Skip to main content

Advertisement

Log in

Contrast-enhanced ultrasound for abdominal image-guided procedures

  • Special Section: Cross Sectional Interventions
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Introduction

Since FDA approval for contrast-enhanced ultrasound (CEUS), clinical applications have increased to include diagnostic imaging of hepatic, renal, and other abdominal lesions. The modality has also demonstrated utility in certain image-guided procedures. Intravascular ultrasound contrast agents use microbubbles to improve visibility of solid tumors. Lesions not well seen on grayscale or Doppler ultrasound may become amenable to CEUS-guided biopsy or ablation.

Materials and Methods

This pictorial essay provides eleven examples to illustrate the current use of CEUS in a variety of abdominal image-guided procedures. Hepatic, renal, peritoneal, and soft tissue cases are presented.

Conclusion

CEUS can improve visualization and targeting in abdominal image-guided procedures, without nephrotoxicity or radiation exposure.

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

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13

Similar content being viewed by others

References

  1. Gramiak R, Shah PM (1968) Echocardiography of the aortic root. Investigative Radiology 3(5): 356–366. doi: https://doi.org/10.1097/00004424-196809000-00011

    Article  CAS  PubMed  Google Scholar 

  2. Brannigan M, Burns PN, Wilson SR (2004) Blood flow patterns in focal liver lesions at microbubble-enhanced US. RadioGraphics 24(4):921–935. https://doi.org/https://doi.org/10.1148/rg.244035158

    Article  PubMed  Google Scholar 

  3. Gulati M, King KG, Gill IS, Pham V, Grant E, Duddalwar VA (2015) Contrast-enhanced ultrasound (CEUS) of cystic and solid renal lesions: a review. Abdom Imaging 40(6):1982–1996. https://doi.org/https://doi.org/10.1007/s00261-015-0348-5

    Article  PubMed  Google Scholar 

  4. Dietrich CF, Averkiou M, Nielsen MB et al. (2017) How to perform contrast-enhanced ultrasound (CEUS). Ultrasound Int Open 4(1):E2–E15. https://doi.org/https://doi.org/10.1055/s-0043-123931

    Article  Google Scholar 

  5. Lorentzen T, Nolsoe CP (2019) The role of US contrast agents in US-guided biopsy of focal liver lesions: a pictorial review. Ultrasound Int Open 5(1):E11–E19. https://doi.org/https://doi.org/10.1055/a-0770-4237

    Article  PubMed  Google Scholar 

  6. Huang DY, Yusuf GT, Daneshi M, Ramnarine R, Deganello A, Sellars ME, Sidhu PS (2018) Contrast-enhanced ultrasound (CEUS) in abdominal intervention. Abdom Radiol 43:960–976. https://doi.org/https://doi.org/10.1007/s00261-018-1473-8

    Article  Google Scholar 

  7. Lorentzen T, Nolsøe C, Ewertsen C et al. (2015) EFSUMB guidelines on interventional ultrasound (INVUS), part I – general aspects (long version). Ultraschall Med 36(05): E1–E14. DOI: https://doi.org/10.1055/s-0035-1553593

    Article  CAS  PubMed  Google Scholar 

  8. Sidhu PS, Brabrand K, Cantisani V et al. (2015) EFSUMB guidelines on interventional ultrasound (INVUS), part II – diagnostic ultrasound-guided interventional procedures (long version). Ultraschall Med 36(06): E15–E35. DOI: https://doi.org/10.1055/s-0035-1554036

    Article  CAS  PubMed  Google Scholar 

  9. Burak KW, Sherman M (2015) Hepatocellular carcinoma: Consensus, controversies and future directions. A report from the Canadian Association for the Study of the Liver Hepatocellular Carcinoma Meeting. Can J Gastroenterol Hepatol. 29(4):178–84. doi: https://doi.org/10.1155/2015/824263

    Article  PubMed  PubMed Central  Google Scholar 

  10. Omata M, Lesmana LA, Tateishi R et al. (2010) Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma. Hepatol Int. 18;4(2):439–74. doi: https://doi.org/10.1007/s12072-010-9165-7

  11. Chen C, Liang P, Yu J, Yu X, Cheng Z, Han Z, Liu F, Li X (2016) Contrast-enhanced ultrasound-guided percutaneous microwave ablation of renal cell carcinoma that is inconspicuous on conventional ultrasound. International Journal of Hyperthermia, 32:6, 607–613, DOI: https://doi.org/10.3109/02656736.2016.1172118

    Article  PubMed  Google Scholar 

  12. Emanuel AL, Meijer RI, Van Poelgeest E, Spoor P, Serné EH, Eringa EC (2020) Contrast-enhanced ultrasound for quantification of tissue perfusion in humans. Microcirculation 27(1):e12588. doi: https://doi.org/10.1111/micc.12588

    Article  PubMed  Google Scholar 

  13. Shakeri S, Afshari Mirak S, Mohammadian Bajgiran A et al. (2019) The effect of tumor size and location on efficacy and safety of US- and CT- guided percutaneous microwave ablation in renal cell carcinomas. Abdom Radiol 44, 2308–2315. https://doi.org/https://doi.org/10.1007/s00261-019-01967-8

    Article  Google Scholar 

  14. Jenssen C, Hocke M, Fusaroli P et al. (2015) EFSUMB guidelines on interventional ultrasound (INVUS), Part IV – EUS-guided interventions: General aspects and EUS-guided sampling (long version). Ultraschall Med 37(02): E33–E76. DOI: https://doi.org/10.1055/s-0035-1553785

