reperfusion in cerebral ischemia, during the healing phase of cerebral infarction, and with encephalitis. Nodular subcortical lesions are typical for hematogenous dissemination and may be neoplastic (metastases) or infectious (septic emboli). Deeper lesions may form rings or affect the ventricular margins. Ring enhancement that is smooth and thin is typical of an organizing abscess, whereas thick irregular rings suggest a necrotic neoplasm. Some low-grade neoplasms are "fluid-secreting," and they may form heterogeneously enhancing lesions with an incomplete ring sign as well as the classic "cyst-with-nodule" morphology. Demyelinating lesions, including both classic multiple sclerosis and tumefactive demyelination, may also create an open ring or incomplete ring sign. Thick and irregular periventricular enhancement is typical for primary central nervous system lymphoma. Thin enhancement of the ventricular margin occurs with infectious ependymitis. Understanding the classic patterns of lesion enhancement--and the radiologic-pathologic mechanisms that produce them--can improve image assessment and differential diagnosis.

  10. Diagnosing upper extremity deep vein thrombosis with non-contrast-enhanced Magnetic Resonance Direct Thrombus Imaging: A pilot study.

    Science.gov (United States)

    Dronkers, C E A; Klok, F A; van Haren, G R; Gleditsch, J; Westerlund, E; Huisman, M V; Kroft, L J M

    2018-03-01

    Diagnosing upper extremity deep vein thrombosis (UEDVT) can be challenging. Compression ultrasonography is often inconclusive because of overlying anatomic structures that hamper compressing veins. Contrast venography is invasive and has a risk of contrast allergy. Magnetic Resonance Direct Thrombus Imaging (MRDTI) and Three Dimensional Turbo Spin-echo Spectral Attenuated Inversion Recovery (3D TSE-SPAIR) are both non-contrast-enhanced Magnetic Resonance Imaging (MRI) sequences that can visualize a thrombus directly by the visualization of methemoglobin, which is formed in a fresh blood clot. MRDTI has been proven to be accurate in diagnosing deep venous thrombosis (DVT) of the leg. The primary aim of this pilot study was to test the feasibility of diagnosing UEDVT with these MRI techniques. MRDTI and 3D TSE-SPAIR were performed in 3 pilot patients who were already diagnosed with UEDVT by ultrasonography or contrast venography. In all patients, UEDVT diagnosis could be confirmed by MRDTI and 3D TSE-SPAIR in all vein segments. In conclusion, this study showed that non-contrast MRDTI and 3D TSE-SPAIR sequences may be feasible tests to diagnose UEDVT. However diagnostic accuracy and management studies have to be performed before these techniques can be routinely used in clinical practice. Copyright © 2018 Elsevier Ltd. All rights reserved.

  11. Transabdominal Ultrasonography of the Small Bowel

    Directory of Open Access Journals (Sweden)

    Rudolf Kralik

    2013-01-01

    Full Text Available In the era of double balloon enteroscopy, capsule endoscopy, CT, and MRI enterography is transabdominal ultrasonography (TUS underestimated method for evaluation of small bowel pathology. As often initial imagine method in abdominal complaints, nowadays has TUS much better diagnostic potential than two decades ago. High-resolution ultrasound probes with harmonic imaging significantly improve resolution of bowel wall in real time, with possibility to asses bowel peristalsis. Color flow doppler enables evaluation of intramural bowel vascularisation, pulse wave doppler helps to quantificate flow in coeliac and superior mesenteric arteries. Small intestine contrast ultrasonography with oral contrast fluid, as well as contrast enhanced ultrasonography with intravenous microbubble contrast also improves small bowel imaging. We present a review of small intestine pathology that should be detected during ultrasound examinations, discuss technical requirements, advantages and limitations of TUS, typical ultrasound signs of Crohn's disease, ileus, celiac disease, intussusception, infectious enteritis, tumours, ischemic and haemorrhagic conditions of small bowel. In the hands of experienced investigator, despite some significant limitations(obesity, meteorism, is transabdominal ultrasonography reliable, noninvasive and inexpensive alternative method to computerised tomography (CT and magnetic resonance imaging (MRI in small bowel examination.

  12. Contrast-enhanced dedicated breast CT detection of invasive breast cancer preceding mammographic diagnosis

    Directory of Open Access Journals (Sweden)

    Nicolas D. Prionas, MD, PhD

    2015-01-01

    Full Text Available Dedicated breast computed tomography (bCT generates high-resolution, three-dimensional images of the pendent uncompressed breast. Intravenous iodinated contrast during bCT provides additional physiologic information. In this case, a 10.0-mm invasive ductal carcinoma was visualized using contrast-enhanced breast CT one year before mammographic detection. Mammography four months before bCT was negative. The bCT contrast enhancement pattern closely matched the dynamic contrast-enhanced MRI obtained after diagnosis. Lesion enhancement at contrast-enhanced breast CT matched previously published enhancement values of breast cancer. Contrast-enhanced dedicated bCT provided high-resolution tomographic images and physiologic contrast enhancement data that facilitated the detection of an early breast cancer.

  13. Intravenous contrast-enhanced sonography in children and adolescents – a single center experience

    Directory of Open Access Journals (Sweden)

    Martin Stenzel

    2013-06-01

    Full Text Available Compared to adult patients, ultrasonography in children and adolescents is much more common, due to lack of ionizing radiation, and its wide availability. With the introduction of contrast-media for use in ultrasonography, one major drawback of the method could be overcome. In Europe, SonoVue® is the only widely available agent, which due to improved stability makes it possible to image normal and diseased tissue perfusion and vascularization with high accuracy. Inability to hold the breath and voluntary body movement of the patient is less of an obstacle compared to color Doppler techniques and makes the method very attractive for use in children, which, depending on age, may not be very cooperative. Use of intravenous contrast-medium in minors is currently very limited for several reasons: availability, lack of recommendation in national and international guidelines, and lack of official licensing. The article will touch medical indications, technique, safety considerations, and perspective of intravenous use of contrast-media in children and adolescents, including data from a 6-year period in 37 patients. Purpose: The purpose of the study was to collect data on ultrasonographic examinations, expanded by intravenous administration of the contrast agent SonoVue® in children and adolescents. Besides assessing diagnostic yield, data on adverse medication effects was collected. Materials and methods: The study includes contrast-enhanced ultrasound examinations in 37 children at a single institution. Indications for the examinations were tumor lesions, infections, traumatic organ injuries, and parenchymal organ ischemia. Parents of the patients and adolescent patients were informed about the off-label use of the contrast agent. Thirty-nine examinations were performed, the average age of the patient was 11.1 years (range 1 7/ 12 to 17 11/ 12 years. Results: All of the examinations yielded additional diagnostic value, always expanding results

  14. Cryotherapy for renal-cell cancer: diagnosis, treatment, and contrast-enhanced ultrasonography for follow-up

    NARCIS (Netherlands)

    Wink, M. H.; Lagerveld, B. W.; Laguna, M. P.; de la Rosette, J. J. M. C. H.; Wijkstra, H.

    2006-01-01

    Cryotherapy is a curative treatment option for patients with small ( <4 cm) renal-cell cancers. For the followup of ablated lesions, imaging is the only available method, but the best tool has not yet been determined. The method selected should be able to determine the presence or absence of

  15. Contrast-enhanced ultrasound and computed tomography findings of recurrent ovarian steroid cell tumor presenting with peritoneal seeding: A case report

    International Nuclear Information System (INIS)

    Im, A Lan; Lee, Young Hwan; Kim, Hye Won; Lee, Han Ah; Choi, Keum Ha

    2013-01-01

    We present ultrasonography and computed tomography (CT) findings of a case of recurrent ovarian steroid cell tumor presenting with peritoneal seeding in a 45-year-old woman. On abdominal ultrasonography, there were multiple hypoechoic round masses in the peritoneal cavity including the perihepatic area. Contrast-enhanced ultrasonography showed intense homogenous enhancement on the arterial phase and delayed prolonged enhancement of the masses. CT revealed multiple peritoneal solid masses with strong enhancement. Five years ago, the patient had been diagnosed with a steroid cell tumor of the left ovary. At that time, the CT showed a well-enhancing, lobulating, large solid mass at the left adnexa. Imaging findings of the peritoneal masses suggested peritoneal seeding from the preexisting ovarian steroid cell tumor. For treatment of the metastatic lesions in the perihepatic area, ultrasonography-guided radiofrequency ablation (RFA) was performed, and debulking surgery for the peritoneal masses was done. Six months later, complete ablation of the perihepatic metastases by RFA and a marked decrease in the peritoneal metastases by surgery were found on the follow-up CT.

  16. Contrast-enhanced flair imaging in the evaluation of infectious leptomeningeal diseases

    International Nuclear Information System (INIS)

    Parmar, Hemant; Sitoh, Y.-Y.; Anand, Pooja; Chua, Violet; Hui, Francis

    2006-01-01

    Purpose: The purpose of our study was to compare contrast-enhanced fluid-attenuated inversion recovery (FLAIR) images with contrast-enhanced T1 weighted images for infectious leptomeningitis. Materials and methods: We studied twenty-four patients with a clinical suspicion of infectious meningitis with unenhanced FLAIR, contrast-enhanced T1 weighted and contrast-enhanced FLAIR MR sequences. Twelve patients had cytologic and biochemical diagnosis of meningitis on cerebrospinal fluid (CSF) examination obtained 48 h before or after the MR study. Sequences were considered positive if abnormal signal was seen in the subarachnoid space (cistern or sulci) or along pial surface. Results: Twenty-seven examinations in 24 patients were performed. Of the 12 patients (thirteen studies) in whom cytology was positive, unenhanced FLAIR images were positive in six cases (sensitivity 46%), contrast-enhanced FLAIR images were positive in 11 (sensitivity 85%), and contrast-enhanced T1 weighted MR images were positive in 11 patients (sensitivity 85%). Of the 12 patients (14 studies) in whom cerebrospinal fluid study was negative, unenhanced FLAIR images were negative in 13, contrast-enhanced FLAIR images were negative in 11, and contrast-enhanced T1 weighted MR images were negative in eight. Thus, the specificity of unenhanced FLAIR, contrast-enhanced FLAIR and contrast-enhanced T1 weighted images was 93, 79 and 57%, respectively. Conclusion: Our results suggest that post-contrast FLAIR images have similar sensitivity but a higher specificity compared to contrast-enhanced T1 weighted images for detection of leptomeningeal enhancement. It can be a useful adjunct to post-contrast T1 weighted images in evaluation of infectious leptomeningitis

  17. Diagnositc value of 3D-gradient echo dynamic contrast enhanced MRI in breast cancer

    International Nuclear Information System (INIS)

    Yang, Ik; Chung, Soo Young; Park, Hai Jung; Lee, Yul; Chung, Bong Wha; Shim, Jeong Won

    1997-01-01

    To assess the usefulness of 3D-gradient echo dynamic contrast enhanced MRI (3D-DMRI) in the diagnosis of breast cancer and to determine the most useful parameter for this diagnosis. Using a 1.0T MR unit, (Magnetom, Siemens, Erlaugen, Germany), 3D-DMRI (TR/TE=3D30/12) with Gd-DTPA was performed in 38 cases of breast cancer, 22 of fibroadenoma, and in three normal volunteers. We retrospectively evaluated the findings according to the speed on dynamic study and maximal amount of contrast enhancement during the delayed phase;we calculated the contrast index and morphology of the cancers and compared diagnostic accuracy among these three diagnostic parameters. On conventional spin-echo T1-and T2-weighted images, there was no significant difference of signal intensity between benign fibroadenoma and breast carcinoma. Rapid contrast enhancement (within one minute) was noted in 35 breast cancer lesions (92.1%), but relatively low and slow contrast enhancement (after five minutes) was noted in three such lesions (7.9%). Gradual contrast enhancement was noted in 21 lesions of fibroadenoma(95.5%), but a moderate degree of rapid contrast enhancement (from three to five minutes) was noted in the other case (7.9%). of On the delayed enhanced phase of 3D-DMRI, the maximal amount of contrast enhancement showed no significant difference between fibroadenoma and cancer. On 3D-DMRI, an irregular, spiculated border, with high contrast enhancement was noted in all cases of breast cancer, in particular, irregular thick peripheral contrast enhancement with central necrosis was noted 11cases(28.9%). For the diagnosis of breast cancer, 3D-DMRI is a useful technique. Among the diagnostic criteria of speed, maximal amount of contrast enhancement and morphology, morphologic change after contrast enhancement study was the most useful diagnostic parameter.=20

  18. Diagnositc value of 3D-gradient echo dynamic contrast enhanced MRI in breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Ik; Chung, Soo Young; Park, Hai Jung; Lee, Yul; Chung, Bong Wha; Shim, Jeong Won [Hallym Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-10-01

    To assess the usefulness of 3D-gradient echo dynamic contrast enhanced MRI (3D-DMRI) in the diagnosis of breast cancer and to determine the most useful parameter for this diagnosis. Using a 1.0T MR unit, (Magnetom, Siemens, Erlaugen, Germany), 3D-DMRI (TR/TE=3D30/12) with Gd-DTPA was performed in 38 cases of breast cancer, 22 of fibroadenoma, and in three normal volunteers. We retrospectively evaluated the findings according to the speed on dynamic study and maximal amount of contrast enhancement during the delayed phase;we calculated the contrast index and morphology of the cancers and compared diagnostic accuracy among these three diagnostic parameters. On conventional spin-echo T1-and T2-weighted images, there was no significant difference of signal intensity between benign fibroadenoma and breast carcinoma. Rapid contrast enhancement (within one minute) was noted in 35 breast cancer lesions (92.1%), but relatively low and slow contrast enhancement (after five minutes) was noted in three such lesions (7.9%). Gradual contrast enhancement was noted in 21 lesions of fibroadenoma(95.5%), but a moderate degree of rapid contrast enhancement (from three to five minutes) was noted in the other case (7.9%). of On the delayed enhanced phase of 3D-DMRI, the maximal amount of contrast enhancement showed no significant difference between fibroadenoma and cancer. On 3D-DMRI, an irregular, spiculated border, with high contrast enhancement was noted in all cases of breast cancer, in particular, irregular thick peripheral contrast enhancement with central necrosis was noted 11cases(28.9%). For the diagnosis of breast cancer, 3D-DMRI is a useful technique. Among the diagnostic criteria of speed, maximal amount of contrast enhancement and morphology, morphologic change after contrast enhancement study was the most useful diagnostic parameter.=20.

