The Value of Contrast-Enhanced Ultrasound in the Diagnosis of Cesarean Scar Pregnancy

Objective. To evaluate the value of contrast-enhanced ultrasound (CEUS) in the cesarean scar pregnancy (CSP).Methods. Clinical data from 92 patients with lower uterine segment pregnancy, who underwent conventional ultrasound and CEUS examination in the Department of Obstetrics and Gynecology, were collected by Xinqiao Hospital Third Military Medical University from March 2014 to March 2015. The parameters of ultrasound contrast time-intensity curve (TIC), including arrival time, time to peak, time from peak to one half, basic intensity, peak intensity, and wash-in slope, were analyzed.Results. Of the 92 cases of patients with pregnancy in the lower uterine segment, 52 cases were CSP, and 40 cases were intrauterine pregnancy. CEUS was significantly better than conventional ultrasound in terms of sensitivity, negative predictive value, Youden index, and diagnostic accuracy (P<0.05). There was no significant difference in specificity and positive predictive value (P>0.05).Conclusion. CEUS has a higher accuracy than conventional ultrasound in diagnosis of CSP.

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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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Contrast-enhanced ultrasound performance in predicting blunt splenic injuries requiring only observation and monitoring

Medical Ultrasonography ◽

10.11152/mu-1700 ◽

2019 ◽

Vol 21 (1) ◽

pp. 16 ◽

Cited By ~ 2

Author(s):

Corrado Tagliati ◽

Giulio Argalia ◽

Gian Marco Giuseppetti

Keyword(s):

Predictive Value ◽

Imaging Modality ◽

Splenic Trauma ◽

Trauma Patients ◽

Contrast Enhanced Ultrasound ◽

True Negative ◽

Contrast Enhanced ◽

Blunt Splenic Trauma ◽

Conventional Ultrasound

Aims: To assess contrast enhanced ultrasound (CEUS) performance in the prediction of non-operatively managed blunt spleen injuries requiring only observation and monitoring during follow-up and to evaluate if CEUS accuracy was higher than conventional ultrasound (US) in this field.Material and methods: In 112 hemodynamic stable blunt spleen trauma patients, CEUS was performed for follow-up after computed tomography evaluation in the emergency department. CEUS and US performance were assessed considering as true negative cases patients that had not underwent interventional or surgical treatment during follow-up and were assessed as negative for splenic complications respectively by CEUS or US examinations.Results: CEUS showed sensitivity of 100%, specificity of 96.1%, positive predictive value of 69.2%, negative predictive value of 100.0% and accuracy of 96.4%. CEUS showed a significantly higher accuracy than conventional US (p=0.013).Conclusions: CEUS is a very useful imaging modality during follow-up of blunt splenic trauma non-operatively managed, allowing an efficientprediction of splenic injuries requiring only observation and monitoring during follow-up.

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Efficacy of contrast-enhanced ultrasound for diagnosis of cesarean scar pregnancy type

Medicine ◽

10.1097/md.0000000000017741 ◽

2019 ◽

Vol 98 (44) ◽

pp. e17741 ◽

Cited By ~ 3

Author(s):

Yun Wu ◽

Liuying Zhou ◽

Lin Chen ◽

Qian Zhou ◽

Tao Zeng

Keyword(s):

Contrast Enhanced Ultrasound ◽

Cesarean Scar Pregnancy ◽

Cesarean Scar ◽

Contrast Enhanced

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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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Real-time monitoring of contrast-enhanced ultrasound for radio frequency ablation

Open Medicine ◽

10.1515/med-2017-0066 ◽

2017 ◽

Vol 12 (1) ◽

pp. 474-480 ◽

Cited By ~ 1

Author(s):

Jiangwei Liu ◽

Yan Liu ◽

Jianzhao Huang ◽

Lei Huang ◽

Pengwei Zhao

Keyword(s):

