Incidentally Detected Splenic Lesions in Ultrasound: Does Contrast-Enhanced Ultrasonography Improve the Differentiation of Benign Hemangioma/Hamartoma from Malignant Lesions?

2011 ◽  
Vol 32 (06) ◽  
pp. 582-592 ◽  
Author(s):  
A. Stang ◽  
H. Keles ◽  
S. Hentschke ◽  
C.-U. von Seydewitz ◽  
J. Dahlke ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Sulfur Hexafluoride ◽  
Multivariate Analyse ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
Malignant Lesions

Zusammenfassung Ziel: Ziele dieser Arbeit waren die Identifikation und die Validierung von unterschiedlichen tumorspezifischen Kontrastmittelmustern für die Differenzialdiagnose zwischen benignen vaskulären Neoplasien (Typ Hämangiom/Hamartom) und malignen Milzherden in der Kontrastmittelsonografie (CEUS). Material und Methoden: 136 Milzläsionen (58 benigne vaskuläre Neoplasien, 78 maligne Läsionen) wurden jeweils in der B-Bild-Sonografie (US) und nachfolgend in der Kontrastmittelsonografie nach Sulfur-Hexafluoride-Injektion untersucht und dokumentiert. Zwei On-site-Reader analysierten das Kontrastmittelverhalten der Milzläsionen während der arteriellen und parenchymalen Phase. Mittels univariater und multivariater Analyse wurden tumorspezifische Kontrastmittelmuster, die signifikant mit einer der beiden Tumordiagnosen korreliert waren, identifiziert. Zwei geblindete Off-site-Reader benutzten diese tumorspezifischen Kontrastmittelmuster als Diagnosekriterien und stellten unabhängig voneinander anhand der Befunde der B-Bild-Sonografie und der Kontrastmittelsonografie eine Diagnose der Milzherde. Die diagnostische Treffsicherheit und Confidence (Az-Werte) sowie die Übereinstimmung der Off-site-Reader (қ-Werte) wurden kalkuliert. Referenzstandards waren Histopathologie oder CT und/oder MRI mit klinischem Verlauf. Ergebnisse: In der multivariate Analyse waren arterielles Hyper- oder Isoenhancement unabhängige Prediktoren für eine benigne vaskuläre Neoplasie (Odds Ratio, 3,558; p < 0,0017). In der Subgruppe der iso- oder hypoechogenen Läsionen war arterielles Hyperenhancement praktisch beweisend für eine benigne vaskuläre Neoplasie (Odds Ratio, 21,333; p < 0,001). In der geblindeten Situation verbesserte sich die diagnostische Treffsicherheit und Confidence (Az-Werte) für beide Off-site Reader signifikant von 63,2 % und 70,6 % (0,785 und 0,818) in der B-Bild-Sonografie auf 87,5 % und 88,2 % (0,915 und 0,908) in der Kontrastmittelsonografie (p < 0,001). Die Interreaderübereinstimmung verbesserte sich ebenfalls (қ = 0,52 für B-Bild-Sonografie vs. қ = 0,88 nach Kontrastmittelsonografie). Schlussfolgerung: Die Kontrastmittelsonografie verbessert die Differenzialdiagnose zwischen benigen vaskulären Neoplasien und malignen Tumoren in der Milz und scheint besonders hilfreich bei unklaren, zufällig im Ultraschall entdeckten hypoechogenen Milzherden.

MO226A NEW DIAGNOSTIC TOOL FOR CKD PATIENTS: CONTRAST-ENHANCED ULTRASONOGRAPHY. A SINGLE CENTER EXPERIENCE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Mirela Liana Gliga ◽  
Cristian Chirila ◽  
Paula Chirila ◽  
Adriana Gomotarceanu ◽  
Imola Torok ◽  
...  
Keyword(s):  
Diagnostic Tool ◽  
Final Diagnosis ◽  
Medical System ◽  
Focal Lesions ◽  
Non Invasive ◽  
Single Center Experience ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
Malignant Lesions ◽  
Guidelines And Recommendations

Abstract Background and Aims Contrast-enhanced ultrasonography (CEUS) is a minimally invasive diagnostic tool available for diagnosing microvascular disturbances in tumors and many vascular pathologies. Unlike other radiological contrast agents, it is completely harmless for CKD patients and therefore it is used for the safe diagnosis of many diffuse or focal pathologies. Method We used CEUS examination in 50 CKD patients for the following pathologies: 10 atypical cysts, 15 liver focal lesions, 2 splenic focal lesions, 3 renal infarcts, 12 kidney focal lesions and 8 other organ involvements. Examination was made using a VOLUSON E8 machine (GE Medical System Kreztechnik GmbH Tiefenbach 15, Austria) with a 3.5 MHz convex array abdominal transducer. 2.4 ml of microbubble contrast-agent was administered intravenously and recording of the results were made for 3-5 minutes after injection. Results Depending on the organ vascular characteristics, contrast enhancement and/or wash-out were suggestive for the final diagnosis. In liver lesions there are three phases and in kidneys, spleen, gallbladder, adenopathies there are two vascular phases. We obtained a very good positive predictive value and sensitivity in detecting malignant lesions. Conclusion According to The EFSUMB Guidelines and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound they are used both for hepatic and Non-Hepatic Applications. Being non-invasive and non-irradiating it could be the main diagnostic examination in CKD population in the future.

scholarly journals Contrast-enhanced ultrasonography features of hepatobiliary neoplasms in cats