  19. Contrast-enhanced flair imaging in the evaluation of infectious leptomeningeal diseases

    Energy Technology Data Exchange (ETDEWEB)

    Parmar, Hemant [Department of Neuroradiology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433 (Singapore) and Department of Diagnostic Imaging, Hospital for Sick Children, Toronto (Canada)]. E-mail: parurad@hotmail.com; Sitoh, Y.-Y. [Department of Neuroradiology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433 (Singapore); Anand, Pooja [Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng (Singapore); Chua, Violet [Department of Neuroradiology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433 (Singapore); Hui, Francis [Department of Neuroradiology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433 (Singapore)

    2006-04-15

    Purpose: The purpose of our study was to compare contrast-enhanced fluid-attenuated inversion recovery (FLAIR) images with contrast-enhanced T1 weighted images for infectious leptomeningitis. Materials and methods: We studied twenty-four patients with a clinical suspicion of infectious meningitis with unenhanced FLAIR, contrast-enhanced T1 weighted and contrast-enhanced FLAIR MR sequences. Twelve patients had cytologic and biochemical diagnosis of meningitis on cerebrospinal fluid (CSF) examination obtained 48 h before or after the MR study. Sequences were considered positive if abnormal signal was seen in the subarachnoid space (cistern or sulci) or along pial surface. Results: Twenty-seven examinations in 24 patients were performed. Of the 12 patients (thirteen studies) in whom cytology was positive, unenhanced FLAIR images were positive in six cases (sensitivity 46%), contrast-enhanced FLAIR images were positive in 11 (sensitivity 85%), and contrast-enhanced T1 weighted MR images were positive in 11 patients (sensitivity 85%). Of the 12 patients (14 studies) in whom cerebrospinal fluid study was negative, unenhanced FLAIR images were negative in 13, contrast-enhanced FLAIR images were negative in 11, and contrast-enhanced T1 weighted MR images were negative in eight. Thus, the specificity of unenhanced FLAIR, contrast-enhanced FLAIR and contrast-enhanced T1 weighted images was 93, 79 and 57%, respectively. Conclusion: Our results suggest that post-contrast FLAIR images have similar sensitivity but a higher specificity compared to contrast-enhanced T1 weighted images for detection of leptomeningeal enhancement. It can be a useful adjunct to post-contrast T1 weighted images in evaluation of infectious leptomeningitis.

  20. Detection of the Single-Session Complete Ablation Rate by Contrast-Enhanced Ultrasound during Ultrasound-Guided Laser Ablation for Benign Thyroid Nodules: A Prospective Study

    Directory of Open Access Journals (Sweden)

    Shuhua Ma

    2016-01-01

    Full Text Available This study aimed to investigate the single-session complete ablation rate of ultrasound-guided percutaneous laser ablation (LA for benign thyroid nodules. LA was performed in 90 patients with 118 benign thyroid nodules. Contrast-enhanced ultrasound (CEUS was used to evaluate complete nodule ablation one day after ablation. Thyroid nodule volumes, thyroid functions, clinical symptoms and complications were evaluated 1, 3, 6, 12, and 18 months after ablation. Results showed that all benign thyroid nodules successfully underwent LA. The single-session complete ablation rates for nodules with maximum diameters ≤2 cm, 2-3 cm and ≥3 cm were 93.4%, 70.3% and 61.1%, respectively. All nodule volumes significantly decreased than that one day after ablation (P0.05. Three patients had obvious pain during ablation; one (1.1% had recurrent laryngeal nerve injury, but the voice returned to normal within 6 months after treatment. Thus, ultrasound-guided LA can effectively inactivate benign thyroid nodules. LA is a potentially viable minimally invasive treatment that offers good cosmetic effects.

  1. An improved contrast enhancement algorithm for infrared images based on adaptive double plateaus histogram equalization

    Science.gov (United States)

    Li, Shuo; Jin, Weiqi; Li, Li; Li, Yiyang

    2018-05-01

    Infrared thermal images can reflect the thermal-radiation distribution of a particular scene. However, the contrast of the infrared images is usually low. Hence, it is generally necessary to enhance the contrast of infrared images in advance to facilitate subsequent recognition and analysis. Based on the adaptive double plateaus histogram equalization, this paper presents an improved contrast enhancement algorithm for infrared thermal images. In the proposed algorithm, the normalized coefficient of variation of the histogram, which characterizes the level of contrast enhancement, is introduced as feedback information to adjust the upper and lower plateau thresholds. The experiments on actual infrared images show that compared to the three typical contrast-enhancement algorithms, the proposed algorithm has better scene adaptability and yields better contrast-enhancement results for infrared images with more dark areas or a higher dynamic range. Hence, it has high application value in contrast enhancement, dynamic range compression, and digital detail enhancement for infrared thermal images.

  2. FDG-PET/contrast-enhanced CT as a post-treatment tool in head and neck squamous cell carcinoma: comparison with FDG-PET/non-contrast-enhanced CT and contrast-enhanced CT

    Energy Technology Data Exchange (ETDEWEB)

    Suenaga, Yuko; Kitajima, Kazuhiro; Sugimura, Kazuro [Kobe University Graduate School of Medicine, Department of Radiology, Kobe (Japan); Ishihara, Takeaki; Sasaki, Ryohei [Kobe University Graduate, School of Medicine, Department of Radiology, Division of Radiation Oncology, Kobe (Japan); Otsuki, Naoki; Nibu, Ken-ichi [Kobe University Graduate, School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Kobe (Japan); Minamikawa, Tsutomu [Kobe University Graduate School of Medicine, Department of Oral and Maxillofacial Surgery, Kobe (Japan); Kiyota, Naomi [Kobe University Hospital, Department of Medical Oncology and Hematology, Kobe (Japan)

    2016-04-15

    To evaluate the accuracy of PET/CT using {sup 18}F-fluorodeoxyglucose (FDG) with IV contrast for suspected recurrent head and neck squamous cell carcinoma (HNSCC). One hundred and seventy patients previously treated for HNSCC underwent PET/CT, consisting of non-contrast-enhanced and contrast-enhanced CT, to investigate suspected recurrence. Diagnostic performance of PET/contrast-enhanced CT (PET/ceCT), PET/non-contrast-enhanced CT (PET/ncCT) and contrast-enhanced CT (ceCT) for local or regional recurrence, distant metastasis, overall recurrence and second primary cancer was evaluated. The reference standard included histopathology, treatment change and imaging follow-up. The patient-based areas under the receiver operating characteristic curves (AUC) for ceCT, PET/ncCT and PET/ceCT were 0.82, 0.96 and 0.98 for local recurrence, 0.73, 0.86 and 0.86 for regional recurrence, 0.86, 0.91 and 0.92 for distant metastasis, 0.72, 0.86 and 0.87 for overall recurrence, and 0.86, 0.89 and 0.91 for a second primary cancer. Both PET/ceCT and PET/ncCT statistically showed larger AUC than ceCT for recurrence, and the difference between PET/ceCT and PET/ncCT for local recurrence reached a significant level (p = 0.039). The accuracy of PET/ceCT for diagnosing overall recurrence was high, irrespective of the time interval after the last treatment (83.3-94.1 %). FDG-PET/CT was a more accurate HNSCC restaging tool than ceCT. The added value of ceCT at FDG-PET/CT is minimal. (orig.)

  3. Fibroadenomas of the breast: histopathological/dynamic contrast-enhanced MR correlation

    Energy Technology Data Exchange (ETDEWEB)

    Gilles, R. [Dept. of Radiology, Inst. Gustave Roussy, 94 - Villejuif (France)]|[CIERM, Hopital Bicetre, 94 - Le Kremin-Bicetre (France); Garnier, C. [Dept. of Radiology, Inst. Gustave Roussy, 94 - Villejuif (France)]|[CIERM, Hopital Bicetre, 94 - Le Kremin-Bicetre (France); Meingan, P. [Dept. of Radiology, Inst. Gustave Roussy, 94 - Villejuif (France)]|[CIERM, Hopital Bicetre, 94 - Le Kremin-Bicetre (France); Zemoura, L. [Dept. of Histopathology C, Inst. Gustave Roussy, 94 - Villejuif (France); Lucidarme, O. [Dept. of Radiology, Hopital Salpetriere, 75 - Paris (France); Guinebretiere, J.M. [Dept. of Histopathology C, Inst. Gustave Roussy, 94 - Villejuif (France); Tardivon, A.A. [Dept. of Radiology, Inst. Gustave Roussy, 94 - Villejuif (France)]|[CIERM, Hopital Bicetre, 94 - Le Kremin-Bicetre (France); Arriagada, R. [Breast Cancer Study Group, Inst. Gustave Roussy, 94 - Villejuif, (France)

    1995-12-31

    A total of 22 women with fibroadenomas had preoperative dynamic MR study (T1-weighted images every 47 s after injection of Gd-DOTA). Their age, hormonal status, breast MR studies and histopathological slides were retrospectively reviewed. Eleven pre- (n = 2) or post-menopausal (n = 9) women showed no early contrast enhancement. The absence of early contrast enhancement correlated with hyalin stromal component. Eleven pre- (n = 7) or post-menopausal (n = 4) women showed focal (n = 9) or diffuse (n = 2) early contrast enhancement. Early focal contrast enhancement correlated with myxoid (n = 9), mixed hyalin/myxoid (n = 1) or hyalin (n = 1) fibroadenomas. Early diffuse contrast enhancement of the breast correlated with myxoid (n = 1) or hyalin (n = 1) stromal component associated with proliferative fibrocystic disease of the breast parenchyma. The presence of contrast enhancement correlated with myxoid fibroadenomas, whereas absence of contrast enhancement correlated with hyalin fibroadenomas. As hyalin fibroadenomas occurs in post-menopausal women, the diagnostic accuracy of dynamic MRI may be improved in this age group. (orig.)

  4. Fibroadenomas of the breast: histopathological/dynamic contrast-enhanced MR correlation

    International Nuclear Information System (INIS)

    Gilles, R.; Garnier, C.; Meingan, P.; Zemoura, L.; Lucidarme, O.; Guinebretiere, J.M.; Tardivon, A.A.; Arriagada, R.

    1995-01-01

    A total of 22 women with fibroadenomas had preoperative dynamic MR study (T1-weighted images every 47 s after injection of Gd-DOTA). Their age, hormonal status, breast MR studies and histopathological slides were retrospectively reviewed. Eleven pre- (n = 2) or post-menopausal (n = 9) women showed no early contrast enhancement. The absence of early contrast enhancement correlated with hyalin stromal component. Eleven pre- (n = 7) or post-menopausal (n = 4) women showed focal (n = 9) or diffuse (n = 2) early contrast enhancement. Early focal contrast enhancement correlated with myxoid (n = 9), mixed hyalin/myxoid (n 1) or hyalin (n = 1) fibroadenomas. Early diffuse contrast enhancement of the breast correlated with myxoid (n = 1) or hyalin (n = 1) stromal component associated with proliferative fibrocystic disease of the breast parenchyma. The presence of contrast enhancement correlated with myxoid fibroadenomas, whereas absence of contrast enhancement correlated with hyalin fibroadenomas. As hyalin fibroadenomas occurs in post-menopausal women, the diagnostic accuracy of dynamic MRI may be improved in this age group. (orig.)

  5. Ring-enhancement pattern on contrast-enhanced CT predicts adenosquamous carcinoma of the pancreas: a matched case-control study.

    Science.gov (United States)

    Imaoka, Hiroshi; Shimizu, Yasuhiro; Mizuno, Nobumasa; Hara, Kazuo; Hijioka, Susumu; Tajika, Masahiro; Tanaka, Tsutomu; Ishihara, Makoto; Ogura, Takeshi; Obayashi, Tomohiko; Shinagawa, Akihide; Sakaguchi, Masafumi; Yamaura, Hidekazu; Kato, Mina; Niwa, Yasumasa; Yamao, Kenji

    2014-01-01

    Adenosquamous carcinoma of the pancreas (ASC) is a rare malignant neoplasm of the pancreas, exhibiting both glandular and squamous differentiation. However, little is known about its imaging features. This study examined the imaging features of pancreatic ASC. We evaluated images of contrast-enhanced computed tomography (CT) and endoscopic ultrasonography (EUS). As controls, solid pancreatic neoplasms matched in a 2:1 ratio to ASC cases for age, sex and tumor location were also evaluated. Twenty-three ASC cases were examined, and 46 solid pancreatic neoplasms (43 pancreatic ductal adenocarcinomas, two pancreatic neuroendocrine tumors and one acinar cell carcinoma) were matched as controls. Univariate analysis demonstrated significant differences in the outline and vascularity of tumors on contrast-enhanced CT in the ASC and control groups (P outline, cystic changes, and the ring-enhancement pattern on contrast-enhanced CT were seen to have significant predictive powers by stepwise forward logistic regression analysis (P = 0.044, P = 0.010, and P = 0.001, respectively). Of the three, the ring-enhancement pattern was the most useful, and its predictive diagnostic sensitivity, specificity, positive predictive value and negative predictive value for diagnosis of ASC were 65.2%, 89.6%, 75.0% and 84.3%, respectively. These results demonstrate that presence of the ring-enhancement pattern on contrast-enhanced CT is the most useful predictive factor for ASC. Copyright © 2014 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  6. Confident Diagnosis of Bronchobiliary Fistula Using Contrast-Enhanced Magnetic Resonance Cholangiography

    Energy Technology Data Exchange (ETDEWEB)

    Karabulut, Nevzat; Cakmak, Vefa; Kiter, Go ksel [Pamukkale University Medical Center, Denizli (Turkmenistan)

    2010-08-15

    We report the utility of contrast-enhanced magnetic resonance cholangiography (MRC) using gadoxetic acid (Gd-EOB-DTPA) in the diagnosis of bronchobiliary fistula associated with liver hydatid cyst. Contrast-enhanced MRC clearly delineated the leakage of contrast agent from the biliary duct and its communication with the bronchial tree. Providing functional information about physiologic or pathologic biliary flow in addition to the display of biliary anatomy, contrast enhanced MRC stands as a robust technique in confidently detecting bronchobiliary fistula and bile leaks

  7. A multi-slice gradient sequence for contrast enhanced MR diagnosis of intracranial tumours

    International Nuclear Information System (INIS)

    Schoerner, W.; Sander, B.; Kornmesser, W.; Laniado, M.; Nakamura, T.; Felix, R.

    1988-01-01

    A multi-slice gradient echo sequence (FLASH) was compared with a conventional spin-echo (SE) technique with regard to its value for contrast enhanced MR diagnosis. In 28 patients with cerebral tumours, SE images (SE 400/30; four images/3.4 minutes) and FLASH images (FLASH 315/14; 15 images/1.4 minutes) were obtained before and after gadolinium DTPA. After gadolinium-DTPA results were comparable for both techniques with respect to contrast enhancement, tumor contrast and delineation. Because of the higher efficiency of the FLASH 315/14 technique, this sequence is the method of choice for contrast enhanced cerebral MR imaging. (orig.) [de

  8. Contrast-enhanced voiding urosonography: in vitro evaluation of a second-generation ultrasound contrast agent for in vivo optimization.

    Science.gov (United States)

    Back, Susan J; Edgar, J Christopher; Canning, Douglas A; Darge, Kassa

    2015-09-01

    Pediatric contrast-enhanced ultrasound (CEUS) is primarily performed outside the United States where a track record for safety in intravenous and intravesical applications has been established. Contrast-enhanced voiding urosonography (ceVUS) has also been shown to have a much higher rate of vesicoureteral reflux detection compared to voiding cystourethrography. US contrast agents available in the United States differ from those abroad. Optison® (GE Healthcare, Princeton, NJ) is such an US contrast agent. While Optison® has similar characteristics to other second-generation agents, it has never been used for ceVUS. In vitro optimization of dose and imaging parameters as well as assessment of contrast visualization when delivered in conditions similar to ceVUS are necessary starting points prior to in vivo applications. To optimize the intravesical use of Optison® in vitro for ceVUS before its use in pediatric studies. The experimental design simulated intravesical use. Using 9- and 12-MHz linear transducers, we scanned 20-mL syringes varying mechanical index, US contrast agent concentration (0.25%, 0.5%, 1.0%), solvent (saline, urine, radiographic contrast agent) and time out of refrigeration. We evaluated mechanical index settings and contrast duration, optimized the contrast dose, measured the effect of urine and radiographic contrast agent, and the impact of length of time of contrast outside of the refrigerator on US contrast appearance. We scanned 50-ml saline bags to assess the appearance and duration of US contrast with different delivery systems (injection vs. infusion). Consistent contrast visualization was achieved at a mechanical index of 0.06-0.17 and 0.11-0.48 for the L9 and L12 MHz transducers (P contrast visualization of the microbubbles with a higher transducer frequency. The lowest mechanical index for earliest visible microbubble destruction was 0.21 for the 9 MHz and 0.39 for the 12 MHz (P contrast agent volume to bladder filling was the

  9. Ultrasonography versus intravenous urography

    International Nuclear Information System (INIS)

    Aslaksen, A.

    1991-01-01

    The present study was performed to compare the clinical value of urography and ultrasonography in a non-selected group of patients referred for urography to a university hospital. The conslusions and clinical implications of the study are as follows: Intravenous urography remains the cornerstone imaging examination in the evaluation of ureteral calculi. Ultrasonography is a valuable adjunct in cases of non- visualization of the kidneys, in distal obstruction and known contrast media allergy. When women with recurrent urinary tract infection are referred for imaging of the urinary tract, ultrasonography should be used. Ultrasonography should replace urography for screening of non-acute hydronephrosis like in female genital cancer and benign prostate hyperplasia. There is good correlation between urography and ultrasonography in assessing the degree of hydronephrosis. However, more researh on the relationship between hydronephrosis and obstruction is necessary. Ultrasonography should be used as the only imaging method of the upper urinary tract in patients with microscopic hematuria. In patients less than 50 years with macroscopic hematuria, ultrasonography should be used as the only imaging of the upper urinary tract, and an examination of the urinary bladder should be included. In patients over 50 years, urography supplied with ultrasonography should be used, but more research is necessary on the subject of imaging method and age. 158 refs

  10. An automatic respiratory gating method for the improvement of microcirculation evaluation: application to contrast-enhanced ultrasound studies of focal liver lesions

    Energy Technology Data Exchange (ETDEWEB)

    Mule, S; Kachenoura, N; Lucidarme, O; De Oliveira, A; Pellot-Barakat, C; Herment, A; Frouin, F, E-mail: Sebastien.Mule@gmail.com [INSERM UMR-S 678, 75634 Paris Cedex 13 (France)

    2011-08-21

    Contrast-enhanced ultrasound (CEUS), with the recent development of both contrast-specific imaging modalities and microbubble-based contrast agents, allows noninvasive quantification of microcirculation in vivo. Nevertheless, functional parameters obtained by modeling contrast uptake kinetics could be impaired by respiratory motion. Accordingly, we developed an automatic respiratory gating method and tested it on 35 CEUS hepatic datasets with focal lesions. Each dataset included fundamental mode and cadence contrast pulse sequencing (CPS) mode sequences acquired simultaneously. The developed method consisted in (1) the estimation of the respiratory kinetics as a linear combination of the first components provided by a principal components analysis constrained by a prior knowledge on the respiratory rate in the frequency domain, (2) the automated generation of two respiratory-gated subsequences from the CPS mode sequence by detecting end-of-inspiration and end-of-expiration phases from the respiratory kinetics. The fundamental mode enabled a more reliable estimation of the respiratory kinetics than the CPS mode. The k-means algorithm was applied on both the original CPS mode sequences and the respiratory-gated subsequences resulting in clustering maps and associated mean kinetics. Our respiratory gating process allowed better superimposition of manually drawn lesion contours on k-means clustering maps as well as substantial improvement of the quality of contrast uptake kinetics. While the quality of maps and kinetics was satisfactory in only 11/35 datasets before gating, it was satisfactory in 34/35 datasets after gating. Moreover, noise amplitude estimated within the delineated lesions was reduced from 62 {+-} 21 to 40 {+-} 10 (p < 0.01) after gating. These findings were supported by the low residual horizontal (0.44 {+-} 0.29 mm) and vertical (0.15 {+-} 0.16 mm) shifts found during manual motion correction of each respiratory-gated subsequence. The developed

  11. THE EXPERIENCE OF USING ULTRASOUND WITH CONTRAST ENHANCEMENT IN THE DIAGNOSIS OF CERVICAL CANCER

    Directory of Open Access Journals (Sweden)

    M. A. Chekalova

    2017-01-01

    Full Text Available The purpose of the study was to evaluate the value of contrast-enhanced ultrasound in detecting local spread, regional and distant metastases from cervical cancer. Materials and methods. The findings of contrast-enhanced ultrasound examination of 4 cervical cancer patients (IB1–IVB treated at N.N. Blokhin Russian Cancer Research Center from September to October 2016 were evaluated. The HI VISION Ascendus device was used. Ultrasound patterns in different phases of contrast-enhanced accumulation and excretion were analyzed. Results. Our first experience in using contrast-enhanced ultrasound in the detection of local spread, regional and distant metastases from cervical cancer allowed us to study the structure of the tumor and its spread in greater detail. Conclusion. A small number of observations do not yet allow us to draw serious conclusions about the capabilities of this modern technology. 

  12. Vessel diameter measurements in gadolinium contrast-enhanced three-dimensional MRA of peripheral arteries

    NARCIS (Netherlands)

    Westenberg, J.J.M.; Geest, van der R.J.; Wasser, M.N.J.M.; Linden, van der E.L.; Walsum, van T.; Assen, van H.C.; Roos, de A.; Vanderschoot, J.; Reiber, J.H.C.

    2000-01-01

    In this study, the possibilities for quantification of vessel diameters of peripheral arteries in gadolinium contrast-enhanced magnetic resonance angiography (Gd CE MRA) were evaluated. Absolute vessel diameter measurements were assessed objectively and semi-automatically in maximum intensity

  13. Value of the Gd-DTPA contrast enhanced MR in patients with failed back surgery syndrome

    International Nuclear Information System (INIS)

    Paprzycki, W.; Gradzki, J.; Sosnowski, P.; Stajgis, M.

    1994-01-01

    Gd-DTPA contrast - enhanced MR enables differentiation between postoperative scar and recurrent prolapse of nucleus pulposus (RPNP). Pre- and post-contrast MR studies in 40 patients with failed back surgery syndrome, previously treated surgically on 54 intervertebral levels, were evaluated. Presence of RPNP was confirmed on 4, postoperative scars on 35 and both condition on 15 invertebral levels. Correct interpretation of pathologic changes on 15 invertebral levels (28%) was only possible after contrast enhancement. Contrast enhancement of scar excluded the diagnosis of coexistence of RPNP and scar, based on pre-contrast MR studies. MR with Gd-DTPA contrast enhancement is the best diagnostic method in patients with failed back surgery syndrome (author)

  14. Biliary complications following orthotopic liver transplantation: May contrast-enhanced MR Cholangiography provide additional information?

    Directory of Open Access Journals (Sweden)

    Piero Boraschi

    2016-01-01

    Conclusions: Contrast-enhanced T1-weighted MR Cholangiography may improve the level of diagnostic confidence provided by conventional T2-weighted MR Cholangiography in the evaluation of biliary complications after orthotopic liver transplantation.

  15. Improvement of observer performance during fluoroscopy by local adaptive contrast enhancement

    International Nuclear Information System (INIS)

    Gould, R.G.; Demas, B.E.; Maroney, T.P.

    1988-01-01

    The ability of a video processor (FluoroVision FV-1), which performs two-dimensional locally adaptive contrast enhancement, to improve the detection of a low-contrast object was evaluated by means of receiver operating characteristic (ROC) curves. Three independent observers viewed a videotape of 50 fluoroscopic images of a varied background, in which a test object was present in 25. Each observer viewed the tape under four conditions: (1) no processing, (2) temporal noise reduction (gaussian weighted time averaging, (3) contrast enhancement, and (4) both noise reduction and contrast enhancement. The results were that detection was significantly improved by the locally adaptive contrast enhancement. Noise reduction did not significantly improve performance, probably because washer detection was limited by background contrast variations as well as noise and because only a small amount of noise reduction was used. The authors conclude that the processing device is potentially valuable in improving the quality of clinical fluoroscopic images

  16. MR imaging of spine and spinal canal neoplasms: value of Gd-DTPA contrast enhancement

    International Nuclear Information System (INIS)

    Paprzycki, W.; Gradzki, J.; Sosnowski, P.; Stajgis, M.

    1994-01-01

    Value of Gadolinium-DTPA contrast enhancement in diagnosis of neoplastic diseases of spinal canal was estimated on the basis of retrospective analysis of MR examinations performed in 75 patients. The analyzed material consisted of 15 cases of intramedullary tumors (group 1.), 38 of subdural extramedullary (group 2.) and 22 extradural ones (group 3.). Contrast enhanced MR contributed significant information to the final diagnosis in all groups. The utmost significance of Gd-DTPA contrast enhancement was ascertained in group 1. Authors conclude that contrast enhancement with Gd-DTPA is indispensable in all these cases of spinal canal neoplasms, where non-contrast MR did not reveal pathologic changes in optimal manner. (author)

  17. Local Contrast Enhancement Using Intuitionistic Fuzzy Sets Optimized By Artificial Bee Colony Algorithm

    Directory of Open Access Journals (Sweden)

    Daniel M. Wonohadidjojo

    2017-03-01

    was applied. The results of local contrast enhancement using both methods were compared with the results using histogram equalization method. The tests were conducted using two MDCK cell images. The results of local contrast enhancement using both methods were evaluated by observing the enhanced images and IEM values. The results show that the methods outperform the histogram equalization method. Furthermore, the method using IFSABC is better than the IFS method.

  18. Dynamic contrast-enhanced magnetic resonance imaging of the wrist in children with juvenile idiopathic arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Nusman, Charlotte M. [Emma Children' s Hospital, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Academic Medical Center, Amsterdam (Netherlands); Academic Medical Center, Department of Radiology, Amsterdam (Netherlands); Lavini, Cristina; Hemke, Robert; Caan, Matthan W.A.; Maas, Mario [Academic Medical Center, Department of Radiology, Amsterdam (Netherlands); Schonenberg-Meinema, Dieneke; Berg, J.M. van den; Kuijpers, Taco W. [Emma Children' s Hospital, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Academic Medical Center, Amsterdam (Netherlands); Dolman, Koert M. [Sint Lucas Andreas Hospital, Department of Pediatrics, Amsterdam (Netherlands); Reade Institute location Jan van Breemen, Department of Pediatric Rheumatology, Amsterdam (Netherlands); Rossum, Marion A.J. van [Reade Institute location Jan van Breemen, Department of Pediatric Rheumatology, Amsterdam (Netherlands); Emma Children' s Hospital, Department of Pediatrics, Academic Medical Center, Amsterdam (Netherlands)

    2017-02-15

    Dynamic contrast-enhanced MRI provides information on the heterogeneity of the synovium, the primary target of disease in children with juvenile idiopathic arthritis (JIA). To evaluate the feasibility of dynamic contrast-enhanced MRI in the wrist of children with JIA using conventional descriptive measures and time-intensity-curve shape analysis. To explore the association between enhancement characteristics and clinical disease status. Thirty-two children with JIA and wrist involvement underwent dynamic contrast-enhanced MRI with movement-registration and were classified using validated criteria as clinically active (n = 27) or inactive (n = 5). Outcome measures included descriptive parameters and the classification into time-intensity-curve shapes, which represent the patterns of signal intensity change over time. Differences in dynamic contrast-enhanced MRI outcome measures between clinically active and clinically inactive disease were analyzed and correlation with the Juvenile Arthritis Disease Activity Score was determined. Comprehensive evaluation of disease status was technically feasible and the quality of the dynamic dataset was improved by movement registration. The conventional descriptive measure maximum enhancement differed significantly between clinically active and inactive disease (P = 0.019), whereas time-intensity-curve shape analysis showed no differences. Juvenile Arthritis Disease Activity Score correlated moderately with enhancing volume (P = 0.484). Dynamic contrast-enhanced MRI is a promising biomarker for evaluating disease status in children with JIA and wrist involvement. Conventional descriptive dynamic contrast-enhanced MRI measures are better associated with clinically active disease than time-intensity-curve shape analysis. (orig.)

  19. Contrast enhancement of the cochlear aqueduct in MR imaging: its frequency and clinical significance

    International Nuclear Information System (INIS)

    Nakamura, T.; Naganawa, S.; Fukatsu, H.; Sakurai, Y.; Ishigaki, T.; Aoki, I.; Ninomiya, A.; Nakashima, T.

    2003-01-01

    There have been no previous reports on contrast enhancement of the cochlear aqueduct in magnetic resonance imaging. The purpose of the present study was to evaluate the frequency and significance of this finding. Thirty-one patients (15 men and 16 women; age range 18-81 years) with otologic symptoms (sudden sensorineural hearing loss, vertigo, or tinnitus) were examined using contrast-enhanced imaging on a 1.5-T MR scanner. The normal ear served as the control. Two radiologists evaluated contrast enhancement in the area of the cochlear aqueduct. Forty-eight of 62 ears (77.4%) showed contrast enhancement of the cochlear aqueduct, but no significant differences in the frequency of contrast enhancement were observed between patients with and patients without vertigo, tinnitus, sensorineural hearing loss, cerebellopontine angle tumors, or a high-riding jugular bulb. In addition, no gender- or age-related differences were noted. Contrast enhancement of the cochlear aqueduct was frequently observed, but the frequency of enhancement in symptomatic ears was not significantly higher than in control ears. The results of this study may prove helpful in avoiding unnecessary examinations and potential diagnostic confusion. (orig.)

  20. Contrast enhancement of the cochlear aqueduct in MR imaging: its frequency and clinical significance

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, T; Naganawa, S; Fukatsu, H; Sakurai, Y; Ishigaki, T [Department of Radiology, Nagoya University School of Medicine, 65 Tsurumai-cho, 466-8550, Shouwa-ku, Nagoya (Japan); Aoki, I; Ninomiya, A [Medical Systems Company, Toshiba Corporation, Nasu Operations, Otawara-shi, Tochigi (Japan); Nakashima, T [Department of Otorhinolaryngology, Nagoya University School of Medicine, Shouwa-ku, Nagoya (Japan)

    2003-09-01

    There have been no previous reports on contrast enhancement of the cochlear aqueduct in magnetic resonance imaging. The purpose of the present study was to evaluate the frequency and significance of this finding. Thirty-one patients (15 men and 16 women; age range 18-81 years) with otologic symptoms (sudden sensorineural hearing loss, vertigo, or tinnitus) were examined using contrast-enhanced imaging on a 1.5-T MR scanner. The normal ear served as the control. Two radiologists evaluated contrast enhancement in the area of the cochlear aqueduct. Forty-eight of 62 ears (77.4%) showed contrast enhancement of the cochlear aqueduct, but no significant differences in the frequency of contrast enhancement were observed between patients with and patients without vertigo, tinnitus, sensorineural hearing loss, cerebellopontine angle tumors, or a high-riding jugular bulb. In addition, no gender- or age-related differences were noted. Contrast enhancement of the cochlear aqueduct was frequently observed, but the frequency of enhancement in symptomatic ears was not significantly higher than in control ears. The results of this study may prove helpful in avoiding unnecessary examinations and potential diagnostic confusion. (orig.)

  1. Central and Eastern United States (CEUS) Seismic Source Characterization (SSC) for Nuclear Facilities Project

    Energy Technology Data Exchange (ETDEWEB)

    Kevin J. Coppersmith; Lawrence A. Salomone; Chris W. Fuller; Laura L. Glaser; Kathryn L. Hanson; Ross D. Hartleb; William R. Lettis; Scott C. Lindvall; Stephen M. McDuffie; Robin K. McGuire; Gerry L. Stirewalt; Gabriel R. Toro; Robert R. Youngs; David L. Slayter; Serkan B. Bozkurt; Randolph J. Cumbest; Valentina Montaldo Falero; Roseanne C. Perman' Allison M. Shumway; Frank H. Syms; Martitia (Tish) P. Tuttle

    2012-01-31

    This report describes a new seismic source characterization (SSC) model for the Central and Eastern United States (CEUS). It will replace the Seismic Hazard Methodology for the Central and Eastern United States, EPRI Report NP-4726 (July 1986) and the Seismic Hazard Characterization of 69 Nuclear Plant Sites East of the Rocky Mountains, Lawrence Livermore National Laboratory Model, (Bernreuter et al., 1989). The objective of the CEUS SSC Project is to develop a new seismic source model for the CEUS using a Senior Seismic Hazard Analysis Committee (SSHAC) Level 3 assessment process. The goal of the SSHAC process is to represent the center, body, and range of technically defensible interpretations of the available data, models, and methods. Input to a probabilistic seismic hazard analysis (PSHA) consists of both seismic source characterization and ground motion characterization. These two components are used to calculate probabilistic hazard results (or seismic hazard curves) at a particular site. This report provides a new seismic source model. Results and Findings The product of this report is a regional CEUS SSC model. This model includes consideration of an updated database, full assessment and incorporation of uncertainties, and the range of diverse technical interpretations from the larger technical community. The SSC model will be widely applicable to the entire CEUS, so this project uses a ground motion model that includes generic variations to allow for a range of representative site conditions (deep soil, shallow soil, hard rock). Hazard and sensitivity calculations were conducted at seven test sites representative of different CEUS hazard environments. Challenges and Objectives The regional CEUS SSC model will be of value to readers who are involved in PSHA work, and who wish to use an updated SSC model. This model is based on a comprehensive and traceable process, in accordance with SSHAC guidelines in NUREG/CR-6372, Recommendations for Probabilistic

  2. Central and Eastern United States (CEUS) Seismic Source Characterization (SSC) for Nuclear Facilities

    International Nuclear Information System (INIS)

    Coppersmith, Kevin J.; Salomone, Lawrence A.; Fuller, Chris W.; Glaser, Laura L.; Hanson, Kathryn L.; Hartleb, Ross D.; Lettis, William R.; Lindvall, Scott C.; McDuffie, Stephen M.; McGuire, Robin K.; Stirewalt, Gerry L.; Toro, Gabriel R.; Youngs, Robert R.; Slayter, David L.; Bozkurt, Serkan B.; Cumbest, Randolph J.; Falero, Valentina Montaldo; Perman, Roseanne C.; Shumway, Allison M.; Syms, Frank H.; Tuttle, Martitia P.

    2012-01-01

    This report describes a new seismic source characterization (SSC) model for the Central and Eastern United States (CEUS). It will replace the Seismic Hazard Methodology for the Central and Eastern United States, EPRI Report NP-4726 (July 1986) and the Seismic Hazard Characterization of 69 Nuclear Plant Sites East of the Rocky Mountains, Lawrence Livermore National Laboratory Model, (Bernreuter et al., 1989). The objective of the CEUS SSC Project is to develop a new seismic source model for the CEUS using a Senior Seismic Hazard Analysis Committee (SSHAC) Level 3 assessment process. The goal of the SSHAC process is to represent the center, body, and range of technically defensible interpretations of the available data, models, and methods. Input to a probabilistic seismic hazard analysis (PSHA) consists of both seismic source characterization and ground motion characterization. These two components are used to calculate probabilistic hazard results (or seismic hazard curves) at a particular site. This report provides a new seismic source model. Results and Findings The product of this report is a regional CEUS SSC model. This model includes consideration of an updated database, full assessment and incorporation of uncertainties, and the range of diverse technical interpretations from the larger technical community. The SSC model will be widely applicable to the entire CEUS, so this project uses a ground motion model that includes generic variations to allow for a range of representative site conditions (deep soil, shallow soil, hard rock). Hazard and sensitivity calculations were conducted at seven test sites representative of different CEUS hazard environments. Challenges and Objectives The regional CEUS SSC model will be of value to readers who are involved in PSHA work, and who wish to use an updated SSC model. This model is based on a comprehensive and traceable process, in accordance with SSHAC guidelines in NUREG/CR-6372, Recommendations for Probabilistic

  3. Diagnostic nerve ultrasonography

    International Nuclear Information System (INIS)

    Baeumer, T.; Grimm, A.; Schelle, T.

    2017-01-01

    For the diagnostics of nerve lesions an imaging method is necessary to visualize peripheral nerves and their surrounding structures for an etiological classification. Clinical neurological and electrophysiological investigations provide functional information about nerve lesions. The information provided by a standard magnetic resonance imaging (MRI) examination is inadequate for peripheral nerve diagnostics; however, MRI neurography is suitable but on the other hand a resource and time-consuming method. Using ultrasonography for peripheral nerve diagnostics. With ultrasonography reliable diagnostics of entrapment neuropathies and traumatic nerve lesions are possible. The use of ultrasonography for neuropathies shows that a differentiation between different forms is possible. Nerve ultrasonography is an established diagnostic tool. In addition to the clinical examination and clinical electrophysiology, structural information can be obtained, which results in a clear improvement in the diagnostics. Ultrasonography has become an integral part of the diagnostic work-up of peripheral nerve lesions in neurophysiological departments. Nerve ultrasonography is recommended for the diagnostic work-up of peripheral nerve lesions in addition to clinical and electrophysiological investigations. It should be used in the clinical work-up of entrapment neuropathies, traumatic nerve lesions and spacy-occupying lesions of nerves. (orig.) [de

  4. Contrast-enhanced magnetic resonance angiography of persistent fifth aortic arch in children

    International Nuclear Information System (INIS)

    Zhong, Yumin; Zhu, Ming; Sun, Aimin; Li, Yuhua; Jaffe, Richard B.; Gao, Wei

    2007-01-01

    Cine angiography and echocardiography have been utilized to diagnose congenital aortic arch anomalies. However, the visualization of great vessels by echocardiography is limited, while cine angiography requires cardiac catheterization with ionizing radiation. Contrast-enhanced magnetic resonance angiography (MRA) is a noninvasive modality suitable for visualization of congenital aortic arch anomalies. To evaluate the utility of contrast-enhanced MRA in the diagnosis of persistent fifth aortic arch, a rare congenital aortic arch anomaly, and to compare the diagnostic accuracy of MRA with that of echocardiography and cine angiography. In four pediatric patients, contrast-enhanced MRA studies were performed for diagnosing persistent fifth aortic arch. The findings of MRA were compared with echocardiographic findings and confirmed by cine angiography and operation. Transthoracic surface echocardiography noted an aberrant vessel arising from the ascending aorta in two of four patients; the etiology of this vessel was uncertain. In the other two patients a diagnosis of coarctation was made. Of the four patients, only one was diagnosed with interruption of the aortic arch. Contrast-enhanced MRA clarified uncertain echocardiographic findings, enabling the correct diagnosis of persistent fifth aortic arch with fourth aortic arch interruption in all four patients. Contrast-enhanced MRA is a safe, accurate, and fast imaging technique for the evaluation of persistent fifth aortic arch and may obviate the need for conventional cine angiography. Cardiac catheterization may be reserved for some types of complicated congenital heart disease and for obtaining hemodynamic information. (orig.)

  5. Analysis of peritumoral edema and contrast enhancement by computerized axial tomography

    International Nuclear Information System (INIS)

    Oi, Shizuo; Szper, I.; Wetzel, N.; Kim, Kwang-S.

    1980-01-01

    For the purpose of treating brain tumors satisfactorily with steroids, CT findings of brain tumors were analyzed, and pathogenesis of peritumoral edema and supposed effects of steroids were investigated. The degree of peritumoral edema and contrast enhancement and their relationship were analyzed in total 201 patients with brain tumors (gliomas, meningiomas, and metastatic brain tumors). As a result, significant peritumoral edema was recognized in 59% of patients with metastatic brain tumors, 46% of patients with glioma, and 34% of patients with meningioma. As a rule, there was a relationship between peritumoral edema and malignancy or localization of braiin tumors. Severe peritumoral edema was observed in malignant supratentorial tumors (over 60%), but peritumoral edema which was found in infratentorial tumors benign gliomas was mild. The degree of contrast enhancement differed according to tumors, and there was not always a relationship between the degree of contrast enhancement and malignancy or localization of brain tumors. CT findings of brain tumors after the administration of steroids showed decrease in the degree of contrast enhancement. Judging from the effect of steroids to inhibit increased vascular permeability associated with brain edema, like CT findings of peritumoral edema, the degree of contrast enhancement which probably expressed vascularity or vascular permeability seemed to be important in deciding the indications for steroid administration. (Tsunoda, M.)

  6. The role of contrast-enhanced digital subtraction MRI in the diagnosis of vertebral metastasic tumors

    International Nuclear Information System (INIS)

    Xiao Yeyu; Yang Jun; Qi Weili; Liu Qize; Hong Bikai; Wu Renhua

    2008-01-01

    Objective: To evaluate the contrast-enhanced digital subtraction MRI in the diagnosis of vertebral metastasic tumors. Methods 66 vertebral metastasic tumors in 43 patients were examined with conventional MRI (T 1 WI, STIR and Contrast-enhanced T 1 WI) and contrast-enhanced digital subtraction MR imaging. All lesions were histologically proved. The quantity and characteristic imaging signs (including spiculation, bull eye sign and irregular edge) of lesions were detected separately by different sequences. K independent samples test was used. Results: The detection rates of 35 vertebral metastasic tumors with vertebral morphological changes were same in all MR sequences. But in the other 31 lesions without vertebral morphological changes, the detection rates were different and STIR was the highest in all sequences. Contrast-enhanced digital subtraction MRI was more sensitive than all the conventional MR sequences in finding characteristic imaging signs with statistically significant differences. Conclusion: Contrast enhanced subtraction MRI is an useful and convenient technique which has great value in finding vertebral metastasic tumors and depicting the characteristic imaging signs. (authors)

  7. Contrast-enhanced power Doppler US of hepatocellular carcinomas: Quantitative analysis

    International Nuclear Information System (INIS)

    Kim, Ah Young; Choi, Byung Ihn; Kim, Tae Kyoung; Lee, Kyoung Ho; Han, Joon Koo

    1999-01-01

    To determine peak time and duration of contrast enhancement of nodular hepatocellular carcinoma (HCC) on contrast-enhancement power Doppler ultrasound (US) with Levovist by quantitative analysis. Twenty eight patients with nodular HCC were prospectively evaluated with power Doppler US by one examiner. Serial images were obtained before and after injection of 300 mg/mL US contrast agent (SH U 508 A, Levovist, Schering) with the injection rate of 0.2 mL/sec. Power Doppler signals on obtained digital images were quantified using 'Ultrasound Imaging Tool Version 1.0' (Seoul, Korea). The grade, peak time and duration of contrast enhancement of the tumors were analyzed. For nodular HCCs, mean peak enhancement time was 60 seconds after injection of Levovist (mean enhanced area 41.6 ± 28.6 %). These tumoral enhancement decreased from 90 seconds and returned to near baseline state at 5 minutes after injection of Levovist. Maximum enhanced areas (%) were variable at a range of 8-98.5% and mean maximum enhanced area was 46.4 ± 28.6%. On contrast-enhanced power Doppler US with Levovist, nodular HCCs showed peak contrast enhancement (41.6± 28.6) at 60 seconds after injection of contrast agent. This tumoral enhancement nearly disappeared at 5 minutes after injection of contrast agent.