Radio Frequency ◽

Real Time ◽

Radio Frequency Ablation ◽

Contrast Enhanced Ultrasound ◽

Liver Model ◽

Horizontal Diameter ◽

Contrast Enhanced ◽

Significant Difference ◽

Swine Liver ◽

Conventional Ultrasound

AbstractBackgroundThis study compared the realtime monitoring effects of conventional ultrasound and contrast-enhanced ultrasound (CEUS) on evaluating radio frequency ablation (RFA) in a living swine liver model.MethodologyLiver RFA was performed on 10 young swine. Conventional ultrasound and CEUS were performed immediately. After the animals were sacrificed, ablation lesions were removed to histopathologically examine the range of the lesions. Ablation completeness based on three methods were compared using histopathology as the gold standard.ResultsForty-three ablation lesions were produced in the animals. The horizontal diameter, vertical diameter and ablation lesion area based on conventional ultrasound were all significantly smaller than those based on the gross sample, but no significant differences existed between the results of the CEUS and the gross sample. Histopathology showed that 30 lesions were incompletely ablated and 13 were completely ablated, while CEUS showed that 28 lesions were incompletely ablated and 15 were completely ablated. Compared with histopathology, CEUS had an accuracy of 81.4%, a sensitivity of 83.3%, and a specificity of 76.9%. No significant difference in ablation completeness judgment between CEUS and histopathology was observed.ConclusionCEUS provides a real-time radiological foundation for evaluating RFA lesion ranges and completeness in a living swine liver model.

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Predictive value of contrast-enhanced ultrasound combined with conventional ultrasound in solid renal parenchymal lesions

British Journal of Radiology ◽

10.1259/bjr.20210518 ◽

2021 ◽

pp. 20210518

Author(s):

Yingyu Cai ◽

Fan Li ◽

Zhaojun Li ◽

Xin Li ◽

Chunxiao Li ◽

...

Keyword(s):

Logistic Regression ◽

Predictive Value ◽

Contrast Enhanced Ultrasound ◽

Counting Method ◽

Scoring Method ◽

Renal Lesions ◽

Contrast Enhanced ◽

Risk Of Malignancy ◽

Conventional Ultrasound ◽

Ultrasound Features

Objective: This study aimed to develop a model to predict the risk of malignancy in solid renal parenchymal lesions based on the imaging features of combined conventional and contrast-enhanced ultrasound (CEUS). Methods: A retrospective review was performed among patients with focal solid renal parenchymal lesions on ultrasound images. Ultrasound features were characterized by two experienced radiologists independently. A multiple logistic regression analysis was performed to determine the most relevant features and to estimate the risk of malignancy. Scoring and counting methods were developed based on the most relevant features. The diagnostic performance was evaluated by the sensitivity, specificity, positive predictive value, negative predictive value and area under the receiver operating characteristic curve (AUC). Results: A total of 519 renal lesions were included in this study. The conventional ultrasound features of diameter, echogenicity, hypoechoic rim and the CEUS feature of heterogeneity were identified as the most relevant features for prediction of malignancy. The sensitivity and specificity for the logistic regression model, the scoring method and the counting method were 95.3 and 93.4%, 93.8 and 87.8%, 88.8 and 93.9%, respectively. The logistic model had the best performance for diagnosing malignant renal lesions with AUC of 0.978, compared with the scoring method and the counting method with AUCs of 0.958 and 0.965. Conclusion: The combination of contrast-enhanced ultrasound with conventional ultrasound improved the diagnostic performance of solid renal lesions based on the logistic regression model. Advances in knowledge: In this study, we revealed that the combination of CEUS and conventional ultrasound provided higher accuracy for diagnosing malignant renal tumors.

