Imaging features and differences among the three primary malignant non-Wilms tumors in children

Abstract Background The pathology, treatment and prognosis of malignant non-Wilms tumors (NWTs) are different, so it is necessary to differentiate these types of tumors. The purpose of this study was to review the clinical and imaging features of malignant NWTs and features of tumor metastasis. Methods We retrospectively analyzed the CT images of 65 pediatric patients with NWTs from March 2008 to July 2020, mainly including clear cell sarcoma of the kidney (CCSK), malignant rhabdomyoma tumor of the kidney (MRTK) and renal cell carcinoma (RCC). Available pretreatment contrast-enhanced abdominal CT examinations were reviewed. The clinical features of the patients, imaging findings of the primary mass, and locoregional metastasis patterns were evaluated in correlation with pathological and surgical findings. Results The study included CCSK (22 cases), MRTK (27 cases) and RCC (16 cases). There were no significant differences observed among the sex ratios of CCSK, MRTK and RCC (all P > 0.05). Among the three tumors, the onset age of MRTK patients was the smallest, while that of RCC patients was the largest (all P < 0.05). The tumor diameter of CCSK was larger than that of MRTK and RCC (all P < 0.001). For hemorrhage and necrosis, the proportion of MRTK patients was larger than that of the other two tumors (P = 0.017). For calcification in tumors, the proportion of calcification in RCC was highest (P = 0.009). Only MRTK showed subcapsular fluid (P < 0.001). In the arterial phase, the proportion of slight enhancement in RCC was lower than that in the other two tumors (P = 0.007), and the proportion of marked enhancement was the highest (P = 0.002). In the venous phase, the proportion of slight enhancement in RCC was lower than that in the other two tumors (P < 0.001). Only CCSK had bone metastasis. There was no liver and lung metastasis in RCC. Conclusions NWTs have their own imaging and clinical manifestations. CCSK can cause vertebral metastasis, MRTK can cause subcapsular effusion, and RCC tumor density is usually high and calcification. These diagnostic points can play a role in clinical diagnosis.

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Use of Contrast-Enhanced Ultrasonography for the Characterization of Tumor Thrombi in Seven Dogs

Animals ◽

10.3390/ani10091613 ◽

2020 ◽

Vol 10 (9) ◽

pp. 1613

Author(s):

Alessia Cordella ◽

Pascaline Pey ◽

Nikolina Linta ◽

Manuela Quinci ◽

Marco Baron Toaldo ◽

...

Keyword(s):

Color Doppler ◽

Case Series ◽

Arterial Phase ◽

Retrospective Case ◽

Primary Tumors ◽

Contrast Enhanced ◽

Venous Phase ◽

Contrast Enhanced Ultrasonography ◽

Tumor Thrombi

Tumors of adrenal and thyroid glands have been associated with vascular invasions—so-called tumor thrombi, both in humans and dogs. The detection and characterization of venous thrombi is an important diagnostic step in patients with primary tumors for both surgical planning and prognosis. The aim of this study was to describe the use of contrast-enhanced ultrasonography (CEUS) for the characterization of tumor thrombi. Dogs with tumor thrombus who underwent bi-dimensional ultrasound (B-mode US) and CEUS were included. Seven dogs were enrolled in this retrospective case series. On B-mode US, all thrombi were visualized, and vascular distension and thrombus-tumor continuity were seen in three and two cases, respectively. On color Doppler examination, all thrombi were identified, seemed non-occlusive and only two presented vascularity. On CEUS, arterial-phase enhancement and washout in the venous phase were observed in all cases. Non-enhancing areas were identified in the tumor thrombi most likely representing non-vascularized tissue that could potentially be embolized in the lungs after fragmentation of the tumor thrombi. On the basis of these preliminary study, CEUS appeared to be useful for the characterization of malignant intravascular invasion.

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Influence of Contrast Media on Bone Mineral Density (BMD) Measurements from Routine Contrast-Enhanced MDCT Datasets using a Phantom-less BMD Measurement Tool

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren ◽

10.1055/s-0043-102941 ◽

2017 ◽

Vol 189 (06) ◽

pp. 537-543 ◽

Cited By ~ 5

Author(s):

Andrea Toelly ◽

Constanze Bardach ◽

Michael Weber ◽

Rui Gong ◽

Yanbo Lai ◽

...

