Incidental nonfunctioning pancreatic neuroendocrine tumors: Contrast enhanced ultrasound features in diagnosis

2021 ◽  
pp. 1-10
Author(s):  
Daohui Yang ◽  
Dansong Wang ◽  
Yijie Qiu ◽  
Xiaofan Tian ◽  
Dan Zuo ◽  
...  
Keyword(s):  
Neuroendocrine Tumors ◽  
Clinical Decision Making ◽  
Ultrasound Contrast Agents ◽  
Arterial Phase ◽  
Control Group ◽  
Pancreatic Neuroendocrine Tumors ◽  
Contrast Enhanced Ultrasound ◽  
Color Flow ◽  
Color Flow Imaging ◽  
Contrast Enhanced

AIM: Preoperative suspicion of malignancy in nonfunctioning pancreatic neuroendocrine tumors (pNETs) is mostly based on tumor size. We retrospectively analyzed the contrast enhanced ultrasound (CEUS) features of a series of histopathologically proved nonfunctioning pNETs. METHODS: In this retrospective study, 37 surgery and histologically proved nonfunctioning pNETs were included. All pNETs lesions were incidentally detected by transabdominal ultrasound. B mode ultrasound (BMUS) and CEUS features were reviewed and analyzed. 52 histopathologically proved pancreatic ductal adenocarcinoma (PDACs) lesions were included as a control group. RESULTS: All nonfunctioning pNETs patients showed no typical clinical symptoms. No significant differences were observed in size, echogenicity or internal color flow imaging signal between pNETs and PDAC patients (P >  0.05). Most of nonfunctioning pNETs showed a well-defined tumor margin. The presence of pancreatic duct dilatation was less frequently observed in nonfunctioning pNETs patients (P <  0.05). After injection of ultrasound contrast agents, homogeneous enhancement was more commonly observed in nonfunctioning pNETs group (P <  0.05). During arterial phase of CEUS, most of nonfunctioning pNETs were hyper- or isoenhanced (32/37, 86.5%), whereas most of PDACs were hypoenhanced (34/52, 65.4%) (P <  0.05). Nonenhanced necrosis area was more commonly detected in PDACs (P = 0.012). CONCLUSIONS: CEUS features are helpful for preoperative non-invasive differential diagnosis of nonfunctioning pNETs, assisting further clinical decision-making process.

scholarly journals How to perform Contrast-Enhanced Ultrasound (CEUS)

2018 ◽  
Vol 04 (01) ◽  
pp. E2-E15 ◽  
Author(s):  
Christoph Dietrich ◽  
Michalakis Averkiou ◽  
Michael Nielsen ◽  
Richard Barr ◽  
Peter Burns ◽  
...  
Keyword(s):  
Decision Making ◽  
Personal Experience ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Ultrasound Contrast Agents ◽  
Contrast Enhanced Ultrasound ◽  
Technical Parameters ◽  
Ultrasound Contrast ◽  
Published Evidence ◽  
Contrast Enhanced

Abstract“How to perform contrast-enhanced ultrasound (CEUS)” provides general advice on the use of ultrasound contrast agents (UCAs) for clinical decision-making and reviews technical parameters for optimal CEUS performance. CEUS techniques vary between centers, therefore, experts from EFSUMB, WFUMB and from the CEUS LI-RADS working group created a discussion forum to standardize the CEUS examination technique according to published evidence and best personal experience. The goal is to standardise the use and administration of UCAs to facilitate correct diagnoses and ultimately to improve the management and outcomes of patients.

scholarly journals Differential diagnosis of gallbladder ascariasis debris: the added value of contrast enhanced ultrasound with high frequency transducer

2018 ◽  
Vol 20 (4) ◽  
pp. 413 ◽  
Author(s):  
Yi Dong ◽  
Feng Mao ◽  
Jiaying Cao ◽  
Qi Zhang ◽  
Daohui Yang ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Ultrasound Contrast Agents ◽  
Added Value ◽  
Control Group ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced ◽  
Frequency Transducer ◽  
Real Time Visualization ◽  
High Frequency Transducer ◽  
Diagnostic Modalities