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The Role of Contrast-Enhanced Ultrasound in Selection Indication and Improveing Diagnosis for Transthoracic Biopsy in Peripheral Pulmonary and Mediastinal Lesions

BioMed Research International ◽

10.1155/2015/231782 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Song Wang ◽

Wei Yang ◽

Hui Zhang ◽

Qian Xu ◽

Kun Yan

Keyword(s):

Imaging Features ◽

Contrast Enhanced Ultrasound ◽

Accuracy Rate ◽

Pulmonary Atelectasis ◽

Contrast Enhanced ◽

Significant Difference ◽

Peripheral Lung ◽

Transthoracic Biopsy ◽

Conventional Ultrasound

Objective. To investigate the value of contrast-enhanced ultrasound (CEUS) in transthoracic biopsy of peripheral lung and mediastinal lesions.Methods. Of 142 patients, 82 patients received CEUS before biopsy and were defined as CEUS group. The remaining 60 patients only underwent conventional ultrasound (US) before biopsy and were served as US group. The information of CEUS was used for selecting indication and instructing biopsy. The imaging features, number of punctures, diagnostic successful rate, and complication rate between the two groups were compared.Results. Necrosis was demonstrated in 43.9% of the lesions in CEUS group and in 6.7% of US group (P<0.001). Detection rate of lesion hidden in pulmonary atelectasis in CEUS group was 13.4%, which was statistically higher than 1.7% of US group (P=0.013). The diagnostic success rate was 96.3% for CEUS group and 80% for US group, respectively (P=0.002). The average number of punctures was2.5±0.7and2.6±0.6, respectively. There was no significant difference in complications between CEUS group and US group.Conclusions. CEUS could play an important role in selecting proper indication and improving diagnostic accuracy rate of lung biopsy.

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Contrast-Enhanced Ultrasound in the Short-Term Evaluation of Hepatocellular Carcinoma after Locoregional Treatment

Digestive Diseases ◽

10.1159/000506455 ◽

2020 ◽

Vol 38 (6) ◽

pp. 522-533

Author(s):

Maria Elena Ainora ◽

Roberto Iezzi ◽

Francesca Romana Ponziani ◽

Matteo Garcovich ◽

Enrico Di Stasio ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Predictive Value ◽

Combined Treatment ◽

Residual Tumor ◽

Percutaneous Ethanol Injection ◽

Locoregional Therapy ◽

Contrast Enhanced Ultrasound ◽

Ethanol Injection ◽

Contrast Enhanced ◽

Significant Difference

Background: Contrast-enhanced ultrasound (CEUS) with second-generation contrast agents performed 1 month after hepatocellular carcinoma (HCC) treatment is almost as sensitive as contrast-enhanced computed tomography (CECT) in depicting the residual tumor. However, the efficacy of CEUS performed early after the procedure is still debated. Aim: We evaluated the diagnostic accuracy (DA) of CEUS for the assessment of tumor response shortly after locoregional therapy in patients with unresectable HCC. Methods: Ninety-four patients with 104 HCC lesions who were scheduled to receive percutaneous ethanol injection, radiofrequency ablation, transcatheter arterial chemoembolization, or combined treatment were enrolled in this study. With CECT at 1-month as the reference standard, the DA of CEUS performed 48-h after the procedure was evaluated. Patients were followed-up to look for tumor or disease progression. Results: Based on CECT findings, 43/104 lesions were diagnosed as having residual viability after 1 month. CEUS performed 48 h after treatment detected residual tumor in 34/43 nodules with treatment failure at CECT with a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 79.1, 96.7, 94.4, 86.8, and 89%, respectively. There was a high degree of concordance between CEUS and CECT (kappa coefficient = 0.78). A hyperemic halo was detectable in 35 lesions without a statistically significant difference between concordant and discordant cases. In patients with uninodular disease responders according to 48 h CEUS had a significantly longer mean overall survival and time to progression compared to nonresponders. Conclusion: CEUS performed 48 h after treatment can be considered a reliable modality for the evaluation of the real extent of necrosis and has prognostic value in the assessment of HCC.

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