Keyword(s):

Bone Mineral Density ◽

Bone Mineral ◽

Intraclass Correlation ◽

Arterial Phase ◽

Measurement Tool ◽

Mineral Density ◽

Contrast Enhanced ◽

Significant Difference ◽

Venous Phase ◽

The Mean

Aim To evaluate the differences in phantom-less bone mineral density (BMD) measurements in contrast-enhanced routine MDCT scans at different contrast phases, and to develop an algorithm for calculating a reliable BMD value. Materials and Methods 112 postmenopausal women from the age of 40 to 77 years (mean age: 57.31 years; SD 9.61) who underwent a clinically indicated MDCT scan, consisting of an unenhanced, an arterial, and a venous phase, were included. A retrospective analysis of the BMD values of the Th12 to L4 vertebrae in each phase was performed using a commercially available phantom-less measurement tool. Results The mean BMD value in the unenhanced MDCT scans was 79.76 mg/cm³ (SD 31.20), in the arterial phase it was 85.09 mg/cm³ (SD 31.61), and in the venous phase it was 86.18 mg/cm³ (SD 31.30). A significant difference (p < 0.001) was found between BMD values on unenhanced and contrast-enhanced MDCT scans. There was no significant difference between BMD values in the arterial and venous phases (p = 0.228). The following conversion formulas were calculated using linear regression: unenhanced BMD = -2.287 + 0.964 * [arterial BMD value] and -4.517 + 0.978 * [venous BMD value]. The intrarater agreement of BMD measurements was calculated with an intraclass correlation (ICC) of 0.984 and the interobserver reliability was calculated with an ICC of 0.991. Conclusion Phantom-less BMD measurements in contrast-enhanced MDCT scans result in increased mean BMD values, but, with the formulas applied in our study, a reliable BMD value can be calculated. However, the mean BMD values did not differ significantly between the arterial and venous phases. Key points Citation Format

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Conspicuity of Malignant Pleural Mesothelioma in Contrast Enhanced MDCT – Arterial Phase or Late Phase?

10.21203/rs.3.rs-554728/v1 ◽

2021 ◽

Author(s):

Lukas Luerken ◽

Philipp Laurin Thurn ◽

Florian Zeman ◽

Christian Stroszczynski ◽

Okka Wilkea Hamer

Keyword(s):

Multiple Regression ◽

Late Phase ◽

Objective Analysis ◽

Surrounding Tissue ◽

Arterial Phase ◽

Subjective Analysis ◽

Portal Venous Phase ◽

Contrast Enhanced ◽

Venous Phase ◽

Phase Scan

Abstract Background: To compare two different contrast phases intraindividually regarding conspicuity of MPM in chest MDCT. Methods: 28 patients with MPM were included in this retrospective study. For all patients, chest CT in standard arterial phase and abdominal CT in portal venous phase (scan delay ca. 70 s) was performed. First, subjective analysis of tumor conspicuity was done independently by two radiologists. Second, objective analysis was done by measuring Hounsfield units (HU) in tumor lesions and in the surrounding tissue in identical locations in both phases. Differences of absolute HUs in tumor lesions between phases and differences of contrast (HU in lesion – HU in surrounding tissue) between phases were determined. HU measurements were compared using paired t-test for related samples. Potential confounding effects by different technical and epidemiological parameters between phases were evaluated performing a multiple regression analysis.Results: Subjective analysis: In all 28 patients and for both readers conspicuity of MPM was better on late phase compared to arterial phase. Objective analysis: MPM showed a significantly higher absolute HU in late phase (75.4 vs 56.7 HU, p < 0.001). Contrast to surrounding tissue was also significantly higher in late phase (difference of contrast between phases 18.5 HU, SD 10.6 HU, p < 0.001). Multiple regression analysis revealed contrast phase and tube voltage to be the only significant independent predictors for tumor contrast.Conclusions: In contrast enhanced chest-MDCT for MPM late phase scanning seems to provide better conspicuity and higher contrast to surrounding tissue compared to standard arterial phase scans.