Ascariasis debris of the gallbladder is a very rare incidental or symptomatic presentation. Ascaris debris has a pseudotumorous appearance and may be confused with neoplasia. The aim of the current retrospective study is to investigate the value of contrast enhanced ultrasound (CEUS) for the differential diagnosis of ascariasis debris and neoplasia of the gallbladder.Material and methods: Conventional B-mode ultrasound (BMUS) and CEUS were performed for solitary echo-rich gallbladder lesions. Analysis of the CEUS enhancement pattern of the lesions was conducted according to the current EFSUMB guidelines. Two radiologists assessed the CEUS enhancement patterns in consensus. The final gold standard was surgery with histological examination or imaging follow-up.Results: A total of 9 patients with final diagnoses of gallbladder ascariasis debris were included. As a control group 26 solitary hyperechoic gallbladder lesions without shadowing were included as a control group. The typical zigzag morphology with multiple echogenic parallel lines without shadow were detected inside the lumen of the gallbladder in 6 patients. After injection of 2.4 ml ultrasound contrast agents, all hyperechoic gallbladder ascariasis debris lesions showed no enhancement. All patients in the control group with similar BMUS morphology showed contrast enhancement.Conclusions: Real time visualization of contrast enhancement without radiation exposure is one of the main advantages of CEUS over other diagnostic modalities to differentiate ascariasis debris in the gallbladder from enhancing neoplasia. Thus, surgery and other interventions and their complications could be avoided.

Differentiation between hepatocellular carcinoma and intrahepatic cholangiocarcinoma using contrast-enhanced ultrasound: A systematic review and meta-analysis

2021 ◽  
pp. 1-17
Author(s):  
Yanling Chen ◽  
Wenping Wang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Diagnostic Accuracy ◽  
Publication Bias ◽  
Likelihood Ratio ◽  
Intrahepatic Cholangiocarcinoma ◽  
Cochrane Library ◽  
Arterial Phase ◽  
Contrast Enhanced Ultrasound ◽  
Diagnostic Ability ◽  
Contrast Enhanced

AIM: To explore the diagnostic ability of contrast-enhanced ultrasound (CEUS) in distinguishing intrahepatic cholangiocarcinoma (ICC) from hepatocellular carcinoma (HCC). MATERIALS AND METHODS: PubMed, EMBASE, Cochrane Library, and Web of Science were systematically searched for studies reporting the diagnostic accuracy of CEUS in differentiating ICC from HCC. The diagnostic ability of CEUS was assessed based on the pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and area under the curve (AUC) with 95% confidence intervals (CIs). The methodologic quality was assessed by the QUADAS-2 tool. Subgroup analyses, meta-regression and investigation of publication bias were performed to identify the source of heterogeneity. RESULTS: A total of eight studies were included, consisting of 1,116 patients with HCC and 529 with ICC. The general diagnostic performance of CEUS in distinguishing ICC and HCC were as follows: pooled sensitivity, 0.92 (95% CI: 0.84–0.96); pooled specificity, 0.87 (95% CI: 0.79–0.92); pooled PLR, 7.1 (95% CI: 4.1–12.0); pooled NLR, 0.09 (95% CI: 0.05–0.19); pooled DOR, 76 (95% CI: 26–220) and AUC, 0.95(95% CI: 0.93–0.97). Different liver background may be a potential factor that influenced the diagnostic accuracy of CEUS according to the subgroup analysis, with the pooled DOR of 89.67 in the mixed liver background group and 46.87 in the cirrhosis group, respectively. Six informative CEUS features that may help differentiate HCC from ICC were extracted. The three CEUS features favoring HCC were arterial phase hyperenhancement(APHE), mild washout and late washout (>60s); the three CEUS favoring ICC were arterial rim enhancement, marked washout and early washout(<60s). No potential publication bias was observed. CONCLUSION: CEUS showed great diagnostic ability in differentiating ICC from HCC, which may be promising for noninvasive evaluation of these diseases.

Baseline and contrast-enhanced ultrasound features of hepatic epithelioid angiomyolipoma

2021 ◽  
pp. 1-15
Author(s):  
Pei-Li Fan ◽  
Zheng-Biao Ji ◽  
Jia-Ying Cao ◽  
Chen Xu ◽  
Yi Dong ◽  
...  
Keyword(s):  
Resistive Index ◽  
Malignant Potential ◽  
Arterial Phase ◽  
Hepatic Tumors ◽  
Contrast Enhanced Ultrasound ◽  
Uncertain Malignant Potential ◽  
Epithelioid Angiomyolipoma ◽  
Tumor Vessels ◽  
Contrast Enhanced ◽  
Ultrasound Features