2019 ◽  
Vol 186 (10) ◽  
pp. 320-320 ◽  
Author(s):  
Tommaso Banzato ◽  
Silvia Burti ◽  
Giuseppe Rubini ◽  
Riccardo Orlandi ◽  
Paolo Bargellini ◽  
...  
Keyword(s):  
Bile Duct ◽  
Diagnostic Accuracy ◽  
Large Range ◽  
Liver Parenchyma ◽  
Qualitative And Quantitative ◽  
Hepatocellular Carcinomas ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
Malignant Lesions

BackgroundContrast-enhanced ultrasonography (CEUS) features of primary hepatobiliary neoplasms have been reported in dogs but no information is available in cats.MethodsQualitative and quantitative features of bile duct adenomas (BDAs, n=20), bile duct carcinomas (BDCs, n=16), and hepatocellular carcinomas (HCCs, n=8) are described in 44 cats.ResultsThere was an overlap in CEUS qualitative features between different histotypes, both in wash-in and wash-out phases. Distinction between different neoplasms based only on the CEUS qualitative features was not possible. At peak of enhancement, the BDAs, BDCs and HCCs showed a large range of echogenicities, from hypoenhancement to hyperenhancement, in comparison to the liver parenchyma. Eight of 20 BDAs showed inhomogeneous hyperenhancement during wash-in, which is a feature reported as typical of malignant lesions in dogs. BDC had a significantly faster wash-in compared with both BDA and HCC but the diagnostic accuracy of all the included quantitative variables was only moderate. No significant differences in the wash-out quantitative features of BDA and BDC were evident.ConclusionThere is poor evidence that CEUS may be used to distinguish between different primary hepatobiliary neoplasms in cats.

scholarly journals The Use of Contrast-Enhanced Ultrasonography for the Characterization of Focal Liver Lesions

2017 ◽  
Vol 33 (6) ◽  
pp. 500-511
Author(s):  
Jennifer E. Bagley ◽  
Dennis E. Paul ◽  
Sutton Halferty ◽  
Dora DiGiacinto
Keyword(s):  
High Sensitivity ◽  
Diagnostic Process ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Benign Lesions ◽  
Underlying Liver Disease ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
Malignant Lesions

Focal liver lesions often occur with or without an underlying liver disease. Contrast-enhanced ultrasonography can aid in characterizing liver lesions, potentially avoiding biopsy and computed tomography procedures. Contrast-enhanced ultrasonography has a high sensitivity and specificity for differentiating characteristics of liver lesions compared with noncontrast sonography. The different contrast characteristics aid in differentiating benign and malignant lesions. Malignant lesions tend to have washout of contrast in the venous phases, whereas benign lesions have hyperenhancement during the venous phases. Therefore, contrast-enhanced ultrasonography should be considered an essential component of the diagnostic process for diagnosing and following focal liver lesions.

New Aspects Concerning Sulphur Hexafluoride Use As Contrast Agent for Ultrasonographyc Diagnosis

2017 ◽  
Vol 68 (2) ◽  
pp. 250-254
Author(s):  
Oana Timofte ◽  
Gabriela Stefanescu ◽  
Elena Gologan ◽  
Gheorghe G. Balan ◽  
Elena Toader ◽  
...  
Keyword(s):  
Contrast Agent ◽  
Focal Liver Lesions ◽  
European Federation ◽  
Liver Lesions ◽  
Sulphur Hexafluoride ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
Examination Techniques ◽  
Malignant Lesions

Introduction of contrast agents as microbubbles and to improve ultrasound examination techniques has increased the rate of detection and characterization of liver lesions. Contrast-enhanced ultrasonography (CEUS) is a relatively new method of exploring the liver and diagnosing focal liver lesions (FLL). The aim of this study is to determine the efficiency of microbubbles used for CEUS in managing patients detected in conventional ultrasonography with FLL. We examined 84 patients with FLL, detected on conventional ultrasonography (US), during October 2012-September 2015. We performed contrast-enhanced ultrasonography, using sulphur hexafluoride as a contrast agent, and contrast-enhanced MRI to set the diagnosis. For 37 patients (44.1%) CEUS showed a malignity pattern of enhancement (according to the EFSUMB - European Federation of Societies for Ultrasound in Medicine and Biology- Guidelines 2012), while for 54 (64.3%) patients MRI set the diagnosis of malignity. CEUS detected fewer malignant lesions than MRI, in 20.1% of the cases MRI set de diagnosis. We need further studies in order to improve the quality of CEUS images and technique.

scholarly journals Contrast-Enhanced Ultrasonography in the Diagnosis and Treatment Modulation of Breast Cancer

2021 ◽  
Vol 11 (2) ◽  
pp. 81
Author(s):  
Ioana Boca (Bene) ◽  
Sorin M. Dudea ◽  
Anca I. Ciurea
Keyword(s):  
Breast Cancer ◽  
High Performance ◽  
Axillary Staging ◽  
Imaging Method ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
Malignant Lesions

The aim of this paper is to highlight the role of contrast-enhanced ultrasound in breast cancer in terms of diagnosis, staging and follow-up of the post-treatment response. Contrast-enhanced ultrasound (CEUS) is successfully used to diagnose multiple pathologies and has also clinical relevance in breast cancer. CEUS has high accuracy in differentiating benign from malignant lesions by analyzing the enhancement characteristics and calculating the time-intensity curve’s quantitative parameters. It also has a significant role in axillary staging, especially when the lymph nodes are not suspicious on clinical examination and have a normal appearance on gray-scale ultrasound. The most significant clinical impact consists of predicting the response to neoadjuvant chemotherapy, which offers the possibility of adjusting the therapy by dynamically evaluating the patient. CEUS is a high-performance, feasible, non-irradiating, accessible, easy-to-implement imaging method and has proven to be a valuable addition to breast ultrasound.

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