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Imaging features of hepatocellular carcinoma with bile duct tumor thrombus：a multicenter study

10.21203/rs.3.rs-40799/v2 ◽

2020 ◽

Author(s):

Li-Ming Huang ◽

Jun-Yi Wu ◽

Yan-Nan Bai ◽

Jia-Yi Wu ◽

Yong-Gang Wei ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Bile Duct ◽

Ct Scans ◽

Arterial Phase ◽

Imaging Features ◽

Portal Venous Phase ◽

Bile Duct Tumor ◽

Hepatic Arterial Phase ◽

Mri Scans ◽

Venous Phase

Abstract Background: There are still difficult and challenging problems in diagnosis of hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) before operation. This study aimed to analyze the imaging features of HCC with B1-B3 BDTT. Methods: The clinicopathological data and imaging findings of 30 HCC patients with B1-B3 BDTT from three high-volume institutions were retrospectively reviewed. Eighteen patients underwent computed tomography (CT) scans and twelve patients underwent magnetic resonance imaging (MRI) scans before operation, respectively. The diagnosis of HCC with BDTT was conﬁrmed by postoperative pathologic examination.Results: According to Japanese classification, 5 patients were classified as B1 BDTT, 12 B2, 13 B3, and 82 B4, respectively. The HCC lesions were detected in all patients, and the localized bile duct dilation were detected in 28 (93.3%) patients. The BDTT was observed in all B3 patients and 3 B2 patients, but it was not observed in all B1 patients on CT or MRI. The BDTT showed relatively hypoattenuation on plain CT scans and T1W images, relatively hyperattenuation signals on T2W. The BDTT showed hyperattenuation at hepatic arterial phase with washout at portal venous phase. The localized biliary dilation showed no enhancement at hepatic arterial phase and no progressively delayed enhancement at portal venous phase, but it was more obvious at portal venous phase on CT.Conclusions: The HCC lesions and the localized bile duct dilatation on CT or MRI scans are imaging features of HCC with BDTT, which might facilitate the early diagnosis for B1-B3 BDTT.

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

Medical Visualization ◽

10.24835/1607-0763-2017-2-36-52 ◽

2017 ◽

pp. 36-52

Author(s):

E. I. Peniaeva ◽

J. R. Kamalov ◽

A. N. Sencha ◽

U. N. Patrunov ◽

E. A. Sencha

Keyword(s):

Differential Diagnosis ◽

Contrast Enhancement ◽

Complex Analysis ◽

Final Diagnosis ◽

Arterial Phase ◽

Focal Liver Lesions ◽

Diagnostic Feature ◽

Liver Lesions ◽

Contrast Enhanced ◽

Venous Phase

Purpose:to evaluate the diagnostic value of contrastenhanced ultrasound (CEUS) with SonoVue in differential diagnosis of focal liver lesions (FLL) in a multidisciplinary clinic in Russian Federation.Materials and methods. Bolus intravenous administration of 1.2 ml of SonoVue (Bracco Swiss CA, Switzerland) followed with 5ml saline flush was used for liver CEUS. We utilized the scanners Mindray DC-8 (Mindrаy, China), Logiq S8 (GE, USA), Philips Epiq 7 (Philips, Holland), SonoScape S9 (SonoScape, China), Hitachi Ascendus (Hitachi, Japan) with 3.0–5.0 MHz convex probes in specialized “contrast” mode with low mechanic index (MI 0.08–0.1). The study conferred 73 patients in the age between 18 and 84 years (mean age 49 years) with FLL. CEUS was performed in 22 patients with previously verified diagnosis, while the rest of patients underwent CEUS before the final diagnosis. Contrast-enhanced liver CT was performed in all patients. In 49 (67.12%) of 73 cases, a pathology was performed after a targeted core-needle biopsy or autopsy. Qualitative features of US contrast enhancement of FLL were evaluated.Results. Qualitative aspects of CEUS for differentiation of FLL were defined. The principal sign for diagnosis between benign and malignant masses with CEUS was hypoenhancement of malignant lesions in comparison to surrounding normal parenchyma in portal and late venous phase (p ≤ 0.01). Alternatively, hyper- or isoenhancement throughout late venous phase was characteristic for benign FLL. Diffuse heterogeneous contrast enhancement was indicative of malignant FLL, and homogeneous – for benign. Additional diagnostic feature (p ≤ 0.05) was the type of contrast enhancement in the arterial phase. Heterogeneous diffuse contrast enhancement was observed in malignant FLL, while homogeneous – in benign FLL. Peripheral nodular contrast enhancement with centripetal filling was characteristic for liver hemangioma, centrifugal filling with “spoke-wheel” vascular pattern – for FNH, and peripheral rim-like hyperenhancement with rapid achievement of hypoenhancement at the beginning of the portal phase – for liver metastasis.Conclusion.Complex analysis of qualitative characteristics of CEUS with SonoVue is a promising option for differential diagnosis of FLL (sensitivity 92.85%, specificity 91.3%, diagnostic accuracy 92.15%) and can be utilized in daily practice.

