Contrast-Enhanced Ultrasound in Clinical Practice: Liver, Prostate, Pancreas, Kidney and Lymph Nodes

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  4. Medical ultrasound

Second-generation USCA, are blood pool agents that do not leak into the organ tissue to be examined but remain in the intravascular compartment increasing the Doppler signal amplitude during their dynamic vascular phase. Taking advantage of the stability of their microbubbles, they can withstand the acoustic pressure of insonation much better than first-generation contrast media, which results in an increased half-life of the agent and, consequently, in a prolonged diagnostic window.

Concomitant with the improvement of contrast agents, different contrast-specific imaging modalities have been developed which, used in combination with USCA and a low mechanical index, allow continuous real-time grey-scale imaging. These recent technical improvements have opened new possibilities in the use of USCA in a variety of indications.


Written by internationally renowned experts, the contributions gathered in this book give an overview of current and possible future new applications of USCA in routine and clinical practice. Here at Walmart. Your email address will never be sold or distributed to a third party for any reason. Due to the high volume of feedback, we are unable to respond to individual comments. Sorry, but we can't respond to individual comments.

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Hepato Cellular Carcinoma ultrasound

False positive endoscopic ultrasound fine needle aspiration cytology: Incidence and risk factors. Gut ; Prospective cytological assessment of gastrointestinal luminal fluid acquired during EUS: A potential source of false-positive FNA and needle tract seeding. Mocellin S, Pasquali S. Diagnostic accuracy of endoscopic ultrasonography EUS for the preoperative locoregional staging of primary gastric cancer. Endoscopic ultrasound, endoscopic sonoelastography, and strain ratio evaluation of lymph nodes with histology as gold standard. Endosonography in bronchopulmonary disease. Best Pract Res Clin Gastroenterol ; Lung cancer.

N Engl J Med ; ESTS guidelines for preoperative lymph node staging for non-small cell lung cancer. Eur J Cardiothorac Surg ; Endoscopic ultrasound as a first test for diagnosis and staging of lung cancer: A prospective study. Endoscopic ultrasound-guided fine-needle aspiration in the diagnosis and staging of lung cancer and its impact on surgical staging. J Clin Oncol ; Endoscopic ultrasound guided biopsy performed routinely in lung cancer staging spares futile thoracotomies: Preliminary results from a randomised clinical trial.

Lung Cancer ; Endoscopic ultrasound reduces surgical mediastinal staging in lung cancer: A randomized trial. Bronchial endoscopic ultrasound elastography: Preliminary feasibility data. Eur Respir J ; Initial experience with real-time elastography using an ultrasound bronchoscope for the evaluation of mediastinal lymph nodes. Arch Bronconeumol ;e Diagnosis of involvement of hepatoduodenal ligament and lymphnodes using EUS-elastography in the cases of biliary malignancies [Abstract]. Gastrointest Endosc ;AB Liver transplantation with neoadjuvant chemoradiation is more effective than resection for hilar cholangiocarcinoma.

Ann Surg ; Endoscopic ultrasound fine needle aspiration: Technique and applications in clinical practice. World J Gastrointest Endosc ; A prospective, blinded assessment of the impact of preoperative staging on the management of rectal cancer. Clinical impact of endoscopic ultrasound and endoscopic ultrasound-guided fine-needle aspiration in the management of rectal carcinoma. Dis Colon Rectum ; Preoperative staging of rectal cancer using magnetic resonance imaging with external phase-arrayed coils.

Arch Surg ; Risk of prostate carcinoma death in patients with lymph node metastasis. Intra- and interobserver agreement of endoscopic sonoelastography in the evaluation of lymph nodes. Ultraschall Med ;E Contrast-enhanced endoscopic ultrasound in discrimination between focal pancreatitis and pancreatic cancer. Pathological angioarchitecture in lymph nodes: Underlying histopathologic findings.

Guidelines and good clinical practice recommendations for contrast enhanced ultrasound CEUS - update Sentinel lymph nodes in a swine model with melanoma: Contrast-enhanced lymphatic US. The role of contrast-enhanced gray-scale ultrasonography in the differential diagnosis of superficial lymph nodes.

