Arrival Time Of Contrast Agent Research Articles

Can Ultrasound and Contrast-Enhanced Ultrasound Help Differentiate between Subpleural Focal Organizing Pneumonia and Primary Lung Malignancy?

Background: Subpleural focal organizing pneumonia (FOP) and primary lung malignancy (PLM) are usually confused. The aim of this study was to explore the value of ultrasound (US) and contrast-enhanced ultrasound (CEUS) in the differential diagnosis of FOP and PLM. Methods: A total of 23 patients (mean age: 64.57 ± 11.86 years) with FOP and 100 (mean age: 66.29 ± 11.05 years) with subpleural lesions diagnosed as PLM, confirmed by pathological diagnosis and clinical follow-up, were retrospectively enrolled. The largest lesion diameter, angle between the lesion border and thoracic wall, air bronchial sign, internal blood supply, blood supply form, and pleural effusion examined using conventional US were retrospectively analyzed. The indicators of CEUS included the arrival time of contrast agent in the lesion, lesion–lung arrival time difference, degree of enhancement, distribution uniformity of contrast medium, presence of non-enhancing region, and arterial filling mode in the lesion. A p < 0.05 was considered statistically significant. Results: Presence of air bronchial sign (odds ratio [OR] = 6.18, p = 0.025), acute angle between the lesion border and thoracic wall (OR = 7.124, p = 0.033), and homogeneous enhancement (OR = 35.26, p = 0.01) showed predictive value for the diagnosis of FOP. According to the results of the logistic regression analysis, the area under the receiver operating curve of the above features combined was 0.960, and the sensitivity and specificity were 95.0% and 82.6%, respectively. Conclusions: US combined with CEUS has the potential to differentiate between FOP and PLM.

Study on the diagnosis of metastatic hepatic neuroendocrine neoplasms by contrast-enhanced ultrasound

Objective To retrospectively analyze the contrast-enhanced ultrasound (CEUS) features of metastatic hepatic neuroendocrine neoplasm (MHNEN) and their diagnostic value. Methods Twenty-eight patients with 35 MHNEN lesions were enrolled in this retrospectively study and underwent CEUS examination. The dynamic enhancement features, including enhancement pattern, peak intensity, and washout pattern were analyzed. Results The arrival time of contrast agent, time to peak, time to iso-echogenity and time to hypo-echogenity was (15.96±4.14)s, (21.42±5.01)s, (29.41±4.83)s and (42.06±22.84)s, respectively. Compared with adjacent liver parenchyma, rapid enhancement, synchronous enhancement and slow enhancement were found in 42.9% (15/35), 48.6%(17/35), 8.5%(3/35) of MHNEN lesions, respectively. As for enhancement patterns, 82.9% (29/35) of MHNEN lesions showed global enhancement, while 17.1%(6/35) showed rim-like enhancement. In addition, 22.9%(8/35) of the selesions had a centripetal pattern during the arterial phase. Compared with liver parenchyma, all lesions demonstrated hyper-enhancement at peak enhancement. In portal venous phase, 68.6%(24/35) of MHNEN lesions presented marked hypo-enhancement and 31.4%(11/35) with slight hypo-enhancement. And in late phase, all the lesions showed marked hypo-enhancement.Moreover, the boundaries of the lesions became distinct after contrast injection and another 36 lesions were identified on CEUS compared with conventional ultrasound. Conclusions CEUS can afford more diagnostic information of MHNEN and may be a good technique for diagnosing MHNEN. Key words: Contrast enhanced ultrasound; Liver neoplasms; Neuroendocrine neoplasm; Neoplasms metastasis

Study of quantitative analysis of contrast-enhanced ultrasonic technique in acute radiation-induced liver injury