  8. The analysis of the contrast enhanced lesions on cerebro-vascular diseases

    International Nuclear Information System (INIS)

    Terada, Tomoaki; Nishiguchi, Takashi; Hyoutani, Genhachi; Miyamoto, Kazuki; Komai, Norihiko

    1989-01-01

    The contrast enhancement of cerebro-vascular diseases on CT is thought to be due to the increase of the cerebral blood volume (CBV) and/or the disruption of the blood brain barrier (BBB). However, it is difficult to differentiate these two conditions only by contrast enhanced CT. We employed dynamic CT (DCT) to analyse these lesions with respect to the patterns of time-density curve and peak height (PH) of the curve upon the theoretical basis that flattening of the latter part of the time-density curve reflected the degree of BBB disruption and PH reflected the CBV. In all cases of hypertensive intracerebral hemorrhage (11 cases), the contrast enhanced lesion around the hematoma showed marked BBB disruption according to the results of DCT. In 11 cases of cerebral infarction, patterns of BBB disruption and CBV varied at the contrast enhanced lesions according to the result of DCT. However, all contrast enhanced lesions with increased PH were associated with hemorrhagic infarction. Thus, the precise analysis of DCT provides appropriate therapeutic schedules by predicting the occurrence of hemorrhagic infarction. (author)

  9. Diagnosis of hepatic steatosis by contrast-enhanced abdominal computed tomography

    Directory of Open Access Journals (Sweden)

    Rodrigo da Fonseca Monjardim

    2013-06-01

    Full Text Available Objective To evaluate the diagnostic capacity of abdominal computed tomography in the assessment of hepatic steatosis using the portal phase with a simplified calculation method as compared with the non-contrast-enhanced phase. Materials and Methods In the present study, 150 patients were retrospectively evaluated by means of non-contrast-enhanced and contrast-enhanced computed tomography. One hundred patients had hepatic steatosis and 50 were control subjects. For the diagnosis of hepatic steatosis in the portal phase, the authors considered a result of < 104 HU calculated by the formula [L - 0.3 × (0.75 × P + 0.25 × A] / 0.7, where L, P and A represent the attenuation of the liver, of the main portal vein and abdominal aorta, respectively. Sensitivity, specificity, positive and negative predictive values were calculated, using non-contrast-enhanced computed tomography as the reference standard. Results The simplified calculation method with portal phase for the diagnosis of hepatic steatosis showed 100% sensitivity, 36% specificity, negative predictive value of 100% and positive predictive value of 75.8%. The rate of false positive results was 64%. False negative results were not observed. Conclusion The portal phase presents an excellent sensitivity in the diagnosis of hepatic steatosis, as compared with the non-contrast-enhanced phase of abdominal computed tomography. However, the method has low specificity.

  10. Diagnosis of hepatic steatosis by contrast-enhanced abdominal computed tomography

    International Nuclear Information System (INIS)

    Monjardim, Rodrigo da Fonseca; Costa, Danilo Manuel Cerqueira; Romano, Ricardo Francisco Tavares; Salvadori, Priscila Silveira; Santos, Jaime de Vargas Conde dos; Atzingen, Augusto Castelli Von; Shigueoka, David Carlos; D'Ippolito, Giuseppe

    2013-01-01

    Objective: to evaluate the diagnostic capacity of abdominal computed tomography in the assessment of hepatic steatosis using the portal phase with a simplified calculation method as compared with the non-contrast-enhanced phase. Materials and methods: in the present study, 150 patients were retrospectively evaluated by means of non-contrast-enhanced and contrast-enhanced computed tomography. One hundred patients had hepatic steatosis and 50 were control subjects. For the diagnosis of hepatic steatosis in the portal phase, the authors considered a result of < 104 HU calculated by the formula [L - 0.3 × (0.75 × P + 0.25 × A)] / 0.7, where L, P and A represent the attenuation of the liver, of the main portal vein and abdominal aorta, respectively. Sensitivity, specificity, positive and negative predictive values were calculated, using non-contrast-enhanced computed tomography as the reference standard. Results: the simplified calculation method with portal phase for the diagnosis of hepatic steatosis showed 100% sensitivity, 36% specificity, negative predictive value of 100% and positive predictive value of 75.8%. The rate of false positive results was 64%. False negative results were not observed. Conclusion: The portal phase presents an excellent sensitivity in the diagnosis of hepatic steatosis, as compared with the non-contrast-enhanced phase of abdominal computed tomography. However, the method has low specificity. (author)

  11. Value of fat suppression and dynamic contrast-enhanced MRI in the diagnosis of insulinoma

    International Nuclear Information System (INIS)

    Xu Zengbin; Ruan Lingxiang; Peng Zhiyi; Zhang Minming; Xu Shunliang; Zhang Xidao

    2003-01-01

    Objective: To evaluate the value of fat suppression and dynamic contrast-enhanced MRI in the preoperative localization of insulinoma. Methods: Twelve cases with pathologically proven insulinoma were evaluated with MRI. SE T 1 WI, FSE T 2 WI, T 1 WI and T 2 WI with fat suppression, dynamic contrast-enhanced FMPSPGR sequences were used in MR scanning. Results: On SE T 1 WI, the lesions displayed hypointense in 4, isointense in 8 cases. Lesions showed hyperintense in 4, isointense in 8 cases on FSE T 2 WI. In contrast, 7 cases appeared as hypointense on T 1 WI with fat suppression and 6 cases appeared as hyperintense on T 2 WI with fat suppression. With dynamic contrast-enhanced FMPSPGR sequence 11 of 12 insulinomas were detected. In the arterial phase, the lesions presented as hyperintense with different degrees in 11 cases and isointense in 1 case. 6 cases remained hyperintense and 6 cases were isointense in pancreatic parenchymal and portal phase. 4 lesions were identified only in dynamic enhancement images. The diagnostic accuracy of insulinoma by dynamic contrast-enhanced MRI was 91.7% (11/12) as compared with histological study. Conclusion: The results indicate that dynamic contrast-enhanced MRI is an sensitive and accurate method for the preoperative localization of insulinoma

  12. Dynamic contrast enhanced MRI study of primary primitive neuroectodermal tumor in the thoracic spine

    International Nuclear Information System (INIS)

    Chen Yu; Xu Jianmin; Li Ying; Zhang Jingzhong; Zhu Jing

    2004-01-01

    Objective: To investigate the value of dynamic contrast-enhanced MR imaging in the diagnosis and differentiation of primitive neuroectodermal tumor (PNET) in the thoracic spine. Methods: The dynamic contrast-enhanced MR imaging of 2 patients (3 times) with PNET in the thoracic spine proved by surgery and pathology were prospectively studied. Results: In the curves of SI-time and CER-time, PNET in the thoracic spine showed a rapid rise to the peak between 60 s and 120 s, then the flat level was kept and no obvious decline was detected after about 3.5 minute. Conclusion: Dynamic contrast-enhanced MRI can help to make the diagnosis and differential diagnosis for PNET in the thoracic spine, offer reliable information for the choice of clinical management, and predict the prognosis

  13. Dynamic contrast-enhanced subtraction MR angiography in intracranial vascular abnormalities

    International Nuclear Information System (INIS)

    Takano, K.; Ono, H.; Utsunomiya, H.; Okazaki, M.; Tanaka, A.

    1999-01-01

    We present our clinical experience with dynamic contrast-enhanced MR angiography (MRA) with subtraction for assessing intracranial vascular abnormalities. Ten patients with various cerebrovascular disorders underwent dynamic contrast-enhanced MRA on a 1.0-T system. Thirty sections (2 mm) were acquired in 29-30 s. Maximum intensity projection images and subtracted source images were compared with those obtained by conventional angiography. In all cases, the presence or absence of abnormalities in the targeted vessels, as well as the morphology of the sagittal sinuses, was clearly visualized as in conventional angiography, without any obstructions such as hyperintense hematomas or thrombi, or intraluminal turbulence. Although the temporal and spatial resolutions with current hardware are insufficient, these preliminary results suggest that dynamic contrast-enhanced MRA with subtraction may be useful for assessing vascular lesions with hemorrhage or thrombus, and the dural sinuses. (orig.)

  14. Delayed contrast-enhanced MRI: use in myocardial viability assessment and other cardiac pathology

    International Nuclear Information System (INIS)

    Bogaert, J.; Dymarkowski, S.

    2005-01-01

    As in other organs, tissue characterization is important for many cardiac diseases. For example, in ischemic heart disease, differentiation between reversibly and irreversibly damaged myocardium in patients with a prior myocardial infarction is crucial in determining disease severity, functional recovery and patient outcome. With the recent advent of the single inversion-recovery contrast-enhanced magnetic resonance imaging (MRI) sequence (delayed contrast-enhanced MRI), contrast between normal and abnormal tissues could be significantly enhanced compared with the conventional cardiac MRI sequences, enabling even subtle abnormalities to be visualized. Together with other advances in cardiac MRI (e.g. functional imaging, coronary artery imaging), MRI has become one of the preferred non-invasive modalities to study cardiac diseases. In this paper an overview of the versatility of delayed contrast-enhanced MRI for investigating cardiac diseases is given. (orig.)

  15. The role of contrast-enhanced ultrasound in risk assessment of carotid atheroma

    Directory of Open Access Journals (Sweden)

    Silviu Stanciu

    2016-07-01

    Full Text Available Background and objective: Contrast-enhanced ultrasound, used to assess atherosclerotic carotid plaques, improves visualization of vessel wall irregularities and depicts intraplaque neovascularization. This article illustrates the use of contrast-enhanced ultrasound in the risk assessment of carotid atherosclerotic lesions, especially in challenging plaques evaluation. Materials and methods: For 23 patients with difficult duplex ultrasound examination due to carotid tortuosity or calcifications we assessed plaque morphology (contour, echogenicity and stenosis degree using contrast substance (Sonovue, Braco with dedicated vascular low mechanical index CPC software. Conclusion: Contrast-enhanced ultrasound is a new, noninvasive, and safe procedure for imaging carotid atherosclerotic lesions. It is a valuable tool for evaluating the vulnerable plaque at risk for rupture and for the diagnostic of the development and severity of systemic atherosclerotic disease

  16. MRI contrast enhancement of the lung using a Gd-DTPA aerosol

    International Nuclear Information System (INIS)

    Bockisch, A.; Harvey, R.C.; Davis, M.A.; Kabalka, G.W.

    1993-01-01

    A MR imaging study was performed in anesthetized female beagle dogs to investigate the effectiveness of Gd-DTPA aerosol for contrast enhancement in ventilated lungs. Ventilation was performed using a commercially available atomizer to administer Gd-DTPA solution. MR imaging was performed with a 1.9 T whole body imager using respiratory gated acquisition. To define the amount of Gd-DTPA being trapped in the lungs identical experiments were performed with 99m Tc-DTPA. MR imaging confirmed at 70% contrast enhancement following inhalation of Gd-DTPA. Because of the inherently low signal intensity of lung parenchyma the degree of contrast enhancement is not sufficient for clinical application. (orig.) [de

  17. Carotid Artery Stenosis: Comparison of 3D Time-of-Flight MR Angiography and Contrast-Enhanced MR Angiography at 3T

    Directory of Open Access Journals (Sweden)

    Ivan Platzek

    2014-01-01

    Full Text Available Purpose. The aim of this study was to assess the correlation of 3D time-of-flight MR angiography (TOF MRA and contrast-enhanced MR angiography (CEMRA for carotid artery stenosis evaluation at 3T. Material and Methods. Twenty-three patients (5 f, 18 m; mean age 61 y, age range 45–78 y with internal carotid artery stenosis detected with ultrasonography were examined on a 3.0T MR system. The MR examination included both 3D TOF MRA and CEMRA of the carotid arteries. MR images were evaluated independently by two board-certified radiologists. Stenosis evaluation was based on a five-point scale. Stenosis grades determined by TOF and CEMRA were compared using Spearman’s rank correlation coefficient and the Wilcoxon test. Cohen’s Kappa was used to evaluate interrater reliability. Results. CEMRA detected stenosis in 24 (52% of 46 carotids evaluated, while TOF detected stenosis in 27 (59% of 46 carotids. TOF MRA yielded significantly higher results for stenosis grade in comparison to CEMRA (P=0.014. Interrater agreement was very good for both TOF MRA (κ=0.93 and CEMRA (κ=0.93. Conclusion. At 3T, 3D TOF MRA should not be used as replacement for contrast-enhanced MRA of the carotid arteries, as it results in significantly higher stenosis grades.

  18. Contrast-enhanced sonography for quantitative assessment of portal hypertension in patients with liver cirrhosis.

    Science.gov (United States)

    Qu, En-Ze; Zhang, Ying-Cai; Li, Zhi-Yan; Liu, Yang; Wang, Jin-Rui

    2014-11-01

    The clinical utility of contrast-enhanced sonography in portal hypertension remains unclear. We explored the feasibility of using contrast-enhanced sonography for noninvasive assessment of portal venous pressure. Twenty healthy individuals (control group; 9 men; mean age, 46.4 years) and 18 patients with portal hypertension (15 men; mean age, 46.2 years) were enrolled in this study. The portal hypertension group included patients who underwent splenectomy and pericardial blood vessel disarticulation at our hospital from October 2010 to March 2011. One week before surgery, patients with portal hypertension underwent preoperative liver contrast-enhanced sonography. Two-dimensional, Doppler, and contrast-enhanced sonographic parameters were compared between the groups. Portal venous pressure was measured intraoperatively by portal vein puncture in the portal hypertension group, and its relationship with the other parameters was analyzed. The 2-dimensional, Doppler, and contrast-enhanced sonographic parameters differed between the groups (P Portal venous pressure was inversely correlated with the area under the portal vein/hepatic artery time-intensity curve ratio (Qp/Qa), portal vein/hepatic artery strength ratio (Ip/Ia), and portal vein/hepatic artery wash-in perfusion slope ratio (βp/βa), with correlation coefficients of -0.701, -0.625, and -0.494, respectively. Measurement of the liver contrast-enhanced sonographic parameters Qp/Qa, Ip/Ia, and βp/βa could be used as a new quantitative method for noninvasively assessing portal venous pressure. © 2014 by the American Institute of Ultrasound in Medicine.

