OP18.02: Contrast-enhanced ultrasound (CEU) before and after uterine artery embolisation (UAE) for fibroid treatment

Contrast-enhanced ultrasound (CEUS) is a cost-effective, quick, and non-invasive imaging modality that has yet to be incorporated in uterine artery embolization (UAE). We present two cases that demonstrate the utility of CEUS in UAE for the identification of uterine-ovarian collaterals which otherwise can result in ineffective fibroid treatment and non-target embolization.

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Quantitative analysis of microcirculation blood perfusion in patients with hepatocellular carcinoma before and after transcatheter arterial chemoembolisation using contrast-enhanced ultrasound

European Journal of Cancer ◽

10.1016/j.ejca.2016.08.016 ◽

2016 ◽

Vol 68 ◽

pp. 82-89 ◽

Cited By ~ 11

Author(s):

Hui Tian ◽

Qi Wang

Keyword(s):

Hepatocellular Carcinoma ◽

Quantitative Analysis ◽

Blood Perfusion ◽

Contrast Enhanced Ultrasound ◽

Contrast Enhanced ◽

Before And After ◽

Transcatheter Arterial Chemoembolisation

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Clinical and Contrast-Enhanced Ultrasound Echography Outcomes in Psoriatic Arthritis Patients after One Year of Continuous Therapy with Anti-TNF Drugs

ISRN Dermatology ◽

10.1155/2014/932721 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Claudio Bonifati ◽

Fulvia Elia ◽

Dario Graceffa ◽

Fabrizio Ceralli ◽

Elisa Maiani ◽

...

Keyword(s):

Psoriatic Arthritis ◽

Significant Proportion ◽

Joint Inflammation ◽

Joint Involvement ◽

Contrast Enhanced Ultrasound ◽

Continuous Therapy ◽

Clinical Variables ◽

Contrast Enhanced ◽

Before And After ◽

One Year

Background. We wanted to verify retrospectively the proportion of patients with psoriatic arthritis who were in remission after 1 year of continuous therapy with either etanercept or adalimumab. Remission was defined as the absence of both clinical and contrast-enhanced ultrasound (CEUS) findings suggestive of joint inflammation. Patients and Methods. The data of twenty-five patients with psoriatic arthritis were available for the clinical and CEUS evaluations before and after 1 year of continuous therapy with etanercept or adalimumab. The count of swollen (ACR66), tender (ACR68), and active inflamed joints (AJC) was used to measure the severity of joint involvement. PASI was used to score the severity of psoriasis. HAQ, DLQI, VAS pain, and VAS itching were administered to each patient before starting therapy and every 3 months, up to 1 year. Results. Eight (32%) out of twenty-five patients were in remission after 1 year of therapy with etanercept or adalimumab. A significant reduction of all clinical variables analysed was seen during the course of therapy. Conclusion. Although a significant proportion of patients achieved remission of arthritis after 1 year of effective anti-TNF therapy, the majority of them continued to have either clinical or CEUS findings suggestive of persistence of joint inflammation.

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Contrast-Enhanced Ultrasound Evaluation of Mifepristone for Treatment of Low-Risk Cesarean Scar Pregnancy

Contrast Media & Molecular Imaging ◽

10.1155/2020/3725353 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Xi Xiong ◽

Chun-yan Gao ◽

De-mei Ying ◽

Ping Yan ◽

Zhi-jia Zhang ◽

...

