EFSUMB Recommendations for Gastrointestinal Ultrasound Part 3: Endorectal, Endoanal and Perineal Ultrasound

AbstractThis article represents part 3 of the EFSUMB Recommendations and Guidelines for Gastrointestinal Ultrasound (GIUS). It provides an overview of the examination techniques recommended by experts in the field of endorectal/endoanal ultrasound (ERUS/EAUS), as well as perineal ultrasound (PNUS). The most important indications are rectal tumors and inflammatory diseases like fistula and abscesses in patients with or without inflammatory bowel disease (IBD). PNUS sometimes is more flexible and convenient compared to ERUS. However, the technique of ERUS is quite well established, especially for the staging of rectal cancer. EAUS also gained ground in the evaluation of perianal diseases like fistulas, abscesses and incontinence. For the staging of perirectal tumors, the use of PNUS in addition to conventional ERUS could be recommended. For the staging of anal carcinomas, PNUS can be a good option because of the higher resolution. Both ERUS and PNUS are considered excellent guidance methods for invasive interventions, such as the drainage of fluids or targeted biopsy of tissue lesions. For abscess detection and evaluation, contrast-enhanced ultrasound (CEUS) also helps in therapy planning.

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Abdominal Contrast Enhanced Ultrasound, A Practical Review

Internal Medicine ◽

10.2478/inmed-2019-0092 ◽

2019 ◽

Vol 16 (6) ◽

pp. 37-46

Author(s):

Adina Cociorvei

Keyword(s):

Severe Respiratory Failure ◽

Contrast Enhanced Ultrasound ◽

Peripheral Vein ◽

Intravenous Contrast ◽

Contrast Enhanced ◽

Bowel Diseases ◽

Conventional Ultrasound ◽

Inflammatory Bowel ◽

Hepatic Lesions ◽

The One

AbstractAbdominal contrast enhanced ultrasound (CEUS) is a relatively new investigation method that combines conventional ultrasound with a small amount of intravenous contrast through a peripheral vein (usually the cubital vein). The contrast is made by very small gas microbubbles floating in a phospholipid suspension. The size of microbubbles are between 1-10 micrometers, being to large to go out of the vessels, but sufficiently small to stay into the capillaries, and this is the reason for they can be used as vascular tracers. So, it is possible to obtain images with microvessels inside of different organs in different vascular phases (arterial, portal, venous), images that are similar with the one obtained in CECT and CEMRI.The intravenous contrast used in CEUS eliminates trough the lungs, during expiration. These is the reason why the most important contraindication for using iv contrast is severe respiratory failure. Also, it is important that intravenous contrast is not allergenic, the percentage of allergic reaction being extremly small (0,001%).The most important advantages of CEUS are:• It can be safely used for the pacients that are allergic to intravenous contrast used in CECT and CEMRI;• It can be used in pacients with chronic kidney disease;Abdominal contrast enhanced ultrasound is used in day-to-day practice mainly for evaluation of hepatic lesions, but also for pancreatic, kidney, testis pathology, as well as for inflammatory bowel diseases.

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Quantitative contrast-enhanced ultrasound for monitoring vedolizumab therapy in inflammatory bowel disease patients: a pilot study

Acta Radiologica ◽

10.1177/0284185117752032 ◽

2018 ◽

Vol 59 (10) ◽

pp. 1149-1156 ◽

Cited By ~ 3

Author(s):

Ruediger S Goertz ◽

Daniel Klett ◽

Dane Wildner ◽

Raja Atreya ◽

Markus F Neurath ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Bowel Wall ◽

Color Doppler ◽

Response To Treatment ◽

Clinical Activity ◽

Contrast Enhanced Ultrasound ◽

Software Analysis ◽

Contrast Enhanced ◽

Inflammatory Bowel

Background Microvascularization of the bowel wall can be visualized and quantified non-invasively by software-assisted analysis of derived time-intensity curves. Purpose To perform software-based quantification of bowel wall perfusion using quantitative contrast-enhanced ultrasound (CEUS) according to clinical response in patients with inflammatory bowel disease treated with vedolizumab. Material and Methods In a prospective study, in 18 out of 34 patients, high-frequency ultrasound of bowel wall thickness using color Doppler flow combined with CEUS was performed at baseline and after 14 weeks of treatment with vedolizumab. Clinical activity scores at week 14 were used to differentiate between responders and non-responders. CEUS parameters were calculated by software analysis of the video loops. Results Nine of 18 patients (11 with Crohn’s disease and seven with ulcerative colitis) showed response to treatment with vedolizumab. Overall, the responder group showed a significant decrease in the semi-quantitative color Doppler vascularization score. Amplitude-derived CEUS parameters of mural microvascularization such as peak enhancement or wash-in rate decreased in responders, in contrast with non-responders. Time-derived parameters remained stable or increased during treatment in all patients. Conclusion Analysis of bowel microvascularization by CEUS shows statistically significant changes in the wash-in-rate related to response of vedolizumab therapy.

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Combining contrast-enhanced ultrasound, CT perfusion and 99mTc-Sestamibi SPECT/CT to guide diagnosis in a case of solid renal tumour

BJR|case reports ◽

10.1259/bjrcr.20200115 ◽

2020 ◽

pp. 20200115

Author(s):

Georgios Kalarakis ◽

Katharina Brehmer ◽

Anders Svensson ◽

Rimma Axelsson ◽

Torkel B Brismar ◽

...