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Complicated Sonographic View of Diffuse Hepatic Steatosis

Revista de Chimie ◽

10.37358/rc.20.1.7835 ◽

2020 ◽

Vol 71 (1) ◽

pp. 220-222

Author(s):

Melania Ardelean ◽

Roxana Buzas ◽

Daniel Lighezan ◽

Basa Norina ◽

Corina Duda-Seiman ◽

...

Keyword(s):

Hepatic Steatosis ◽

Late Phase ◽

Correct Diagnosis ◽

Abdominal Ultrasound ◽

Arterial Phase ◽

Benign Pathology ◽

Uptake Pattern ◽

Contrast Enhanced ◽

Venous Phase

The aim of this study was to reveal the important role of CEUS in identifying correctly benign hepatic lesion vs a malignant one. We report a case of a diffuse hepatic steatosis particular sonographic aspect in a middle aged male presenting with general malaise. History revealed cardiac pathology, diabetes mellitus type 2 and chemotreated prostate neoplasia. The abdominal ultrasound (US) presented numerous hyperechoic lesions disseminated in the whole parenchyma. A contrast enhanced ultrasound (CEUS) of the lesions described an isoenhancement pattern of the lesions in the arterial phase, followed by the same aspect in the venous phase, with a high uptake pattern in the late phase. The CT and MRI also confirmed a diagnosis of a benign pathology. Hepatic steatosis may occur in chemotreated cancer patients, raising a suspicion of hepatic metastasis, but also due to the amount of lipid deposit distribution in the liver. Thus, CEUS was able to establish a correct diagnosis in a fast and reliable way.

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Application Value of Contrast-Enhanced Ultrasound In The Diagnosis of Intermediate Trophoblastic Tumours

10.21203/rs.3.rs-138492/v2 ◽

2022 ◽

Author(s):

XiaoDan Zhu ◽

Yin Hu ◽

LinYu Zhou ◽

TianAn Jiang

Keyword(s):

Clinical Symptoms ◽

Correct Diagnosis ◽

Clinical Manifestations ◽

Arterial Phase ◽

Imaging Method ◽

Low Grade ◽

Ultrasound Images ◽

Colour Doppler ◽

Contrast Enhanced ◽

Trophoblastic Tumours

Abstract Background: As the rarest gestational trophoblastic neoplasia (GTN), intermediate trophoblastic tumours (ITTs) are very difficult to diagnose before surgery due to the lack of specificity of clinical manifestations. Routine colour Doppler ultrasonography is currently the simplest and reproducible imaging method for diagnosing ITTs, but it is not as specific as other tumours. Through the research and analysis of colour Doppler ultrasound images (CDFI) and contrast-enhanced ultrasonography (CEUS) images of ITTs, the ultrasound characteristics and CEUS perfusion characteristics are summarized, and these findings can provide a reference for the correct diagnosis of ITTs.Methods: Seven ITT patients were diagnosed and treated in our institution from January 2016 to August 2020, and the clinical data of all patients were retrospectively collected and analysed. Two sonographers who had worked for more than 5 years analysed the characteristics of the ultrasound and CEUS. Among them, the characteristics of CEUS are summarized and analysed from the four aspects of contrast enhancement method, time, boundary, and intensity. All cases were diagnosed with pathological support by ITTs.Results: The most common clinical symptoms of ITT are vaginal bleeding and amenorrhea. The serum ß-human chorionic gonadotropin (serum-hCG) level was mainly a low-grade increase, but to determine whether the serum-hCG level can be used as one of the indicators for monitoring ITT recurrence or metastasis, a large sample data analysis is needed. The lesion location, internal echo changes, and blood flow signals of ITTs were not significantly specific compared with those of other GTNs. However, the CEUS performance of ITTs has certain characteristic changes, in which the enhancement mode was mainly regional enhancement, the arterial phase showed slow, equal-slightly high enhancement, and the enhanced bounders were not very clear. Compared with the CEUS performance of other GTNs, it has a certain specificity.Conclusions: Certain characteristic changes in CEUS of ITTs, combined with clinical features, can provide help for the accurate diagnosis of ITT.Trial registration: For non-clinical or non-health care intervention on human participants of what the article reports.

