Skip to main content
SpringerLink
Log in

Dynamic Contrast-Enhanced Ultrasonography of the Liver

  • Chapter
  • First Online:
Liver Diseases

  • 2847 Accesses

Abstract

Contrast-enhanced ultrasonography is a relatively new imaging technique that can be successfully used for the diagnosis and surveillance of liver lesions, among other important roles. The real-time examination possibility and its excellent safety profile represent unique features that make this procedure a highly valuable one. As this technique becomes more widely available, it is of extreme importance that specialists in the field of hepatology understand its clinical applications and capabilities, as well as its disadvantages and limitations. This chapter aims to provide a basic understanding of contrast-enhanced ultrasonography, focusing on its applications in liver imaging.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Wilson SR, Greenbaum LD, Goldberg BB. Contrast-enhanced ultrasound: what is the evidence and what are the obstacles? Am J Roentgenol. 2009;193:55–60. https://doi.org/10.2214/AJR.09.2553.

    Article  Google Scholar 

  2. Jo PC, Jang HJ, Burns PN, Burak KW, Kim TK, Wilson SR. Integration of contrast-enhanced US into a multimodality approach to imaging of nodules in a cirrhotic liver: how I do it. Radiology. 2017;282(2):317–31.

    Article  Google Scholar 

  3. Chung YE, Kim KW. Contrast-enhanced ultrasonography: advance and current status in abdominal imaging. Ultrasonography. 2014;34:3–18.

    Article  Google Scholar 

  4. SonoVue. Assessment Report. European Medicines Agency; 2017.

    Google Scholar 

  5. Park JH, et al. Contrast-enhanced US with Perfluorobutane (Sonazoid) used as a surveillance test for hepatocellular carcinoma (HCC) in cirrhosis (SCAN): an exploratory cross-sectional study for a diagnostic trial. BMC Cancer. 2017;17(1):279. https://doi.org/10.1186/s12885-017-3267-8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Zhang XY, et al. Contrast-enhanced ultrasound: improving the preoperative staging of hepatocellular carcinoma and guiding individual treatment. World J Gastroenterol. 2014;20(35):12628–36.

    Article  Google Scholar 

  7. Kim TK, et al. Contrast-enhanced ultrasound (CEUS) liver imaging reporting and data system (LI-RADS) 2017 - a review of important differences compared to the CT/MRI system. Clin Mol Hepatol. 2017;23(4):280–9.

    Article  Google Scholar 

  8. Claudon M, Dietrich CF, et al. Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS) in the liver – update 2012 a WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS. Ultraschall in Med. 2013;34:11–29.

    Article  CAS  Google Scholar 

  9. ter Haar G. Safety and bio-effects of ultrasound contrast agents. Med Biol Eng Comput. 2009;47:893–900.

    Article  Google Scholar 

  10. Dietrich CF, Averkiou M, Nielsen MB, et al. How to perform contrast-enhanced ultrasound (CEUS). Ultrasound Int Open. 2018;4(1):E2–E15.

    Article  Google Scholar 

  11. Ferraioli G, Franca Meloni M. Contrast-enhanced ultrasonography of the liver using SonoVue. Ultrasonography. 2018;37(1):25–35. https://doi.org/10.14366/usg.17037.

    Article  PubMed  Google Scholar 

  12. Yanagisawa K, Moriyasu F, Miyahara T, et al. Phagocytosis of ultrasound contrast agent microbubbles by Kupffer cells. Ultrasound Med Biol. 2007;33:318–25.

    Article  Google Scholar 

  13. Friedrich-Rust M, Klopffleisch T, Nierhoff J, Herrmann E, Vermehren J, Schneider MD, et al. Contrast-enhanced ultrasound for the differentiation of benign and malignant focal liver lesions: a metaanalysis. Liver Int. 2013;33:739–55.

    Article  CAS  Google Scholar 

  14. Xie L, Guang Y, Ding H, Cai A, Huang Y. Diagnostic value of contrast-enhanced ultrasound, computed tomography and magnetic resonance imaging for focal liver lesions: a meta-analysis. Ultrasound Med Biol. 2011;37:854–61.

    Article  Google Scholar 

  15. Quaia E, De Paoli L, Angileri R, Cabibbo B, Cova MA. Indeterminate solid hepatic lesions identified on non-diagnostic contrast-enhanced computed tomography: assessment of the additional diagnostic value of contrast-enhanced ultrasound in the noncirrhotic liver. Eur J Radiol. 2014;83:456–62.

