scholarly journals Abdominal Contrast Enhanced Ultrasound, A Practical Review

2019 ◽  
Vol 16 (6) ◽  
pp. 37-46
Author(s):  
Adina Cociorvei

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.

2021 ◽  
Vol 25 (2) ◽  
pp. 84-89
Author(s):  
S. E. Dubrova

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.


2019 ◽  
Vol 05 (01) ◽  
pp. E34-E51 ◽  
Author(s):  
Dieter Nuernberg ◽  
Adrian Saftoiu ◽  
Ana Barreiros ◽  
Eike Burmester ◽  
Elena Ivan ◽  
...  

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.


2015 ◽  
Vol 52 (1) ◽  
pp. 76-80 ◽  
Author(s):  
Fábio Vieira TEIXEIRA ◽  
Paulo Gustavo KOTZE ◽  
Aderson Omar Mourão Cintra DAMIÃO ◽  
Sender Jankiel MISZPUTEN

ABSTRACT Biosimilars are not generic drugs. These are more complex medications than small molecules, with identical chemical structures of monoclonal antibodies that lost their patency over time. Besides identical to the original product at the end, the process of achieving its final forms differs from the one used in the reference products. These differences in the formulation process can alter final outcomes such as safety and efficacy of the drugs. Recently, a biosimilar of Infliximab was approved in some countries, even to the management of inflammatory bowel diseases. However, this decision was based on studies performed in rheumatologic conditions such as rheumatoid arthritis and ankylosing spondylitis. Extrapolation of the indications from rheumatologic conditions was done for Crohn’s disease and ulcerative colitis based on these studies. In this article, the authors explain possible different mechanisms in the pathogenesis between rheumatologic conditions and inflammatory bowel diseases, that can lead to different actions of the medications in different diseases. The authors also alert the gastroenterological community for the problem of extrapolation of indications, and explain in full details the reasons for being care with the use of biosimilars in inflammatory bowel diseases without specific data from trials performed in this scenario.


2020 ◽  
Vol 06 (03) ◽  
pp. E76-E86
Author(s):  
Diletta Cozzi ◽  
Simone Agostini ◽  
Elena Bertelli ◽  
Michele Galluzzo ◽  
Emanuela Papa ◽  
...  

AbstractConventional ultrasound imaging (US) is the first-line investigation in acute non-traumatic abdominal emergencies, but sometimes it needs further examinations, such as computed tomography (CT), to reach a certain diagnosis. Contrast-enhanced ultrasound (CEUS), through injection of contrast medium, may provide the radiologist with additional information that could not be investigated with baseline US. It could help reach a diagnosis and rapidly determine the proper therapy in an emergency setting. The purpose of this review is to explain and illustrate the various possibilities and limitations of CEUS in acute non-traumatic abdominal diseases, in particular acute inflammation, parenchymal infarcts, and hemorrhages.


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.


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