Objective To evaluate early diagnostic value of quantitative analysis of contrast-enhanced ultrasound (CEUS) in acute radiation-induced liver injury. Methods Sixty female rats were divided into two groups: 50 rats in an experimental group (model group) and 10 rats in a negative control group. The rats in model group were radiated with stereotactic single dose of 20Gy on their liver to establish acute radiation-induced liver injury models. Each 10 rats from model groups and 2 rats from control group were randomly selected and underwent CEUS and histopathological examination on the 3, 7, 14, 21, 28 days after radiation. The degree of injury was classified into four groups according to pathological grading: non-injured group, mild injured group, moderated injured group and severe injured group. The dynamic images of CEUS were off-line analysis and the parameters of arrival time of contrast agent to hepatic artery (HAAT), the arrival time of contrast agent to hepatic vein (HVAT), and the transit time of hepatic artery-hepatic vein (HA-HVTT) were recorded. Time intensity curve (TIC) of liver parenchyma drawn by the software of quantitative analysis was used to obtain quantitative parameters including time to peak (TTP) and peak intensity (PI). Results Along with the severity degree of radiation-induced liver injury, the quantitative parameters, PI decreased while TTP extended. PI of mild injured group, moderated injured group and severe injured group were lower than that of non-injured group (P<0.05). TTP of the three liver injuried groups was higher than non-injured group ( P<0.05). The quantitative parameters HA-HVTT of moderated injured group and severe injured group were decreased than the non-injured group (P<0.05), whereas the difference between mild injured group and non-injured group was not significant. Conclusions Quantitative analysis of CEUS can provide a certain value for early diagnosis in acute radiation-induced liver injury. Key words: Ultrasonography; Microbubbles; Radiation-induced liver injury

Use of quantitative contrast-enhanced ultrasonography to detect diffuse renal changes in Beagles with iatrogenic hypercortisolism

To determine the feasibility of quantitative contrast-enhanced ultrasonography (CEUS) for detection of changes in renal blood flow in dogs before and after hydrocortisone administration. 11 Beagles. Dogs were randomly assigned to 2 treatment groups: oral administration of hydrocortisone (9.6 mg/kg; n = 6) or a placebo (5; control group) twice a day for 4 months, after which the dose was tapered until treatment cessation at 6 months. Before treatment began and at 1, 4, and 6 months after, CEUS of the left kidney was performed by IV injection of ultrasonography microbubbles. Images were digitized, and time-intensity curves were generated from regions of interest in the renal cortex and medulla. Changes in blood flow were determined as measured via contrast agent (baseline [background] intensity, peak intensity, area under the curve, arrival time of contrast agent, time-to-peak intensity, and speed of contrast agent transport). Significant increases in peak intensity, compared with that in control dogs, were observed in the renal cortex and medulla of hydrocortisone-treated dogs 1 and 4 months after treatment began. Baseline intensity changed similarly. A significant increase from control values was also apparent in area under the curve for the renal cortex 4 months after hydrocortisone treatment began and in the renal medulla 1 and 4 months after treatment began. A significant time effect with typical time course was observed, corresponding with the period during which hydrocortisone was administered. No difference was evident in the other variables between treated and control dogs. Quantitative CEUS allowed detection of differences in certain markers of renal blood flow between dogs treated orally with and without hydrocortisone. Additional studies are needed to investigate the usefulness of quantitative CEUS in the diagnosis of diffuse renal lesions.

Diagnosis of liver cirrhosis with contrast-enhanced ultrasound

The assessment of the extent of liver fibrosis is very important for the prognosis and clinical management of chronic liver diseases. Although liver biopsy is the gold standard for the assessment of liver fibrosis, new non-invasive diagnostic methods are urgently needed in clinical work due to certain limitations and complications of biopsy. Noninvasive imaging studies play an important role in the diagnosis of focal liver disease and diffuse liver diseases. Among them, ultrasonography is the first choice for study of the liver in clinical work. With the development of ultrasound contrast agents and contrast specific imaging techniques, contrast-enhanced ultrasound (CEUS) shows good performance and great potential in the evaluation of liver fibrosis. Researchers have tried different kinds of contrast agent and imaging method, such as arrival time of contrast agent in the hepatic vein, and quantitative analysis of the enhancement level of liver parenchyma, to evaluate the degree of liver fibrosis during the past 10 years. This review mainly summarizes the clinical studies concerning the assessment of liver fibrosis using CEUS.