Influence of limited examination conditions on contrast-enhanced sonography for characterising liver lesions

Contrast enhanced ultrasonography (CEUS) to detect abdominal microcirculatory disorders in severe cases of COVID-19 infection: First experience

“…In our experience, Contrast Enhanced Ultrasound Sonography (CEUS) is an excellent diagnostic tool for monitoring severe cases of intermediate care patients with early changes of abdominal microcirculatory disorders (8,10,14,15]. CEUS can be an important diagnostic tool for monitoring capillary perfusion of abdominal organs [14,15] and as these initial experiences suggest even in severe cases of COVID-19 infection.…”

“…Using Sulphur-Hexafluoride Microbubbles as ultrasound contrast medium, there is no risk for severe side effects for the thyroid and kidneys and only a low allergic risk, which is in the range of other contrast media. However, special ultrasound equipment, the possibility of Contrast Harmonic Imaging (CHI) at low mechanical index (MI < 0.2) and experienced examiners are required [10]. Then, the diagnostic accuracy is in the range of contrast-enhanced computed tomography (ceCT) or contrast-agent-enhanced magnetic resonance imaging (MRI) with correspondingly good sound conditions [8,11].…”

Quality Assessment of CEUS in Individuals with Small Renal Masses—Which Individual Factors Are Associated with High Image Quality?

“…Putz et al reported meteorism and obesity as the main patient-related factors with a negative effect on CEUS image quality [11]. While CEUS is predominantly used for liver imaging, renal applications of CEUS have attracted growing interest.…”

“…For CEUS of focal liver lesions, it has been shown that diagnostic confidence is improved by good examination conditions [11]. The authors of this study defined difficult ultrasound (US) conditions as the presence of meteorism, distinct steatosis, liver cirrhosis with inhomogeneous tissue, and obesity with a body mass index (BMI) > 30 kg/m 2 [11].…”

Abdominal Applications of 4D Flow MRI

“…Doppler ultrasound enables the measurement of flow velocities, whereby the calculation of flow rates is often based on assumptions resulting in possibly inaccurate quantification [4]. The main disadvantages of ultrasound examinations include the missing possibility to comprehensively image the complex abdominal vascular anatomy due to a limited acoustic window [4], reduced image quality e. g. in obesity or meteorism [9] and operator dependency [10]. In contrast, 4D flow MRI has shown strong repeatability [11] and reproducible results regarding the interand intra-reader agreement of blood flow quantification in the abdomen [12].…”