    Article  Google Scholar 

  16. Chernyak V, Santillan CS, Papadatos D, Sirlin CB. LI-RADS(R) algorithm: CT and MRI. Abdom Radiol. 2018;43(1):111–26.

    Article  Google Scholar 

  17. Piscaglia F, Wilson SR, Lyshchik A, Cosgrove D, Dietrich CF, Jang HJ, et al. American College of Radiology contrast enhanced ultrasound liver imaging reporting and data system (CEUS LI-RADS) for the diagnosis of hepatocellular carcinoma: a pictorial essay. Ultraschall Med. 2017;38:320–4.

    Article  Google Scholar 

  18. Badea R, Ioanitescu S. Contrast-enhanced ultrasonography (CEUS) of liver masses—principles, clinical applications, drawbacks. Liver Tumors Epidemiol Diagn Prev Treat. 2013; https://doi.org/10.5772/55500.

    Google Scholar 

  19. Thakur S, Jhobta A, Dhiman DS, Sood RG, Chauhan A, Thakur CS. Role of contrast enhanced ultrasound in characterization of focal liver lesions. Egyptian J Radiol Nucl Med. 2014;45:7–17.

    Article  Google Scholar 

  20. Kim TK, Jang HJ. Contrast-enhanced ultrasound in the diagnosis of nodules in liver cirrhosis. World J Gastroenterol. 2014;20(13):3590–6.

    Article  Google Scholar 

  21. Kunze G, Staritz M, Köhler M. Contrast-enhanced ultrasound in different stages of pyogenic liver abscess. Ultrasound Med Biol. 2015;41:952–9.

    Article  Google Scholar 

  22. Lantinga MA, Gevers TJ, Drenth JP. Evaluation of hepatic cystic lesions. World J Gastroenterol. 2013;19(23):3543–54.

    Article  Google Scholar 

  23. Margini C, Berzigotti A, et al. Portal vein thrombosis: the role of imaging in the clinical setting. Dig Liver Dis. 2017;49(2):113–20.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Internal Medicine and Gastroenterology, Institutul Clinic Fundeni, University of Medicine and Pharmacy (UMF) Carol Davila, Bucharest, Romania

    Laura Iliescu

Authors
  1. Laura Iliescu
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Faculty of Medicine, “Titu Maiorescu” University, Central Military Emergency University Hospital “Dr. Carol Davila”, Bucharest, Romania

    Florentina Radu-Ionita

  2. New Jersey Medical School, Rutgers University New Jersey Medical School, Newark, NJ, USA

    Nikolaos T. Pyrsopoulos

  3. Carol Davila University of Medicine and Pharmacy, Central Military Emergency University Hospital “Dr. Carol Davila”, Bucharest, Romania

    Mariana Jinga

  4. Faculty of Medicine, “Titu Maiorescu” University, Central Military Emergency University Hospital “Dr. Carol Davila”, Bucharest, Romania

    Ion C. Tintoiu

  5. Medical Radiation Sciences, Curtin University, Perth, WA, Australia

    Zhonghua Sun

  6. “Prof. C.C. Iliescu” Emergency Institute for Cardiovascular Diseases, Bucharest, Romania

    Ecaterina Bontas

Self Study

Self Study

1.1 Questions

  1. 1.

    Which statement is true:

    1. (a)

      The arterial phase of CEUS lasts from the first 10 s to 30–45 s.

    2. (b)

      The portal phase of CEUS last from 30–45 s to 120 s.

    3. (c)

      The late phase of CEUS last from 120 s to 4–6 min, until the gas bubbles are fully eliminated.

    4. (d)

      CEUS should not be performed in patients with renal impairment.

  2. 2.

    Which statement is true:

    1. (a)

      Hepatocellular carcinoma appears hyperenhanced in the arterial phase of CEUS.

    2. (b)

      Malignant thrombus in the portal vein appears hyperenhanced in the arterial phase of CEUS.

    3. (c)

      Liver metastases typically have rapid wash-out and appear hypoenhanced in the portal phase.

    4. (d)

      Liver hemangiomas have nodular peripheral enhancement during arterial phase, with centripetal progression during portal venous and late phases.

1.2 Answers

  1. 1.

    Which statement is true:

    1. (a)

      CORRECT

    2. (b)

      CORRECT

    3. (c)

      CORRECT

    4. (d)

      FALSE

  2. 2.

    Which statement is true:

    1. (a)

      CORRECT

    2. (b)

      CORRECT

    3. (c)

      CORRECT

    4. (d)

      CORRECT

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Iliescu, L. (2020). Dynamic Contrast-Enhanced Ultrasonography of the Liver. In: Radu-Ionita, F., Pyrsopoulos, N., Jinga, M., Tintoiu, I., Sun, Z., Bontas, E. (eds) Liver Diseases. Springer, Cham. https://doi.org/10.1007/978-3-030-24432-3_44

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-24432-3_44

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-24431-6

  • Online ISBN: 978-3-030-24432-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation