By Thomas Albrecht, Lars Thorelius, Luigi Solbiati, Luca Cova, Ferdinand Frauscher, M. Hörmann
The worth of ultrasound distinction brokers (USCA) in daily medical perform will depend on the pharmacokinetics, the sign processing, and the contrast-specific imaging modalities. Second-generation USCA, are blood pool brokers that don't leak into the organ tissue to be tested yet stay within the intravascular compartment expanding the Doppler sign amplitude in the course of their dynamic vascular section. profiting from the soundness in their microbubbles, they could face up to the acoustic strain of insonation far better than first-generation distinction media, which leads to an elevated half-life of the agent and, for this reason, in a chronic diagnostic window. Concomitant with the development of distinction brokers, assorted contrast-specific imaging modalities were constructed which, utilized in blend with USCA and a low mechanical index, permit non-stop real-time grey-scale imaging. those contemporary technical advancements have opened new percentages within the use of USCA in numerous symptoms. Written through across the world popular specialists, the contributions accumulated during this booklet provide an summary of present and attainable destiny new purposes of USCA in regimen and medical perform.
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Additional info for Contrast-enhanced ultrasound in clinical practice: liver, prostate, pancreas, kidney and lymph nodes
Example text
Consequently, CEUS is not very good at delineating masses, but it does permit good delineation of non-vascular pancreatic lesions. Non-enhanced ultrasound (US) is underestimated for the delineation of pancreatic masses. An example of a well-delineated necrotic tumor is shown in Fig. 1. Usefulness of CEUS in the Characterization of Pancreatic and Renal Masses A B C Fig. 1. A CT of pancreas cancer. B US of pancreatic cancer (marked by yellow dots). C CEUS of pancreas cancer (marked by yellow dots) 27 28 Lars Thorelius CT depicts the tumor covering the entire head of the pancreas, which is also well delineated as a rounded mass on non-enhanced US images (small tumors can actually often be visualized better by non-enhanced US than CT).
B CEUS of capillary tumor after artery enhancement but not yet of tumor. C CEUS 3 s later, with enhancement of capillary tumor 31 Lars Thorelius 32 ■ Renal Masses CEUS of the kidney provides a clear and detailed view of renal vascularity, with early enhancement in the arterial phase followed by an intense and uniform enhancement in the renal cortex. Enhancement then extends to the pyramids until they become isoechoic with the cortex, about 20-30 s later. The enhancement, which lasts about 2 minutes and then gradually fades, is produced by concentration of contrast medium in the arteries; accumulation of contrast medium in the parenchyma is negligible.
40 Luigi Solbiati, Luca Cova For many years, lymph nodes have been assessed with traditional ultrasound (US) technology using morphological criteria, such as size (thickness), shape (the ratio between the longitudinal and short-axis), hyperechoic hilus, echogenicity of the cortex, calcifications and intranodal necrotic or cystic changes [1-8]. Subsequently, vascularity criteria were added, differentiating between nodes with a visible hilus, focal absence of perfusion, and the presence of subcapsular, displaced and/or burnt vessels (Tschammler’s classification) [9] by means of color and power Doppler.