Keyword(s):

Ct Perfusion ◽

Added Value ◽

Renal Tumour ◽

Contrast Enhanced Ultrasound ◽

Renal Lesions ◽

Ultrasound Contrast ◽

Contrast Enhanced ◽

Renal Tumours ◽

Examination Techniques ◽

99Mtc Sestamibi

Definitive, pre-operative differentiation of solid renal lesions by ultrasound, contrast-enhanced multiphasic CT or MRI examinations is often not possible. An increasing amount of literature indicates the added value of 99mTc-Sestamibi SPECT/CT, CT perfusion and contrast-enhanced ultrasound in the pre-operative characterisation of solid renal tumours. This case report presents the diagnostic approach of a solid renal tumour that turned out to be a hybrid oncocytic chromophobe tumour in a patient with Stage 3 renal failure by combining the three aforementioned modern examination techniques.

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USE OF CONTRAST-ENHANCED ULTRASOUND FOR CHRONIC INFLAMMATORY BOWEL DISEASE

Revista Española de Enfermedades Digestivas ◽

10.17235/reed.2020.7499/2020 ◽

2020 ◽

Author(s):

Berta de las Heras Páez de la Cadena ◽

Ana Martín Algíbez ◽

Ana Martín Algíbez

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Chronic Inflammatory Bowel Disease ◽

Contrast Enhanced Ultrasound ◽

Contrast Enhanced ◽

Inflammatory Bowel ◽

Chronic Inflammatory Bowel

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Value of Contrast-Enhanced Ultrasound in Differential Diagnosis of Focal Liver Lesions

Medical Visualization ◽

10.24835/1607-0763-905 ◽

2021 ◽

Vol 25 (2) ◽

pp. 84-89

Author(s):

S. E. Dubrova

Keyword(s):

Inflammatory Bowel Diseases ◽

Scientific Data ◽

Focal Liver Lesions ◽

Web Pages ◽

Liver Lesions ◽

Contrast Enhanced Ultrasound ◽

Diagnostic Measures ◽

Contrast Enhanced ◽

Bowel Diseases ◽

Inflammatory Bowel

The article discusses the modern possibilities of identifying inflammatory bowel diseases using methods of radiation diagnosis. Methods of radiation diagnostics help determine the stages of inflammatory bowel diseases helping in timely diagnosis, prescription and timely correction of therapy. The use of an adequate amount of diagnostic measures allows early detection of complications requiring immediate surgical treatment, such as fibrostenotic lesions, fistulae, and abscesses.The sources of the review were publications included in peer-reviewed databases E-library, PubMed, GoogleScholar, conference materials and non-indexed publications, including web pages of conferences and repositories of scientific data from universities.

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Role of contrast-enhanced ultrasound (CEUS) in the diagnosis of endometrial pathology

Medicine and Pharmacy Reports ◽

10.15386/cjmed-499 ◽

2015 ◽

Vol 88 (4) ◽

pp. 433-437 ◽

Cited By ~ 1

Author(s):

Ciprian Mihaita Pop ◽

Dan Mihu ◽

Radu Badea

Keyword(s):

Doppler Ultrasound ◽

Current Knowledge ◽

3D Ultrasound ◽

Modern Medicine ◽

Contrast Enhanced Ultrasound ◽

Contrast Enhanced ◽

Examination Techniques ◽

Special Examination ◽

Endometrial Pathology

AbstractUltrasound is the reference imaging procedure used for the exploration of endometrial pathology. As medical procedures improve and the requirements of modern medicine become more demanding, gray-scale ultrasound is insufficient in establishing gynecological diagnosis. Thus, more complex examination techniques are required: Doppler ultrasound, contrast-enhanced ultrasound (CEUS), 3D ultrasound, etc. Contrast-enhanced ultrasound is a special examination technique that gains more and more ground. This allows a detailed real-time evaluation of microcirculation in a certain territory, which is impossible to perform by Doppler ultrasound. The aim of this review is to synthesize current knowledge regarding CEUS applications in endometrial pathology, to detail the technical aspects of endometrial CEUS and the physical properties of the equipment and contrast agents used, as well as to identify the limitations of the method.

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Contrast-Enhanced Ultrasound in the Diagnosis of Ocular Pathology: Application Prospects

Ophthalmology in Russia ◽

10.18008/1816-5095-2021-2-216-221 ◽

2021 ◽

Vol 18 (2) ◽

pp. 216-221

Author(s):

T. N. Kiseleva ◽

A. N. Bedretdinov

Keyword(s):

Ganglion Cells ◽

Inflammatory Diseases ◽

Gene Transfection ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Abdominal Cavity ◽

Nucleic Acid Delivery ◽

Local Contrast ◽

Contrast Enhanced Ultrasound ◽

Contrast Enhanced

Contrast-enhanced ultrasound is a highly informative method for the differential diagnosis of focal changes in various organs and tissues, which allows to visualize vascular structures and obtain new previously unavailable information when using standard b-scan. At the beginning of the 21st century after the development of a new generation of contrast agents consisting of microbubbles with inert gas contrast-enhanced ultrasound became widely used to improve visual assessment of small-caliber vessels in the diagnosis of the abdominal cavity and retroperitoneal space pathology: benign and malignant liver formations, spleen pathology, inflammatory diseases and tumors of the pancreas, defects in renal perfusion, tumor and cystic lesions of the kidneys. Assessment of intraocular tumors microcirculation and diagnosis of vitreoretinal pathology are still two main directions of using contrast-enhanced ultrasound in ophthalmology. In recent years, there has been a growing interest in the use of contrast-enhanced ultrasound in the study of perfusion of different types of uveal melanoma in an animal experiment. A promising direction in the field of genetic engineering is the use of local contrast-enhanced ultrasound exposure on retinal cells (retinal ganglion cells, retinal pigment epithelium) to promote gene transfection (non-viral nucleic acid delivery into the DNA of a cell), which is an important part of gene therapy. Despite the successes achieved in the study of contrast-enhanced ultrasound effectiveness in medicine, further research is needed to increase the informative value of this method in the diagnosis of ophthalmopathology.

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