Keyword(s):

Effective Treatment ◽

Low Risk ◽

Contrast Enhanced Ultrasound ◽

Intrauterine Pregnancy ◽

Cesarean Scar Pregnancy ◽

Cesarean Scar ◽

Ultrasound Evaluation ◽

Contrast Enhanced ◽

Significant Difference ◽

Before And After

Purpose. The effect of mifepristone for treatment of low-risk cesarean scar pregnancy (CSP) was monitored by contrast-enhanced ultrasound (CEUS). Methods. Data were collected from 23 CSP patients with a 10-point risk score <5 (low-risk CSP) and from 23 intrauterine pregnancy (IUP) patients with a scar from a previous cesarean delivery. All patients were prescribed 75 mg mifepristone daily for 2 days and underwent transvaginal CEUS before and after administration of mifepristone. On the third day, uterine curettage was performed after transvaginal CEUS. Arrival time (AT), peak intensity (PI), and area under the curve (AUC) around the gestational sac were monitored by CEUS before and after application of mifepristone, and the rate of effective treatment was compared between the two patient groups. Results. No patients experienced side effects from either the CEUS procedure or the mifepristone treatment. Changes in AT, PI, and AUC index from before vs. after mifepristone treatment did not differ significantly between the two groups (all p values >0.05). There was also no significant difference in the rate of effective treatment between the two groups (95.65% in the CSP group vs. 100% in the IUP group; p > 0.05 ). Conclusions. Based on monitoring by CEUS, the effect of mifepristone in low-risk CSP was comparable to that in IUP.

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Perfusion controls muscle glucose uptake by altering the rate of glucose dispersion in vivo

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.00260.2019 ◽

2019 ◽

Vol 317 (6) ◽

pp. E1022-E1036 ◽

Cited By ~ 3

Author(s):

P. Mason McClatchey ◽

Ian M. Williams ◽

Zhengang Xu ◽

Nicholas A. Mignemi ◽

Curtis C. Hughey ◽

...

Keyword(s):

Flow Velocity ◽

Glucose Uptake ◽

Contrast Enhanced Ultrasound ◽

Capillary Perfusion ◽

Capillary Recruitment ◽

Intravenous Insulin ◽

Regional Flow ◽

Contrast Enhanced ◽

Before And After

These studies test, using intravital microscopy (IVM), the hypotheses that perfusion effects on insulin-stimulated muscle glucose uptake (MGU) are 1) capillary recruitment independent and 2) mediated through the dispersion of glucose rather than insulin. For experiment 1, capillary perfusion was visualized before and after intravenous insulin. No capillary recruitment was observed. For experiment 2, mice were treated with vasoactive compounds (sodium nitroprusside, hyaluronidase, and lipopolysaccharide), and dispersion of fluorophores approximating insulin size (10-kDa dextran) and glucose (2-NBDG) was measured using IVM. Subsequently, insulin and 2[14C]deoxyglucose were injected and muscle phospho-2[14C]deoxyglucose (2[C14]DG) accumulation was used as an index of MGU. Flow velocity and 2-NBDG dispersion, but not perfused surface area or 10-kDa dextran dispersion, predicted phospho-2[14C]DG accumulation. For experiment 3, microspheres of the same size and number as are used for contrast-enhanced ultrasound (CEU) studies of capillary recruitment were visualized using IVM. Due to their low concentration, microspheres were present in only a small fraction of blood-perfused capillaries. Microsphere-perfused blood volume correlated to flow velocity. These findings suggest that 1) flow velocity rather than capillary recruitment controls microvascular contributions to MGU, 2) glucose dispersion is more predictive of MGU than dispersion of insulin-sized molecules, and 3) CEU measures regional flow velocity rather than capillary recruitment.

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The Clinical Value of Extracorporeal Shock Wave Therapy Evaluated by Contrast-Enhanced Ultrasound for Noninfectious Nonunion

Journal of Medical Imaging and Health Informatics ◽

10.1166/jmihi.2021.3652 ◽

2021 ◽

Vol 11 (8) ◽

pp. 2080-2085

Author(s):

Yinfeng Hu ◽

Xuewen Jia ◽

Yingchun Zhu ◽

Youfeng Xu ◽

Minhua Guo ◽

...