  19. Field strength and dose dependence of contrast enhancement by gadolinium-based MR contrast agents

    International Nuclear Information System (INIS)

    Rinck, P.A.; Muller, R.N.

    1999-01-01

    The relaxivities r 1 and r 2 of magnetic resonance contrast agents and the T 1 relaxation time values of tissues are strongly field dependent. We present quantitative data and simulations of different gadolinium-based extracellular fluid contrast agents and the modulation of their contrast enhancement by the magnetic field to be able to answer the following questions: How are the dose and field dependences of their contrast enhancement? Is there an interrelationship between dose and field dependence? Should one increase or decrease doses at specific fields? Nuclear magnetic relaxation dispersion data were acquired for the following contrast agents: gadopentetate dimeglumine, gadoterate meglumine, gadodiamide injection, and gadoteridol injection, as well as for several normal and pathological human tissue samples. The magnetic field range stretched from 0.0002 to 4.7 T, including the entire clinical imaging range. The data acquired were then fitted with the appropriate theoretical models. The combination of the diamagnetic relaxation rates (R 1 = 1/T 1 and R 2 = 1/T 2 ) of tissues with the respective paramagnetic contributions of the contrast agents allowed the prediction of image contrast at any magnetic field. The results revealed a nearly identical field and dose-dependent increase of contrast enhancement induced by these contrast agents within a certain dose range. The target tissue concentration (TTC) was an important though nonlinear factor for enhancement. The currently recommended dose of 0.1 mmol/kg body weight seems to be a compromise close to the lower limits of diagnostically sufficient contrast enhancement for clinical imaging at all field strengths. At low field contrast enhancement might be insufficient. Adjustment of dose or concentration, or a new class of contrast agents with optimized relaxivity, would be a valuable contribution to a better diagnostic yield of contrast enhancement at all fields. (orig.)

  20. Dynamic contrast-enhanced MR of the prostatic cancer and benign prostatic hyperplasia: correlation with angiogenesis

    International Nuclear Information System (INIS)

    Ni Xinchu; Shen Junkang; Lu Zhian; Zhou Lijuan; Yang Xiaochun; Wang Guanzhong; Zhang Caiyuan; Wang Shuizhen; Qian Minghui; Chan Yuxi; Qian Nong; Xiang Jianpo; Pan Changjie; Rong Weiliang; Chen Jianguo

    2005-01-01

    Objective: To evaluate the role of dynamic contrast-enhanced magnetic resonance imaging (MRI) in the diagnose of prostatic cancer and benign prostatic hyperplasia (BPH), and to determine the correlation between dynamic MRI findings with angiogenesis. Methods: Thirty-two cases of prostatic cancer and 40 cases of BPH underwent dynamic contrast-enhanced MRI. All the patients in this study were diagnosed by histopathology. The results of dynamic contrast-enhanced MRI were evaluated by early-phase enhancement parameters and time-signal intensity curves (SI-T curves), and the curves were classified according to their shapes as type I, which had steady enhancement; type II, plateau of signal intensity; and type III, washout of signal intensity. The pathologic specimens of region of interest (ROI ) were obtained, and HE staining, immunohistochemical vascular endothelial growth factor (VEGF), and microvessel density (MVD) measurements were performed. The relationships among dynamic contrast-enhanced MRI features, VEGF, and MVD expression were analyzed. Results: In the early-phase enhancement parameters of dynamic contrast-enhanced MRI, onset time, maximum signal intensity, and early-phase enhancement rate differed between prostatic cancer and BPH (P<0.01, 0.05, 0.01), but there were some overlaps between them. The intermediate and late post-contrast periods were characterized with the lesion SI-T curves. The SI-T curve of prostatic cancer was mainly type III (21 cases). Type II could be seen in both prostatic cancer (8 cases) and BPH (19 cases). Type I most appeared in BPH (18 cases). The distributions proved to have significant difference (P<0.001). The mean VEGF and MVD level of 32 prostatic cancer patients were significantly higher than those of 40 BPH patients (P<0.001). MVD level of prostatic cancer and BPH showed an association with VEGF level (P<0.01). The maximum signal intensity and early-phase enhancement rate in both prostatic cancer and BPH showed an association

  1. Contrast enhancement of cerebral infarcts. Incidence and clinical value in different states of cerebral infarction

    International Nuclear Information System (INIS)

    Skriver, E.B.; Olsen, T.S.

    1982-01-01

    Information obtained from CT scan after contrast administration was evaluated in 59 consecutive stroke patients. CT scans before and after contrast administration were performed 3 days and 2 1/2 weeks after stroke. A plain CT scan was repeated 6 months later. Contrast enhancement was practically not seen on the first examination, but was seen in 46% on the second examination. There was a close relationship between the occurrence of contrast enhancement and the so called fogging effect. Contrast scanning gave additional information only when this effect was present. Plain CT scans 3 days after stroke were superior to contrast scans taken at any time for detecting and visualizing cerebral infarcts. (orig.)

  2. B-mode and contrast-enhanced sonographic assessment of accessory spleen in the dog.

    Science.gov (United States)

    Rossi, Federica; Rabba, Silvia; Vignoli, Massimo; Haers, Hendrik; Terragni, Rossella; Saunders, Jimmy H

    2010-01-01

    Four dogs with an accessory spleen are described. The accessory spleens appeared as a round-to-triangular structure located in the perisplenic area. They were homogeneous and isoechoic with the adjacent spleen. Contrast-enhanced ultrasound was performed using a second generation microbubble contrast medium (sulfur hexafluoride). The type and timing of enhancement of the accessory spleen was similar to that of the parent spleen. Contrast-enhanced ultrasound is a noninvasive modality useful in distinguishing an accessory spleen from a mass of another origin.

  3. Hepatic blood perfusion estimated by dynamic contrast-enhanced computed tomography in pigs

    DEFF Research Database (Denmark)

    Winterdahl, Michael; Sørensen, Michael; Keiding, Inger Susanne

    2012-01-01

    The aim of this study was to determine whether dynamic contrast-enhanced computed tomography (DCE-CT) and the slope method can provide absolute measures of hepatic blood perfusion from the hepatic artery (HA) and portal vein (PV) at experimentally varied blood flow rates.......The aim of this study was to determine whether dynamic contrast-enhanced computed tomography (DCE-CT) and the slope method can provide absolute measures of hepatic blood perfusion from the hepatic artery (HA) and portal vein (PV) at experimentally varied blood flow rates....

  4. Regions of low density in the contrast-enhanced pituitary gland: normal and pathologic processes

    International Nuclear Information System (INIS)

    Chambers, E.F.; Turski, P.A.; LaMasters, D.; Newton, T.H.

    1982-01-01

    The incidence of low-density regions in the contrast-enhanced pituitary gland and the possible causes of these regions were investigated by a retrospective review of computed tomographic (CT) scans of the head in 50 patients and autopsy specimens of the pituitary in 100 other patients. It was found that focal areas of low density within the contrast enhanced pituitary gland can be caused by various normal and pathologic conditions such as pituitary microadenomas, pars intermedia cysts, foci of metastasis, infarcts, epidermoid cysts, and abscesses. Although most focal low-density regions probably represent pituitary microadenomas, careful clinical correlation is needed to establish a diagnosis

  5. Differential diagnosis between pulmonary tuberculosis and lung abscess by contrast enhanced CT

    International Nuclear Information System (INIS)

    Kanauchi, Tetsu; Hoshi, Toshiko; Konno, Miyuki; Hando, Yumiko

    2001-01-01

    The contrast enhanced CT findings in 14 patients with active tuberculosis and 26 patients with lung abscess were retrospectively analyzed. Reflecting the difference of pathogenesis between tuberculosis and abscess, the findings are widely different. The findings suggesting pulmonary tuberculosis rather than lung abscess were as follows; multiple and irregular necrotic areas, positive CT angiogram sign, no marginal enhancement surrounding necrosis. Contrast enhanced CT may help to distinguish pulmonary tuberculosis from lung abscess, especially in cases of caseous pneumonia showing broad consolidations or mass-like shadows. (author)

  6. Independent component analysis of dynamic contrast-enhanced computed tomography images

    Energy Technology Data Exchange (ETDEWEB)

    Koh, T S [School of Electrical and Electronic Engineering, Nanyang Technological University, 50 Nanyang Ave, Singapore 639798 (Singapore); Yang, X [School of Electrical and Electronic Engineering, Nanyang Technological University, 50 Nanyang Ave, Singapore 639798 (Singapore); Bisdas, S [Department of Diagnostic and Interventional Radiology, Johann Wolfgang Goethe University Hospital, Theodor-Stern-Kai 7, D-60590 Frankfurt (Germany); Lim, C C T [Department of Neuroradiology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433 (Singapore)

    2006-10-07

    Independent component analysis (ICA) was applied on dynamic contrast-enhanced computed tomography images of cerebral tumours to extract spatial component maps of the underlying vascular structures, which correspond to different haemodynamic phases as depicted by the passage of the contrast medium. The locations of arteries, veins and tumours can be separately identified on these spatial component maps. As the contrast enhancement behaviour of the cerebral tumour differs from the normal tissues, ICA yields a tumour component map that reveals the location and extent of the tumour. Tumour outlines can be generated using the tumour component maps, with relatively simple segmentation methods. (note)

  7. Villous adenoma of the common hepatic duct: the importance of contrast-enhanced ultrasound and endoscopic retrograde cholangiopancreatography for relevant diagnosis. A case report and review of the literature.

    Science.gov (United States)

    Tefas, Cristian; Tanţău, Marcel; Szenftleben, Alexandru; Chiorean, Liliana; Badea, Radu

    2015-12-01

    Adenomas are frequently encountered in the lower digestive tract but are rarely diagnosed in the biliary tree. We report a case of villous adenoma of the common hepatic duct. A 58-year old male was admitted with a four week history of intermittent upper right quadrant pain. Gray scale and contrast-enhanced abdominal ultrasound showed a mass inside the common hepatic duct with arterial enhancement and slow wash-out during the late venous phase. Subsequent endoscopic retrograde cholangiopancreatography and intraductal ultrasound confirmed the presence of the lesion. The final histopathological examination showed villous adenoma of the common hepatic duct with high-grade dysplasia. Contrast enhanced ultrasonography used in conjecture with endoscopic retrograde cholangiopancreatography can help in differentiating biliary tumors.

  8. Ultrasonography of pediatric urogenital emergencies: review of classic and new techniques

    Directory of Open Access Journals (Sweden)

    Masahiro Kitami

    2017-07-01

    Full Text Available Urogenital emergencies are fairly common in the pediatric population, and a timely and correct diagnosis is necessary to avoid possible future infertility. In this field, ultrasonography is essential, as it has the advantages of being radiation-free and readily accessible. In particular, a high-frequency transducer allows precise evaluation of the morphology and vascularity of the scrotum, which is on the surface of the body. Beyond conventional techniques, new advanced imaging techniques have been developed, including elastography and contrast-enhanced ultrasonography. However, several pitfalls remain in the diagnosis of urogenital diseases using ultrasonography. Thus, accurate knowledge and sufficient experience with the technique are essential for making a correct diagnosis. This review provides an overview of pediatric urogenital emergency pathologies and recent ultrasonography techniques.

  9. Ultrasonography of pediatric urogenital emergencies: review of classic and new techniques

    Energy Technology Data Exchange (ETDEWEB)

    Kitami, Masahiro [Dept. of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai (Japan)

    2017-07-15

    Urogenital emergencies are fairly common in the pediatric population, and a timely and correct diagnosis is necessary to avoid possible future infertility. In this field, ultrasonography is essential, as it has the advantages of being radiation-free and readily accessible. In particular, a high-frequency transducer allows precise evaluation of the morphology and vascularity of the scrotum, which is on the surface of the body. Beyond conventional techniques, new advanced imaging techniques have been developed, including elastography and contrast-enhanced ultrasonography. However, several pitfalls remain in the diagnosis of urogenital diseases using ultrasonography. Thus, accurate knowledge and sufficient experience with the technique are essential for making a correct diagnosis. This review provides an overview of pediatric urogenital emergency pathologies and recent ultrasonography techniques.

  10. Ultrasonography in trauma

    DEFF Research Database (Denmark)

    Weile, Jesper; Nielsen, Klaus; Primdahl, Stine C

    2017-01-01

    BACKGROUND: The Focused Assessment with Sonography in Trauma (FAST) protocol is considered beneficial in emergent evaluation of trauma patients with blunt or penetrating injury and has become integrated into the Advanced Trauma Life Support (ATLS) protocol. No guidelines exist as to the use...... of ultrasonography in trauma in Denmark. We aimed to determine the current use of ultrasonography for assessing trauma patients in Denmark. METHODS: We conducted a nation-wide cross-sectional investigation of ultrasonography usage in trauma care. The first phase consisted of an Internet-based investigation....... Twenty-one (95.5%) of the guidelines included and recommended FAST as part of trauma assessment. The recommended person to perform the examination was the radiologist in n = 11 (50.0%), the surgeon in n = 6 (27.3%), the anesthesiologist in n = 1 (4.5%), and unspecified in n = 3 (13.6%) facilities. FAST...

  11. Ultrasonography of polycystic kidney

    International Nuclear Information System (INIS)

    Oh, Seung Chul; Cho, Seung Gi; Lee, Kwan Seh; Kim, Kun Sang

    1980-01-01

    Polycystic disease is defined as a heritable disorder with diffuse involvement of both kidneys. The term 'Polycystic disease' comprises at least two separate, genetically different disease-one with an onset typically in childhood (infantile polycystic disease) and the other with an onset typically in adulthood (adult polycystic disease). Adult polycystic kidney disease is the most common form of cystic kidney disease in humans. Ultrasonography is a very useful noninvasive diagnostic modality in the patient with clinically suspected renal diseases as well as screening test. 14 cases of ultrasonography in patient with polycystic kidney were reviewed. All cases show unilateral or bilateral enlarged kidneys. 7 cases reveal kidneys and liver replaced by multiple cysts of varing size. Screening ultrasonography for a familial tree is reported

  12. Ultrasonography of jaundice

    International Nuclear Information System (INIS)

    Cho, Byung Jae; Bae, Sang Hoon; Lee, Seung Ro; Kim, Chu Wan

    1980-01-01

    The importance of ultrasonography in the evaluation of jaundice is stressed with an analysis of 47 cases of jaundice. 31 cases proved to be obstructive and 16 non-obstructive jaundice. Obstructive jaundice could be differentiated from non-obstructive jaundice in all but 2 cases, (96%). The site of obstruction in 31 cases of obstructive jaundice could be predicted correctly in 23 cases of 31, (90%), and cause of obstruction with an accuracy of 35% as well. One can certainly recommend ultrasonography as an initial procedure of choice in jaundice patients

  13. Ultrasonography in abdominal emergencies

    International Nuclear Information System (INIS)

    Risi, D.; Alessi, G.; Meli, C.; Marzano, M.; Fiori, E.; Caterino, S.

