Diagnosing Gallbladder Perforation With Contrast-Enhanced Ultrasound: A Case Report

2019 ◽  
Vol 36 (3) ◽  
pp. 252-258
Author(s):  
Talisha M. Hunt ◽  
James H. Boyum

Gallbladder perforation is a rare and severe complication of acute cholecystitis. Sonography is typically the first modality of choice for assessing gallbladder pathology due to its high sensitivity, portability, real-time imaging capability, and nonionizing technique. Gray-scale and color Doppler sonographic imaging may be equivocal for diagnosing perforation. In the presented case, gallbladder wall perforation was definitively diagnosed utilizing contrast-enhanced ultrasound, allowing for prompt treatment and a successful patient outcome.

2021 ◽  
pp. 875647932110189
Author(s):  
Talisha M. Hunt ◽  
Michelle R. Waletzko ◽  
John M. Knudsen ◽  
Thomas D. Atwell ◽  
Nadia M. Chupka

Gallbladder carcinoma is rare and difficult to detect in the early stages of the disease process, due to lack of symptoms. Sonography is typically the first modality of choice for assessing gallbladder pathology due to its high sensitivity, portability, real-time imaging capability, and non-ionizing technique. Conventional gray-scale and color Doppler sonographic imaging may be ambiguous for diagnosing solid tumors, such as gallbladder carcinoma. In this case, gallbladder carcinoma was definitively diagnosed utilizing contrast-enhanced ultrasound, allowing for quick patient treatment options and an optimal surgical outcome.


2018 ◽  
Vol 59 (10) ◽  
pp. 1149-1156 ◽  
Author(s):  
Ruediger S Goertz ◽  
Daniel Klett ◽  
Dane Wildner ◽  
Raja Atreya ◽  
Markus F Neurath ◽  
...  

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.


2018 ◽  
Vol 34 (4) ◽  
pp. 250-267 ◽  
Author(s):  
Emilio Quaia ◽  
Jean Michel Correas ◽  
Maithili Mehta ◽  
John T. Murchison ◽  
Antonio Giulio Gennari ◽  
...  

Medicina ◽  
2020 ◽  
Vol 56 (12) ◽  
pp. 692
Author(s):  
Vincent Schwarze ◽  
Johannes Rübenthaler ◽  
Saša Čečatka ◽  
Constantin Marschner ◽  
Matthias Frank Froelich ◽  
...  

Background and objectives: The aim of the present retrospective single-center study is to evaluate the diagnostic performance of contrast-enhanced ultrasound (CEUS) for assessing Bosniak III complex renal cystic lesions with histopathological validation. Materials and Methods: 49 patients with CEUS-categorized Bosniak III renal cystic lesions were included in this retrospective study. All patients underwent native B-mode, Color Doppler, contrast-enhanced ultrasound (CEUS) between 2010–2020. Eight and five patients underwent computed tomography (CT) and magnetic resonance imaging (MRI), respectively. Twenty-nine underwent (partial) nephrectomy allowing for histopathological analysis. The applied contrast agent for CEUS was a second-generation blood pool agent. Ultrasonography examinations were performed and interpreted by a single experienced radiologist with more than 15 years of experience (EFSUMB Level 3). Results: CEUS examinations were successfully performed in all included patients without registering any adverse effects. The malignancy rate of CEUS-categorized Bosniak III renal lesions accounted for 66%. Initially, cystic complexity was visualized in native B-mode. In none of the renal lesions hypervascularization was detected in Color Doppler. CEUS allowed for detection of contrast enhancement patterns in all included Bosniak III renal lesions. Delayed wash-out could be detected in 6/29 renal lesions. In two cases of histopathologically confirmed clear-cell RCC, appropriate up-grading from Bosniak IIF to III was achieved by CEUS. Conclusions: CEUS depicts a promising imaging modality for the precise diagnostic workup and stratification of renal cystic lesions according to the Bosniak classification system, thereby helping guidance of adequate clinical management in the future.


2020 ◽  
Author(s):  
Hongli Cao ◽  
Liang Fang ◽  
Lin Chen ◽  
Jia Zhan ◽  
Xuehong Diao ◽  
...  