BACKGROUND: Recurrence or metastasis after surgery had been reported in hepatic epithelioid angiomylipoma (epi-AML). Most hepatic epi-AMLs were misdiagnosed with hepatocellular carcinoma or other hepatic tumors before surgery. OBJECTIVE: To describe the baseline and contrast-enhanced ultrasound (CEUS) features of hepatic epi-AMLs and to explore the potential ultrasonic features for prognosis. METHODS: The retrospective study enrolled 67 patients (56 females, 11 males) with 67 pathologically confirmed hepatic epi-AML lesions. All the lesions were examined by baseline ultrasound and 42 lesions were examined using CEUS with SonoVue (Bracco, Milan, Italy) before surgery. RESULTS: Baseline ultrasound features of hepatic epi-AMLs included heterogeneous echo (86.6%), well-defined border (68.7%), hypoecho (64.2%), regular morphology (62.7%), peripheral-tumor arc-shaped or ring-like vessels (53.7%), and low value of resistive index (0.51±0.08). CEUS features of hepatic epi-AMLs included arterial phase hyper-enhancement with smooth and well-defined margin (100%), peripheral-tumor ring-like vessels (57.1%), and intra-tumor vessels (52.4%). Some CEUS features, including arterial phase heterogeneously tortuous filling, intra-tumor vessels and peripheral-tumor ring-like vessels were more commonly found in hepatic epi-AMLs of uncertain malignant potential/malignant than in benign hepatic epi-AMLs (p <  0.05). CONCLUSIONS: Baseline ultrasound and CEUS features may be useful in diagnosis of hepatic epi-AML, and some CEUS features may be indicative of its malignant potential.

scholarly journals Contrast-Enhanced Ultrasound to Monitor Early Recurrence of Primary Hepatocellular Carcinoma after Curative Treatment

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Lian-Feng Liu ◽  
Zhan-Ling Ding ◽  
Jian-Hong Zhong ◽  
Hong-Xue Li ◽  
Jun-Jie Liu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Recurrent Disease ◽  
Intrahepatic Recurrence ◽  
Primary Hepatocellular Carcinoma ◽  
Curative Treatment ◽  
Arterial Phase ◽  
Contrast Enhanced Ultrasound ◽  
Enhancement Pattern ◽  
Recurrent Hepatocellular Carcinoma ◽  
Contrast Enhanced

Objective. To evaluate contrast-enhanced ultrasound (CEUS) for monitoring early intrahepatic recurrence of primary hepatocellular carcinoma (HCC) after curative treatment. Methods. We prospectively analyzed 97 patients (124 nodules) with primary HCC who underwent hepatic resection or radiofrequency ablation and subsequently experienced intrahepatic recurrence. Patients were assessed with conventional ultrasound and CEUS. They were also assessed with contrast-enhanced computed tomography (CECT) and/or magnetic resonance imaging (MRI). The image characteristics of CEUS of recurrent hepatocellular carcinoma and high-grade dysplastic nodules (HGDNs) were analyzed. In addition, the ability of CEUS and CECT/MRI to assess internal artery vascularization in recurrent disease was compared. Results. CEUS of recurrent hepatocellular carcinoma showed hyperenhancement in the arterial phase in 96 of 99 nodules, and it showed hypo- or isoenhancement for portal venous and delayed phases. The most common enhancement patterns were “fast-in and slow-out” and “fast-in and fast-out”. Based on the arterial hyperenhancement of lesions and with clinical data such as patient history of HCC and increased level of serum alpha-fetoprotein, the diagnostic accuracy of CEUS for recurrent HCC was significantly higher than that based on the enhancement pattern of “fast-in and fast-out”. CEUS of HGDNs showed local or global hyperenhancement during the arterial phase, isoenhancement during the portal venous phase, and isoenhancement or slight hypoenhancement during the delayed phase. The enhancement pattern was “fast-in and slow-out”. In some cases, it was difficult to differentiate HGDNs from recurrent disease using CEUS. Vascularization in recurrent disease was significantly higher when assessed by CEUS than when assessed with CECT/MRI (P < 0.05). For detecting recurrent disease, CEUS showed sensitivity of 97.0%, specificity of 68.0%, positive predictive value of 92.3%, and negative predictive value of 85.0%. The corresponding parameters for CECT/MRI were 71.7%, 72.0%, 88.8%, and 39.1%. Conclusion. Intrahepatic recurrent HCC and HGDNs with diameter ≤ 3.0 cm have a characteristic appearance on CEUS. This imaging modality may be effective for monitoring early intrahepatic recurrence after curative treatment of primary HCC.