    Article  PubMed  Google Scholar 

  15. Piscaglia F, Nolsøe C, Dietrich CF et al. (2011) The EFSUMB guidelines and recommendations on the clinical practice of contrast enhanced ultrasound (CEUS): Update 2011 on non-hepatic applications. Ultraschall Med 33(1): 33–59. DOI: https://doi.org/10.1055/s-0031-1281676

    Article  PubMed  Google Scholar 

  16. Eisenbrey JR, Sridharan A, Machado P et al. (2012) 3D subharmonic ultrasound imaging in vitro and in vivo. Acad Radiol. 19(6): 732–739. https://doi.org/https://doi.org/10.1016/j.acra.2012.02.015

    Article  PubMed  PubMed Central  Google Scholar 

  17. Bracco Diagnostic, Inc. (2022) Lumason datasheet. https://imaging.bracco.com/us-en/products/contrast-enhanced-ultrasound/lumason. Accessed 26 February 2022

  18. General Electric Healthcare (2022) Optison datasheet. https://www.gehealthcare.com/products/contrast-media/optison. Accessed 26 February 2022

  19. Lantheus Medical Imaging, Inc. (2022) Definity datasheet. https://www.lantheus.com/products/overview/definity-3/. Accessed 26 February 2022

  20. Claudon M, Dietrich CF, Choi BI et al. (2013) 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 Med 34:11–29. https://doi.org/https://doi.org/10.1055/s-0032-1325499

    Article  CAS  PubMed  Google Scholar 

  21. Lindner JR, Belcik T, Main ML et al. (2021) Expert Consensus Statement from the American Society of Echocardiography on Hypersensitivity Reactions to Ultrasound Enhancing Agents in Patients with Allergy to Polyethylene Glycol (PEG). American Society of Echocardiography, April 2021. https://www.asecho.org/wp-content/uploads/2021/05/ASE-2526_FDA-EDC-Document_p5.pdf. Accessed 17 May 2022

  22. Dietrich CF, Nolsøe CP, Barr RG et al. (2020) Guidelines and good clinical practice recommendations for contrast-enhanced ultrasound (CEUS) in the liver-update 2020 WFUMB in cooperation with EFSUMB, AFSUMB, AIUM, and FLAUS. Ultrasound Med Biol. 46(10):2579–2604. doi: https://doi.org/10.1016/j.ultrasmedbio.2020.04.030

    Article  PubMed  Google Scholar 

  23. D’Onofrio M, Crosara S, De Robertis R, Canestrini S, Mucelli RP (2015) Contrast-enhanced ultrasound of focal liver lesions. Am J Roentgenol 205:W56–W66. https://doi.org/https://doi.org/10.2214/ajr.14.14203

    Article  Google Scholar 

  24. Yoon SH, Lee KH, Kim SY, Kim YH, Kim JH, Lee SH, Kim TK (2010) Real-time contrast-enhanced ultrasound-guided biopsy of focal hepatic lesions not localised on B-mode ultrasound. Eur Radiol 20:2047–2056. https://doi.org/https://doi.org/10.1007/s00330-010-1757-z

    Article  PubMed  Google Scholar 

  25. Francica G, De Sio I, Meloni MF et al. (2018) Biopsy of liver target lesions under contrast-enhanced ultrasound guidance. A multicenter study. Ultraschall Med. 39(4): 448–453. doi: https://doi.org/10.1055/s-0043-122496.

    Article  PubMed  Google Scholar 

  26. Lekht I, Gulati M, Nayyar M, Katz MD, Ter-Oganesyan R, Marx M, Cen SY, Grant E (2016) Role of contrast-enhanced ultrasound (CEUS) in evaluation of thermal ablation zone. Abdom Radiol 41(8):1511–1521. https://doi.org/https://doi.org/10.1007/s00261-016-0700-4

    Article  Google Scholar 

  27. Catalano O, Sandomenico F, Raso MM, Siani A (2005) Real-time, contrast-enhanced sonography: a new tool for detecting active bleeding. J Trauma 59(4):933–939 doi: https://doi.org/10.1097/01.ta.0000188129.91271.ab

    Article  PubMed  Google Scholar 

  28. Tagliati C, Argalia G, Polonara G et al. (2019) Contrast-enhanced ultrasound in delayed splenic vascular injury and active extravasation diagnosis. Radiol Med 124:170–175 https://doi.org/https://doi.org/10.1007/s11547-018-0961-9

    Article  PubMed  Google Scholar 

  29. Rafailidis V, Fang C, Yusuf GT et al. (2018) Contrast-enhanced ultrasound (CEUS) of the abdominal vasculature. Abdom Radiol 43, 934–947. https://doi.org/https://doi.org/10.1007/s00261-017-1329-7

    Article  Google Scholar 

  30. Helck A. Hoffmann RT, Sommer WH et al. (2010) Diagnosis, therapy monitoring and follow up of renal artery pseudoaneurysm with contrast-enhanced ultrasound in three cases.” Clinical Hemorheology and Microcirculation 46(2–3):127–137. DOI: https://doi.org/10.3233/CH-2010-1339

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Craig B. Wilsen.

Ethics declarations

Conflict of interest

All authors declare that they have no conflict of interest.

Research involving human participants and/or animals

Not applicable since no research involving human participants and/or animals was performed.

Informed consent

Not applicable since the manuscript contains no patient-identifiable data.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wilsen, C.B., Patel, M.K., Douek, M.L. et al. Contrast-enhanced ultrasound for abdominal image-guided procedures. Abdom Radiol 48, 1438–1453 (2023). https://doi.org/10.1007/s00261-023-03804-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-023-03804-5

Keywords

Navigation