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Real-time tissue elastography for the diagnosis of lymph node metastasis in oral squamous cell carcinoma. Non-invasive evaluation of axillary lymph node status in breast cancer patients using shear wave elastography. Tohoku J Exp Med ; Shear wave elastography in evaluation of cervical lymph node metastasis of papillary thyroid carcinoma: Elasticity index as a prognostic implication. Lymph nodes, celiac ganglia, spleen: approach, normal findings, variants, characterization.

Endosonography Course Book. Stuttgart: Thieme, Zoller Scandinavian Journal of Gastroenterology.

Thieme E-Journals - Ultraschall in der Medizin - European Journal of Ultrasound / Full Text

Users Online Home. Endoscopic ultrasound: Elastographic lymph node evaluation. Efsumb Guidelines for the Use of us Elastography. Figure 1. Elastographic image of a typical benign mediastinal LN: Homogeneous soft pattern green with delineation of soft vascular structures of the LN hilum red and yellow.

LN: Lymph node Click here to view. Figure 2. Elastographic image of a large reactive mediastinal LN: Heterogeneous soft pattern. The soft structures of the LN hilum and medulla are displayed in red, yellow, and green. The LN cortex is considerably harder blue Click here to view. Figure 3. Elastographic image of a typical malignant LN: Homogeneous hard pattern predominantly blue of a round LN metastasis in a patient with gastric cancer Click here to view.

Figure 4. Elastographic evaluation of lower periesophageal LNs using an EBUS-scope in a patient with stenosing squamous cell cancer of the upper esophagus: Homogeneous hard pattern blue of the oval LN. Figure 5. Elastographic image of a very small LN metastasis in a patient with rectal cancer: The round LN is depicted homogeneously blue and is significantly harder in comparison with surrounding perirectal connective tissue and fat green, yellow, and red Click here to view. Nodal Staging in Carcinoma Patients.

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  • How to perform Contrast-Enhanced Ultrasound (CEUS)!
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Table 1. Diameter of benign and malignant lymph nodes LNs in surgical specimen of nodal-positive and nodal-negative patients with gastrointestinal, pancreatic, and non-small cell lung cancer. Figure 6.

Medical ultrasound

Two periduodenal LNs in one patient with pancreatic cancer: An oblong reactive LN a has an almost identical elasticity compared with the surrounding connective tissue predominantly green. The soft hilar structures are clearly delimited red and yellow. A round LN metastasis b in the same patient is homogenously hard blue Click here to view. Figure 7. Cytology and histology proved metastatic infiltration by HCC.

Figure 8. EBUS elastography in a patient with right-sided peripheral non-small cell lung cancer: A triangular LN is shown in the left mediastinal area 4 4L. Surgery was omitted, and palliative chemotherapy started Click here to view. Figure 9. Elastographic image of a large oblong and hypoechoic mediastinal LN in a patient with sarcoidosis: The LN is predominantly green Click here to view. Table 2. Table 3. Table 4. Figure Elastography in EBUS showing an enlarged LN at the right hilum 10R in two different patients with mediastinal lymphadenopathy of unknown origin.

In one patient with an elastographic heterogeneous LN with clearly visible soft red and yellow hilar structures and a small hard blue peripheral zone of the cortex a cytology and histology showed lymphoid tissue with reactive changes. In the other patient with a predominantly hard LN green and blue without any obvious hilar structures b cytology and histology demonstrated metastasis of a renal cell cancer, which had been treated by surgery 7 years ago Click here to view.

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Copin,Victor Valentin. Ultrasound, endoscopic ultrasound elastography, and the strain ratio in differentiating benign from malignant lymph nodes. Present status and perspectives of endosonography in gastroenterology. Endoscopic ultrasound-guided fine-needle aspiration and cytology for differentiating benign from malignant lymph nodes.

Real-time elastosonography of lipomatous vs. Real time endoscopic ultrasound elastography and strain ratio in the diagnosis of solid pancreatic lesions. Endobronchial ultrasound elastography for the differentiation of benign and malignant lymph nodes - Reply. Sequential endoscopic ultrasound identifies predictive variables for relapse-free follow-up after neoadjuvant chemotherapy in gastric cancer. Scandinavian Journal of Gastroenterology.