    1989-01-01

    From February 1986 to March 1988 113 abdominal US exams were performed in emergency situation to evaluate the accuracy of this methodology: 13 were blunt traumas, 18 post-operative complications. A real-time scanner with a linear probe of 5 MHz was employed. The results were confirmed by surgical and/or clinical and instrumental evaluation. In 81% of the examinations, ultrasonography allowed a diagnosis to be made. Gallbladder and biliary pathologies were the most common findings. The results (sensibility 96%, specificity 88%, accuracy 95%) confirm the affidability of ultrasonography in abdominal emergencies, as shown in literature

  14. Dynamic contrast-enhanced MRI in patients with luminal Crohn's disease

    NARCIS (Netherlands)

    Ziech, M. L. W.; Lavini, C.; Caan, M. W. A.; Nio, C. Y.; Stokkers, P. C. F.; Bipat, S.; Ponsioen, C. Y.; Nederveen, A. J.; Stoker, J.

    2012-01-01

    Objectives: To prospectively assess dynamic contrast-enhanced (DCE-)MRI as compared to conventional sequences in patients with luminal Crohn's disease. Methods: Patients with Crohn's disease undergoing MRI and ileocolonoscopy within 1 month had DCE-MRI (3T) during intravenous contrast injection of

  15. Contrast enhancement of focal hepatic lesions in CT: effect of size and histology

    International Nuclear Information System (INIS)

    Burgener, F.A.; Hamlin, D.J.

    1983-01-01

    The effect of size and histology on the contrast enhancement of hepatic lesions has been analyzed in this clinical and experimental investigation yielding the following results: (1) The attenuation values of hepatic cysts in patients increase significantly and inversely with their size after contrast enhancement when the cysts measure less than twice the CT-slice thickness. This seems to be caused by partial-volume effect. (2) Experimental tumors of identical sizes and originating from the same cell line can demonstrate different contrast-enhancement patterns. (3) Peak contrast uptake in both experimental and human tumors seems to be inversely related to their size. (4) Compared to liver, contrast washout from experimental and human tumors (presumably the extravascular space) is delayed. The delay in the contrast washout from a tumor seems to correlate with tumor size. These findings suggest that in general, it is not possible to differentiate reliably among various hepatic neoplasms on the basis of their contrast enhancement patterns for the following reasons: (1) Attenuation values of small hepatic neoplasms are distorted by partial volume effect. (2) Tumors of different histologies can demonstrate the same enhancement pattern. (3) Tumors of identical histology and size can demonstrate different enhancement patterns. (4) The enhancement pattern of a tumor changes with growth or size

  16. Evaluation of delayed contrast-enhanced CT scan in diagnosing hilar cholangiocarcinoma

    International Nuclear Information System (INIS)

    Li Jianding; Liang Chenyang; Zhang Hua; Zhang Yuezhen; Li Rui

    2001-01-01

    Objective: To assess the diagnostic value of delayed CT contrast enhancement patterns in hilar cholangiocarcinoma based on two-phased dynamic incremental CT scanning. Methods: Fifty-two patients with suspected hilar tumor and bile duct obstruction underwent spiral CT scan. The scan time for one revolution of the X-ray tube was 1 second. To elucidate the delay time for optimal imaging, all proved cholangiocarcinoma with delayed (6, 8, 10, 15, 20, 30 minutes) post-equilibrium-phase contrast-enhanced CT scans were acquired with unenhanced, dynamic contrast-enhanced, and delayed images. Degree of delayed enhancement was compared with that of surrounding liver parenchyma. Results: (1) 8-15 minutes after IV injection of contrast material was the delay time for optimal imaging. (2) Of 29 cholangiocarcinomas, the early CT showed hypo-attenuating (lower than that of liver parenchyma) in 23 tumors, iso-attenuating (equal to that of the liver) in 4 tumors, and hyper-attenuating (higher than that of liver) in 2 tumors. The delayed CT scan showed iso-attenuating in 8 tumors, hyper-attenuating in 21 tumors, and no hypo-attenuating. Most of delay imaging of hilar cholangiocarcinoma may appear hyper-attenuating (U = -4.3073, P 2 = 9.09, P < 0.01). Conclusion: When assessing hilar tumor, delayed CT contrast enhancement patterns based on two-phase dynamic incremental CT scans is useful in the detection and characterization of hilar cholangiocarcinoma

  17. Medical Image Visual Appearance Improvement Using Bihistogram Bezier Curve Contrast Enhancement: Data from the Osteoarthritis Initiative

    Science.gov (United States)

    Gan, Hong-Seng; Swee, Tan Tian; Abdul Karim, Ahmad Helmy; Sayuti, Khairil Amir; Abdul Kadir, Mohammed Rafiq; Tham, Weng-Kit; Wong, Liang-Xuan; Chaudhary, Kashif T.; Yupapin, Preecha P.

    2014-01-01

    Well-defined image can assist user to identify region of interest during segmentation. However, complex medical image is usually characterized by poor tissue contrast and low background luminance. The contrast improvement can lift image visual quality, but the fundamental contrast enhancement methods often overlook the sudden jump problem. In this work, the proposed bihistogram Bezier curve contrast enhancement introduces the concept of “adequate contrast enhancement” to overcome sudden jump problem in knee magnetic resonance image. Since every image produces its own intensity distribution, the adequate contrast enhancement checks on the image's maximum intensity distortion and uses intensity discrepancy reduction to generate Bezier transform curve. The proposed method improves tissue contrast and preserves pertinent knee features without compromising natural image appearance. Besides, statistical results from Fisher's Least Significant Difference test and the Duncan test have consistently indicated that the proposed method outperforms fundamental contrast enhancement methods to exalt image visual quality. As the study is limited to relatively small image database, future works will include a larger dataset with osteoarthritic images to assess the clinical effectiveness of the proposed method to facilitate the image inspection. PMID:24977191

  18. Abducens nerve enhancement demonstrated by multiplanar reconstruction of contrast-enhanced three-dimensional MRI

    Energy Technology Data Exchange (ETDEWEB)

    Hosoya, T.; Adachi, M.; Sugai, Y. [Dept. of Radiology, Yamagata University School of Medicine (Japan); Yamaguchi, K.; Yamaguchi, K. [Dept. of Ophthalmology, Yamagata University School of Medicine (Japan); Kato, T. [3. Dept. of Internal Medicine, Yamagata University School of Medicine (Japan)

    2001-04-01

    We describe contrast enhancement of the cisternal portion of the abducens nerve and discuss its clinical significance. We examined 67 patients with ophthalmoplegia using contrast-enhanced 3-dimensional (3D) MRI with multiplanar reconstruction along the nerves and found 16 patients (ten men, six women), aged 10-73 years (mean 34.4 years), with contrast enhancement of the abducens nerve. Of the 36 patients who had an abducens palsy, 14 (39 %) showed contrast enhancement. In the 16 patients, 23 abducens nerves enhanced; 13 were symptomatic and 10 asymptomatic at the time. The causes were disseminated tumour (1), an inflammatory process (3), trauma (2), ischaemia (2) and autoimmune diseases (8), such as the Miller Fisher syndrome, acute ophthalmoparesis, polyneuropathy and multiple sclerosis. Abducens and/or oculomotor nerve enhancement was the only abnormality on MRI in the patients with traumatic or ischaemic neuropathy or autoimmune diseases. There were 14 patients who recovered fully within 1-6 months after treatment, and resolution of the enhancement correlated well with recovery. (orig.)

  19. Feasibility of contrast-enhanced cone-beam CT for target localization and treatment monitoring

    International Nuclear Information System (INIS)

    Rodal, Jan; Sovik, Aste; Skogmo, Hege Kippenes; Knudtsen, Ingerid Skjei; Malinen, Eirik

    2010-01-01

    A dog with a spontaneous maxillary tumour was given 40 Gy of fractionated radiotherapy. At five out of 10 fractions cone-beam CT (CBCT) imaging before and after administration of an iodinated contrast agent were performed. Contrast enhancement maps were overlaid on the pre-contrast CBCT images. The tumour was clearly visualized in the images thus produced.

  20. Abducens nerve enhancement demonstrated by multiplanar reconstruction of contrast-enhanced three-dimensional MRI

    International Nuclear Information System (INIS)

    Hosoya, T.; Adachi, M.; Sugai, Y.; Yamaguchi, K.; Yamaguchi, K.; Kato, T.

    2001-01-01

    We describe contrast enhancement of the cisternal portion of the abducens nerve and discuss its clinical significance. We examined 67 patients with ophthalmoplegia using contrast-enhanced 3-dimensional (3D) MRI with multiplanar reconstruction along the nerves and found 16 patients (ten men, six women), aged 10-73 years (mean 34.4 years), with contrast enhancement of the abducens nerve. Of the 36 patients who had an abducens palsy, 14 (39 %) showed contrast enhancement. In the 16 patients, 23 abducens nerves enhanced; 13 were symptomatic and 10 asymptomatic at the time. The causes were disseminated tumour (1), an inflammatory process (3), trauma (2), ischaemia (2) and autoimmune diseases (8), such as the Miller Fisher syndrome, acute ophthalmoparesis, polyneuropathy and multiple sclerosis. Abducens and/or oculomotor nerve enhancement was the only abnormality on MRI in the patients with traumatic or ischaemic neuropathy or autoimmune diseases. There were 14 patients who recovered fully within 1-6 months after treatment, and resolution of the enhancement correlated well with recovery. (orig.)

  1. Improved wrist pannus volume measurement from contrast-enhanced MRI in rheumatoid arthritis using shuffle transform.

    Science.gov (United States)

    Xanthopoulos, Emily; Hutchinson, Charles E; Adams, Judith E; Bruce, Ian N; Nash, Anthony F P; Holmes, Andrew P; Taylor, Christopher J; Waterton, John C

    2007-01-01

    Contrast-enhanced MRI is of value in assessing rheumatoid pannus in the hand, but the images are not always easy to quantitate. To develop and evaluate an improved measurement of volume of enhancing pannus (VEP) in the hand in human rheumatoid arthritis (RA). MR images of the hand and wrist were obtained for 14 patients with RA at 0, 1 and 13 weeks. Volume of enhancing pannus was measured on images created by subtracting precontrast T1-weighted images from contrast-enhanced T1-weighted images using a shuffle transformation technique. Maximum intensity projection (MIP) and 3D volume rendering of the images were used as a guide to identify the pannus and any contrast-enhanced veins. Visualisation of pannus was much improved following the shuffle transform. Between 0 weeks and 1 week, the mean value of the within-subject coefficient of variation (CoV) was 0.13 and the estimated total CoV was 0.15. There was no evidence of significant increased variability within the 13-week interval for the complete sample of patients. Volume of enhancing pannus can be measured reproducibly in the rheumatoid hand using 3D contrast-enhanced MRI and shuffle transform.

  2. Breast dynamic contrast enhanced MRI: fibrocystic changes presenting as a non-mass enhancement mimicking malignancy

    Directory of Open Access Journals (Sweden)

    Milosevic Zorica C.

    2017-06-01

    Full Text Available We aimed to analyse the morphokinetic features of breast fibrocystic changes (nonproliferative lesions, proliferative lesions without atypia and proliferative lesions with atypia presenting as a non-mass enhancement (NMEin dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI examination.

  3. Evaluating automated dynamic contrast enhanced wrist 3T MRI in healthy volunteers

    DEFF Research Database (Denmark)

    Rastogi, Anshul; Kubassova, Olga; Krasnosselskaia, Lada V

    2013-01-01

    Dynamic contrast enhanced (DCE)-MRI has great potential to provide quantitative measure of inflammatory activity in rheumatoid arthritis. There is no current benchmark to establish the stability of signal in the joints of healthy subjects when imaged with DCE-MRI longitudinally, which is crucial so...

  4. Data driven analysis of dynamic contrast-enhanced magnetic resonance imaging data in breast cancer diagnosis

    NARCIS (Netherlands)

    Twellmann, T.

    2005-01-01

    In the European Union, breast cancer is the most common type of cancer affecting women. If diagnosed in an early stage, breast cancer has an encouraging cure rate. Thus, early detection of breast cancer continues to be the key for an effective treatment. Recently, Dynamic Contrast-Enhanced Magnetic

  5. Medical Image Visual Appearance Improvement Using Bihistogram Bezier Curve Contrast Enhancement: Data from the Osteoarthritis Initiative

    Directory of Open Access Journals (Sweden)

    Hong-Seng Gan

    2014-01-01

    Full Text Available Well-defined image can assist user to identify region of interest during segmentation. However, complex medical image is usually characterized by poor tissue contrast and low background luminance. The contrast improvement can lift image visual quality, but the fundamental contrast enhancement methods often overlook the sudden jump problem. In this work, the proposed bihistogram Bezier curve contrast enhancement introduces the concept of “adequate contrast enhancement” to overcome sudden jump problem in knee magnetic resonance image. Since every image produces its own intensity distribution, the adequate contrast enhancement checks on the image’s maximum intensity distortion and uses intensity discrepancy reduction to generate Bezier transform curve. The proposed method improves tissue contrast and preserves pertinent knee features without compromising natural image appearance. Besides, statistical results from Fisher’s Least Significant Difference test and the Duncan test have consistently indicated that the proposed method outperforms fundamental contrast enhancement methods to exalt image visual quality. As the study is limited to relatively small image database, future works will include a larger dataset with osteoarthritic images to assess the clinical effectiveness of the proposed method to facilitate the image inspection.