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Characteristics of hepatic solitary necrotic nodules on contrast-enhanced ultrasonography

10.21203/rs.3.rs-44537/v3 ◽

2021 ◽

Author(s):

Chunyu Lu ◽

Shaoshan Tang ◽

Xiaoyue Zhang ◽

Yang Wang ◽

Kaiming Wang ◽

...

Keyword(s):

The Other ◽

Arterial Phase ◽

Focal Lesions ◽

Multiple Lesions ◽

Portal Phase ◽

Contrast Enhanced ◽

The Us ◽

Contrast Enhanced Ultrasonography ◽

Dynamic Enhancement ◽

Three Phases

Abstract Background:To summarize the characteristics of solitary necrotic nodules (SNN) in the liver observed under contrast-enhanced ultrasonography (CEUS).Methods:Conventional ultrasonography (US) and CEUS were performed in 24 patients who were confirmed to have SNN by pathological assessment. The US data and dynamic enhancement patterns of CEUS were recorded and retrospectively analyzed.Results:Ten of 24 patients underwent surgical resection, while the other 14 patients underwent a puncture biopsy to be confirmed as SNN. Among the 24 patients, 13 patients had a single lesion and 11 patients had multiple lesions. The largest lesion was selected for CEUS examination for patients with multiple lesions. Eleven patients presented no enhancement in all three phases, while the other 13 patients presented with a peripheral thin rim-like enhancement in the arterial phase, an iso-enhancement in the portal phase and delayed phase. However, no enhancement in the interior of the lesions was detected during three phases of CEUS.Conclusions:SNN has characteristic findings on the CEUS, which play an important role in the differential diagnoses of liver focal lesions.

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Characteristics of hepatic solitary necrotic nodules on contrast-enhanced ultrasonography

BMC Gastroenterology ◽

10.1186/s12876-021-01608-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Chunyu Lu ◽

Shaoshan Tang ◽

Xiaoyue Zhang ◽

Yang Wang ◽

Kaiming Wang ◽

...

Keyword(s):

The Other ◽

Arterial Phase ◽

Focal Lesions ◽

Multiple Lesions ◽

Portal Phase ◽

Contrast Enhanced ◽

The Us ◽

Contrast Enhanced Ultrasonography ◽

Dynamic Enhancement ◽

Three Phases

Abstract Background To summarize the characteristics of solitary necrotic nodules (SNN) in the liver observed under contrast-enhanced ultrasonography (CEUS). Methods Conventional ultrasonography (US) and CEUS were performed in 24 patients who were confirmed to have SNN by pathological assessment. The US data and dynamic enhancement patterns of CEUS were recorded and retrospectively analyzed. Results Ten of 24 patients underwent surgical resection, while the other 14 patients underwent a puncture biopsy to be confirmed as SNN. Among the 24 patients, 13 patients had a single lesion and 11 patients had multiple lesions. The largest lesion was selected for CEUS examination for patients with multiple lesions. Eleven patients presented no enhancement in all three phases, while the other 13 patients presented with a peripheral thin rim-like enhancement in the arterial phase, an iso-enhancement in the portal phase and delayed phase. However, no enhancement in the interior of the lesions was detected during three phases of CEUS. Conclusions SNN has characteristic findings on the CEUS, which play an important role in the differential diagnoses of liver focal lesions.

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