Keyword(s):

Shock Wave ◽

Extracorporeal Shock Wave Therapy ◽

Healing Time ◽

Contrast Enhanced Ultrasound ◽

Shock Wave Therapy ◽

Clinical Value ◽

Extracorporeal Shock Wave ◽

Contrast Enhanced ◽

Before And After ◽

Bone Nonunion

Objectives: The aim of this study was to investigate the clinical value of Contrast-enhanced ultrasound (CEUS) in evaluating Extracorporeal shock wave therapy (ESWT) for noninfectious nonunion. Methods: Thirty-eight patients with long bone nonunion fractures whose were treated in our hospital from October 2016 to October 2019 were included (20 males and 18 females). The patients received ESWT once a week for 12 consecutive weeks. CEUS was performed before and after the first ESWT session. According to the ratio of the perfusion area to the callus area, neovascular blood flow observed in CEUS was divided into 4 grades: grade 0 = 0%, grade 1 = 0–30%, grade 2 = 30–70% and grade 3 = 70–100%. The peak values of microbubbles perfusion in the callus area were recorded before and after ESWT. Each patient was followed up for 12 months to record the healing time. Nonunion over 12 months was considered a nonhealing fracture. To compare the ultrasonic data before and after ESWT, paired T test was used and the correlation between the ultrasonic data and the nonunion healing time, the pearson analysis was used. Results: Of the 38 patients, 35 patients achieved nonunion healing. The healing time ranged from 5 months to 12 months. Among the 38 patients, 24 patients had a microvascular health score of 0 points and 14 patients had a score of 1 point before treatment. After therapy, the neovascular health score was 0, 1, 2 and 3 in 5, 10, 15 and 8 patients, respectively. There was a statistically significant difference before and after treatment (P < 0.05). The peak value of microbubbles perfusion in the fracture site after ESWT was significantly higher than that before ESWT (P < 0.05). The greater of difference, the shorter of healing time. Conclusion: Under the supervision of CEUS, the changes in microvascular perfusion of noninfectious nonunion patients before and after ESWT effectively reflected the therapeutic effect. CEUS could predict the ESWT on bone nonunion at an early stage. Level of evidence: Level III.

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Contrast-enhanced ultrasound in uterine artery embolization treatment of cesarean scar pregnancy

Journal of International Medical Research ◽

10.1177/0300060520980217 ◽

2020 ◽

Vol 48 (12) ◽

pp. 030006052098021

Author(s):

Dongmei Liu ◽

Xiaoning Gu ◽

Fang Liu ◽

Fuwen Shi ◽

Min Yang

Keyword(s):

Uterine Artery Embolization ◽

Uterine Artery ◽

Transvaginal Ultrasound ◽

Contrast Enhanced Ultrasound ◽

Artery Embolization ◽

Time Intensity Curve ◽

Cesarean Scar Pregnancy ◽

Cesarean Scar ◽

Contrast Enhanced ◽

Myometrial Thickness

Objective The current study aimed to investigate the application of contrast-enhanced ultrasound (CEUS) in diagnosis and treatment of cesarean scar pregnancy (CSP). Methods A retrospective study was performed in 35 patients with clinically suspected CSP who requested termination of pregnancy and underwent contrast-enhanced ultrasound (CEUS). The patients were classified into two groups on the basis of whether they received uterine artery embolization (UAE). The CEUS characteristics of the two groups were reviewed. Results CEUS features of CSP were early enhancement of the cesarean scar and continuous infusion of contrast agent between the gestational sac and cesarean scar. Myometrial thickness in the cesarean scar was thinner in the UAE group than in the non-UAE group by CEUS and transvaginal ultrasound. Myometrial thickness measured by CEUS was thinner than that measured by transvaginal ultrasound in both groups. The parameters of the time-intensity curve in the UAE group were characterized by a faster arrival time, shorter time to peak, higher peak intensity, and greater enhancement rate compared with the non-UAE group. Conclusions CEUS may be a novel supplementary method to diagnose and assess CSP, and to help evaluate whether UAE is required.

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