  6. Contrast enhancement by lipid-based MRI contrast agents in mouse atherosclerotic plaques; a longitudinal study

    NARCIS (Netherlands)

    den Adel, Brigit; van der Graaf, Linda M.; Que, Ivo; Strijkers, Gustav J.; Löwik, Clemens W.; Poelmann, Robert E.; van der Weerd, Louise

    2013-01-01

    The use of contrast-enhanced MRI to enable in vivo specific characterization of atherosclerotic plaques is increasing. In this study the intrinsic ability of two differently sized gadolinium-based contrast agents to enhance atherosclerotic plaques in ApoE(-/-) mice was evaluated with MRI. We

  7. Avascular necrosis of femoral head: findings of contrast-enhanced MR imaging

    International Nuclear Information System (INIS)

    Shin, Yong Moon; Kang, Heung Sik; Kim, Chu Wan; Kim, Hee Joong; Kim, Young Min

    1995-01-01

    To evaluate the findings and the role of contrast enhanced magnetic resonance imaging in avascular necrosis of femoral head. Sixteen patients with avascular necorsis of femoral head were examined with MRI. T1-weighted and T2-weighted image and contrast-enhanced T1-weighted images were obtained. Enhancing characteristics of the necrotic area and synovium were determined. Also a change of the disease extent after enhancement was assessed. Twenty seven avascular necrosis of the femoral head including 11 cases of bilateral lesion were detected. Fifteen cases revealed collapse of the femoral head. The portions of the lesion with low signal intensity on T1-weighted images and high signal intensity on T2-weighted images showed contrast enhancement in 15 cases. However, the potions with low signal intensities both on T1 and T2-weighted images showed enhancement in one case. There was no significant change of the disease extent after enhancement. Synovium showed enhancement in 18 cases, and joint effusion was detected in 23 cases. Contrast enhanced MR images may be helpful in predicting histopathologic findings of avascular necrosis of the femoral head, but not useful for evaluating the extent of disease

  8. Avascular necrosis of femoral head: findings of contrast-enhanced MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Yong Moon; Kang, Heung Sik; Kim, Chu Wan; Kim, Hee Joong; Kim, Young Min [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1995-06-15

    To evaluate the findings and the role of contrast enhanced magnetic resonance imaging in avascular necrosis of femoral head. Sixteen patients with avascular necorsis of femoral head were examined with MRI. T1-weighted and T2-weighted image and contrast-enhanced T1-weighted images were obtained. Enhancing characteristics of the necrotic area and synovium were determined. Also a change of the disease extent after enhancement was assessed. Twenty seven avascular necrosis of the femoral head including 11 cases of bilateral lesion were detected. Fifteen cases revealed collapse of the femoral head. The portions of the lesion with low signal intensity on T1-weighted images and high signal intensity on T2-weighted images showed contrast enhancement in 15 cases. However, the potions with low signal intensities both on T1 and T2-weighted images showed enhancement in one case. There was no significant change of the disease extent after enhancement. Synovium showed enhancement in 18 cases, and joint effusion was detected in 23 cases. Contrast enhanced MR images may be helpful in predicting histopathologic findings of avascular necrosis of the femoral head, but not useful for evaluating the extent of disease.

  9. Contrast enhanced digital mammography: Is it useful in detecting lesions in edematous breast?

    Directory of Open Access Journals (Sweden)

    Noha Abd ElShafy ElSaid

    2015-09-01

    Conclusion: Dual-energy contrast-enhanced digital mammography is a useful technique in identification of lesions in mammographically dense edematous breasts and proved to be a useful tool in the follow-up of cases presenting by edema after conservative breast surgery and chemotherapy.

  10. Non-contrast enhanced magnetic resonance angiography techniques in candidates for kidney transplantation: A comparative study

    International Nuclear Information System (INIS)

    Blankholm, Anne Dorte; Ginnerup-Pedersen, Bodil; Stausbøl-Grøn, Brian; Haislund, Margit; Laustsen, Sussie; Ringgaard, Steffen

    2013-01-01

    Aim: Detailed knowledge of vessel status in potential candidates for kidney transplantation is essential for the surgeon. Contrast enhanced magnetic resonance angiography has previously been used intensively for assessing this, but the discovery that use of gadolinium based contrast agents in magnetic resonance imaging can cause Nephrogenic Systemic Fibrosis in patients suffering from severe kidney disease has lead to renewed interest in non-contrast enhanced magnetic resonance angiography. The aim of this study was to find a non-contrast enhanced magnetic resonance angiography method for preoperative evaluation of the pelvic vessels prior to kidney transplantation, providing a sufficient image quality. Method: In a prospective study we consecutively included 54 patients undergoing examinations prior to kidney transplantation. The patients were examined with the following magnetic resonance angiography sequences: A 2D Time of flight (n = 54), 3D Time of flight (n = 52) patients, 3D Phase Contrast (n = 54), 3D Balanced Steady State Free Precession (n = 52) and a 2D TRiggered Angiography Non-Contrast Enhanced (TRANCE) (a Spin Echo sequence with subtraction) (n = 48). The sequences were evaluated with respect to contrast, diagnostic performance and artefact burden. Results: Evaluating contrast, 3D Phase Contrast was significantly better than 2D Time of flight (p 0.2). The 2D Time of flight was significantly better than the other sequences (p < 0.001) in all cases. The artefact score was lowest for the Phase Contrast images and significantly superior to the 2D Time of flight (p < 0.005). The 2D Time of flight was significantly better than the three other sequences (p < 0.001) in all cases. Conclusion: Non-contrast enhanced magnetic resonance angiography offers a safe preoperative examination for assessment of vessel status before kidney transplantation. A combination of 2D Time of flight and 3D Phase Contrast acquisitions is recommended and can be performed within a

  11. Contrast-enhanced MR imaging of the endolymphatic sac in patients with sudden hearing loss

    International Nuclear Information System (INIS)

    Naganawa, Shinji; Koshikawa, Tokiko; Fukatsu, Hiroshi; Ishigaki, Takeo; Nakashima, Tsutomu; Ichinose, Nobuyasu

    2002-01-01

    Our objective was to evaluate the frequency of contrast enhancement of the endolymphatic sac in patients with sudden hearing loss. Forty consecutive patients with sudden sensorineural hearing loss (20 males and 20 females; age range 11-82 years), 40 age-matched control subjects, and 5 patients with Meniere's disease were examined using the same imaging protocol on a 1.5-T MR system. Pre- and post-contrast-enhanced T1-weighted 3D spoiled gradient-echo sequence (3D SPGR; TR/TE=23/10 ms, no. of excitations=1, flip angle=30 ) images were obtained using a voxel size of 0.6 x 0.7 x 0.8 mm 3 . Contrast enhancement in the area of the endolymphatic sac was assessed by two radiologists, and the frequency of contrast enhancement was compared between the three study groups. Enhancement of the ipsilateral endolymphatic sac was observed in 30 of the 40 patients with sudden hearing loss (75%). Twenty of these 30 patients also showed enhancement on the contralateral side, and 1 patient showed enhancement only on the contralateral side. Only 1 of the 5 patients with Meniere's disease showed enhancement. Nine of the 40 control subjects (22.5%) showed enhancement (bilateral enhancement in 5 subjects, unilateral in 4). The frequency of enhancement in patients with sudden hearing loss was significantly higher than that in control subjects (P<0.0001) or patients with Meniere's disease (P<0.05). The frequency of contrast enhancement of the endolymphatic sac is significantly increased in patients with sudden hearing loss, but further study is necessary to clarify the relationship between this finding and the pathophysiology of sudden hearing loss. (orig.)

  12. The value of contrast-enhanced CT scan in prediction of development of contusional hemorrhage

    International Nuclear Information System (INIS)

    Yokoyama, Kazuhiro; Kyoi, Kikuo; Sakaki, Toshisuke; Kinugawa, Kazuhiko; Morimoto, Tetsuya

    1983-01-01

    It is often experienced that even if there are no significant findings on the initial plain CT scan in the patient with cerebral contusion, the patient has thereafter a serious clinical course and requires emergency operation for so-called contusional hemorrhage. In order to predict of the development of contusional hemorrhage we performed contrast-enhanced CT scan at the time of patient's arrival within 12 hours after injury, if there was cerebral contusion on the initial plain CT scan, and repeated plain CT scan 24 hours after the contrast-enhanced CT scan. If enhancement was demonstrated on the contrastenhanced CT scan, we predicted the development of contusional hemorrhage and if not demonstrated, we predicted no more development of contusional hemorrhage and then we studied the correlation between the prediction and the plain CT 24 hours after the contrast-enhanced CT scan. The results were as follows: 1) The prediction was correct in 13 cases out of 16 cases in which the development of contusional hemorrhage was observed. In 18 cases where no development of contusional hemorrhage was observed, the prediction was correct without exception. 2) Most of the cases in which enhancement was demonstrated were ones examined not before 3 hours after injury. 3) The extent of enhancement shown on contrastenhanced CT scan was well consistent with that of contusional hemorrhage on the plain CT scan 24 hours after the contrast-enhanced CT scan. From these results, the contrast-enhanced CT scan in acute stage of head injury was considered to by very useful in prediction of the development of contusional hemorrhage. (author)

  13. Correlation of thyroid papillary carcinoma CEUS characteristics with cancer cell proliferation and invasion

    Directory of Open Access Journals (Sweden)

    Jing Wan

    2017-04-01

    Full Text Available Objective: To study the correlation of thyroid papillary carcinoma CEUS characteristics with cancer cell proliferation and invasion. Methods: A total of 128 patients with thyroid papillary carcinoma who received surgical treatment in the hospital between May 2013 and May 2016 were collected, CEUS was used to make clear the peak intensity (PI and area under the curve (AUC of tumor tissue and surrounding normal tissue, and the median of PI and AUC was referred to further divide the patients into high PI group and low PI group as well as high AUC group and low AUC group, 64 cases in each group. Fluorescent quantitative PCR was used to determine proliferation and invasion gene mRNA expression in tumor tissues. Results: PI and AUC levels in tumor tissue were lower than those in surrounding normal tissue; proliferation genes EZH2, Livin, hTERT, HMGA1 and Wip1 mRNA expression of low PI group were higher than those of high PI group, and invasion gene Ki-67 mRNA expression was higher than that of high PI group while P53 and MRP-1 mRNA expression were lower than those of high PI group; proliferation genes EZH2, Livin, hTERT, HMGA1 and Wip1 mRNA expression of low AUC group were higher than those of high AUC group, and invasion gene Ki-67 mRNA expression was higher than that of high AUC group while P53 and MRP-1 mRNA expression were lower than those of high AUC group. Conclusion: Thyroid papillary carcinoma CEUS parameters PI and AUC levels can quantifiably reflect the cancer cell proliferation and invasion activity.

  14. Quantitative Assessment of Free Flap Viability with CEUS Using an Integrated Perfusion Software.

    Science.gov (United States)

    Geis, S; Klein, S; Prantl, L; Dolderer, J; Lamby, P; Jung, E-M

    2015-12-01

    New treatment strategies in oncology and trauma surgery lead to an increasing demand for soft tissue reconstruction with free tissue transfer. In previous studies, CEUS was proven to detect early flap failure. The aim of this study was to detect and quantify vascular disturbances after free flap transplantation using a fast integrated perfusion software tool. From 2011 to 2013, 33 patients were examined by one experienced radiologist using CEUS after a bolus injection of 1-2.4 ml of SonoVue(®). Flap perfusion was analysed qualitatively regarding contrast defects or delayed wash-in. Additionally, an integrated semi-quantitative analysis using time-intensity curve analysis (TIC) was performed. TIC analysis of the transplant was conducted on a centimetre-by-centimetre basis up to a penetration depth of 4 cm. The 2 perfusion parameters "Time to PEAK" and "Area under the Curve" were compared in patients without complications vs. patients with minor complications or complete flap loss to figure out significant differences. TtoPk is given in seconds (s) and Area is given in relative units (rU) Results: A regular postoperative process was observed in 26 (79%) patients. In contrast, 5 (15%) patients with partial superficial flap necrosis, 1 patient (3%) with complete flap loss and 1 patient (3%) with haematoma were observed. TtoPk revealed no significant differences, whereas Area revealed significantly lower perfusion values in the corresponding areas in patients with complications. The critical threshold for sufficient flap perfusion was set below 150 rU. In conclusion, CEUS is a mobile and cost-effective opportunity to quantify tissue perfusion and can even be used almost without any restrictions in multi-morbid patients with renal and hepatic failure. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Ultrasonography X gamma radiography

    International Nuclear Information System (INIS)

    Mello Campos, A.M. de

    1989-01-01

    The accumulated experience in the last ten years of substitution to essays by gamma radiography to essay by ultrasonography, starting of the systematic comparison and tabulation of the results obtained by both essays applied in welding joints, in field, in steel pipelines of the SABESP. (V.R.B.)

  16. Surgeon-performed ultrasonography

    DEFF Research Database (Denmark)

    Todsen, Tobias

    2017-01-01

    Surgeons are increasingly using ultrasonography (US) in their clinical management of patients. However, US is a very user-dependent imaging modality and proper skills of the US operator are needed to ensure quality in patient care. This thesis explores the validity evidence for assessment...

  17. Ultrasonography of the Kidney

    DEFF Research Database (Denmark)

    Lindskov Hansen, Kristoffer; Nielsen, Michael Bachmann; Ewertsen, Caroline

    2016-01-01

    Ultrasonography of the kidneys is essential in the diagnosis and management of kidney-related diseases. The kidneys are easily examined, and most pathological changes in the kidneys are distinguishable with ultrasound. In this pictorial review, the most common findings in renal ultrasound...

  18. Contrast-enhanced MR 3D angiography in the assessment of brain AVMs

    International Nuclear Information System (INIS)

    Unlu, Ercument; Temizoz, Osman; Albayram, Sait; Genchellac, Hakan; Hamamcioglu, M. Kemal; Kurt, Imran; Demir, M. Kemal

    2006-01-01

    Background and purpose: Digital subtraction angiography (DSA) is the current reference standard for the diagnosis, assessment, and management of brain arteriovenous malformations (AVMs). The purpose of this study was to compare the diagnostic utility of three-dimensional (3D) time-of-flight (TOF) magnetic resonance angiography (MRA) and contrast-enhanced 3D MRA in patients with intracranial arteriovenous malformations (AVMs) in different sizes and locations. The AVM diagnosis was proved via DSA and almost half of the patients had also hematoma. Materials and methods: Two radiologists, experienced on neurovascular imaging and independent from each other, retrospectively reviewed two MRA techniques and DSA with regard to the as