scholarly journals Recent Experiences and Advances in Contrast-Enhanced Subharmonic Ultrasound

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
John R. Eisenbrey ◽  
Anush Sridharan ◽  
Ji-Bin Liu ◽  
Flemming Forsberg
Keyword(s):  
Contrast Agents ◽  
Tumor Imaging ◽  
Three Dimensional ◽  
Ultrasound Contrast Agents ◽  
Surrounding Tissue ◽  
Contrast Enhanced Ultrasound ◽  
Ultrasound Contrast ◽  
Contrast Enhanced ◽  
Subharmonic Response

Nonlinear contrast-enhanced ultrasound imaging schemes strive to suppress tissue signals in order to better visualize nonlinear signals from blood-pooling ultrasound contrast agents. Because tissue does not generate a subharmonic response (i.e., signal at half the transmit frequency), subharmonic imaging has been proposed as a method for isolating ultrasound microbubble signals while suppressing surrounding tissue signals. In this paper, we summarize recent advances in the use of subharmonic imagingin vivo. These advances include the implementation of subharmonic imaging on linear and curvilinear arrays, intravascular probes, and three-dimensional probes for breast, renal, liver, plaque, and tumor imaging.

scholarly journals Window-Modulated Compounding Nakagami Parameter Ratio Approach for Assessing Muscle Perfusion with Contrast-Enhanced Ultrasound Imaging

Sensors ◽  
2020 ◽  
Vol 20 (12) ◽  
pp. 3584
Author(s):  
Huang-Chen Lin ◽  
Shyh-Hau Wang
Keyword(s):  
Contrast Agents ◽  
Ultrasound Imaging ◽  
Ultrasound Contrast Agents ◽  
Muscle Disease ◽  
Contrast Enhanced Ultrasound ◽  
Time Intensity Curve ◽  
Muscle Perfusion ◽  
Ultrasound Contrast ◽  
Parameter Ratio ◽  
Contrast Enhanced

The assessment of microvascular perfusion is essential for the diagnosis of a specific muscle disease. In comparison with the current available medical modalities, the contrast-enhanced ultrasound imaging is the simplest and fastest means for probing the tissue perfusion. Specifically, the perfusion parameters estimated from the ultrasound time-intensity curve (TIC) and statistics-based time–Nakagami parameter curve (TNC) approaches were found able to quantify the perfusion. However, due to insufficient tolerance on tissue clutters and subresolvable effects, these approaches remain short of reproducibility and robustness. Consequently, the window-modulated compounding (WMC) Nakagami parameter ratio imaging was proposed to alleviate these effects, by taking the ratio of WMC Nakagami parameters corresponding to the incidence of two different acoustic pressures from an employed transducer. The time–Nakagami parameter ratio curve (TNRC) approach was also developed to estimate perfusion parameters. Measurements for the assessment of muscle perfusion were performed from the flow phantom and animal subjects administrated with a bolus of ultrasound contrast agents. The TNRC approach demonstrated better sensitivity and tolerance of tissue clutters than those of TIC and TNC. The fusion image with the WMC Nakagami parameter ratio and B-mode images indicated that both the tissue structures and perfusion properties of ultrasound contrast agents may be better discerned.

Imaging and Contrast-enhanced Ultrasound features of duodenal neuroendocrine tumor: A case report

2020 ◽  
Vol 76 (1) ◽  
pp. 27-32
Author(s):  
Yan-Qun Zhang ◽  
Jie-Xian Wen ◽  
Rong-Kui Luo ◽  
Hai-Xia Yuan ◽  
Wen-Ping Wang
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Neuroendocrine Tumor ◽  
Neuroendocrine Tumors ◽  
Endocrine Cells ◽  
Contrast Enhanced Ultrasound ◽  
Duodenal Neoplasms ◽  
Contrast Enhanced ◽  
Duodenal Neuroendocrine Tumors ◽  
Ultrasound Features

Duodenal neuroendocrine tumors are rare neoplasms arising from endocrine cells. Here we present a case of 32-year-old woman with Duodenal neuroendocrine tumors, report the imaging and contrast-enhanced Ultrasound (CEUS) features and review previous literatures of neuroendocrine tumors, which may be valuable for the differential diagnosis of duodenal neoplasms.

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