Abstract Background: The value of contrast-enhanced ultrasound (CEUS) in differentiating between renal cell carcinoma (RCC) and angiomyolipoma (AML) was analyzed. The purpose of this study was to identify the independent indicators of CEUS for predicting RCC. Methods: A total of 172 renal tumors (150 RCCs, 22 AMLs) in 165 patients underwent conventional ultrasound (CUS) and CEUS examinations before radical or partial nephrectomy, and the features on CUS and CEUS were analyzed. Results: There were significant differences in echogenicity, blood flow signals in color Doppler flow imaging (CDFI), peak intensity, homogeneity of enhancement, wash in, wash out, and perilesional rim-like enhancement between RCC and AML ( P <0.05 for all). Multivariate analysis indicated that perilesional rim-like enhancement ( P =0.035, odds ratio [OR]=9.907, 95% confidence interval [CI]: 1.169-83.971) and fast wash out ( P =0.001, OR =9.755, 95%[CI]: 2.497-38.115) were independent indicators for predicting RCC. The area under the receiver operating characteristic (ROC) curve (AUC) for perilesional rim-like enhancement was 0.838 (95% CI:0.774-0.890) with 76.7% sensitivity and 90.9% specificity, while the AUC of fast wash out was 0.833 (95% CI:0.768-0.885) with 74.7% sensitivity and 81.8% specificity. Conclusions: This study indicated that CEUS has value in differentiating RCC and AML. Present perilesional rim-like enhancement and fast wash out may be important indicators for predicting RCC. Key words: Renal cell carcinoma; angiomyolipoma; contrast-enhanced ultrasound; ultrasonography


BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jie Chu ◽  
Ying Zhang ◽  
Wenzhi Zhang ◽  
Dan Zhao ◽  
Jianping Xu ◽  
...  

Abstract Background To investigate the value of multimodal ultrasonography in differentiating tuberculosis from other lymphadenopathy. Methods Sixty consecutive patients with superficial lymphadenopathy treated at our hospital from January 2017 to December 2018 were categorized into four types based on the color Doppler ultrasound, five types based on contrast-enhanced ultrasound, and five types based on elastography. Sensitivity and specificity were calculated of all the three imaging, including color Doppler examination, contrast-enhanced ultrasound and one individual multimodal method, for detecting lymph nodes. Results A total of 60 patients were included in the final analysis. Of those, Mycobacterium tuberculosis was positive in 38 patients and negative in 22 patients. Among the 38 patients who were positive for Mycobacterium tuberculosis, of which 23 had a history of pulmonary tuberculosis, accounting for 60.53% of the positive cases, and the remaining patients did not combine lesions of other organs. Among the 60 superficial lymph nodes, 63.3% presented with tuberculous lymphadenitis. The sensitivity, specificity, and accuracy of the color Doppler examination were 73.68%, 68.18%, and 71.67%, respectively. The sensitivity, specificity and accuracy of contrast-enhanced ultrasound were 89.47%, 63.64% and 80.00%, respectively. The sensitivity, specificity and accuracy of the elastography were 63.16%, 63.64% and 63.33%, respectively. The sensitivity, specificity and accuracy of one individual multimodal method were 42.11%, 95.45% and 61.67%, respectively. The sensitivity, specificity and accuracy of all modes combined were 100.00%, 27.27% and 73.33%, respectively. Conclusion Multimodal ultrasonography has high predictive value for the differential diagnosis of superficial tuberculous lymphadenitis.


2020 ◽  
Author(s):  
Hongli Cao(Former Corresponding Author) ◽  
Liang Fang ◽  
Lin Chen(New Corresponding Author) ◽  
Jia Zhan ◽  
Xuehong Diao ◽  
...  

Abstract Background: The value of contrast-enhanced ultrasound (CEUS) in differentiating between renal cell carcinoma (RCC) and angiomyolipoma (AML) was analyzed. The purpose of this study was to identify the independent indicators of CEUS for predicting RCC. Methods: A total of 172 renal tumors (150 RCCs, 22 AMLs) in 165 patients underwent conventional ultrasound (CUS) and CEUS examinations before radical or partial nephrectomy, and the features on CUS and CEUS were analyzed. Results: There were significant differences in echogenicity, blood flow signals in color Doppler flow imaging (CDFI), peak intensity, homogeneity of enhancement, wash in, wash out, and perilesional rim-like enhancement between RCC and AML ( P <0.05 for all). Multivariate analysis indicated that perilesional rim-like enhancement ( P =0.035, odds ratio [OR]=9.907, 95% confidence interval [CI]: 1.169-83.971) and fast wash out ( P =0.001, OR =9.755, 95%[CI]: 2.497-38.115) were independent indicators for predicting RCC. The area under the receiver operating characteristic (ROC) curve (AUC) for perilesional rim-like enhancement was 0.838 (95% CI:0.774-0.890) with 76.7% sensitivity and 90.9% specificity, while the AUC of fast wash out was 0.833 (95% CI:0.768-0.885) with 74.7% sensitivity and 81.8% specificity. Conclusions: This study indicated that CEUS has value in differentiating RCC and AML. Present perilesional rim-like enhancement and fast wash out may be important indicators for predicting RCC. Key words: Renal cell carcinoma; angiomyolipoma; contrast-enhanced ultrasound; ultrasonography


2012 ◽  
Vol 30 (3) ◽  
pp. 516.e5-516.e6 ◽  
Author(s):  
Peter Michael Zechner ◽  
Susanne Rienmüller ◽  
Katrin Dorr ◽  
Christina Genger ◽  
Herbert Wurzer

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