The introduction of ultrasound contrast agents has rendered contrast-enhanced ultrasound (CEUS) a valuable complementary technique to address clinically significant problems. This pictorial review describes the use of CEUS guidance in abdominal intervention and illustrates such application for a range of clinical indications. Clinical application of CEUS discussed include commonly performed abdominal interventional procedures, such as biopsy, drainage, nephrostomy, biliary intervention, abdominal tumor ablation and its subsequent monitoring, and imaging of vascular complications following abdominal intervention. The purpose of this article is to further familiarize readers with the application of CEUS, particularly its specific strength over alternative imaging modalities, in abdominal intervention.

Ultrasonography (US) is an established modality for intervention. The introduction of microbubble US contrast agents (UCAs) has the potential to further improve US imaging for intervention. According to licensing, UCAs are currently approved for clinical use in restricted situations, but many additional indications have become accepted as having clinical value. The use of UCAs has been shown to be safe, and there is no risk of renal toxic effects, unlike with iodinated or gadolinium contrast medium. Broadly speaking, UCAs can be injected into the bloodstream (intravascular use) or instilled into almost any accessible body cavity (endocavitary use), either in isolation or synchronously. In microvascular applications, contrast-enhanced US (CEUS) enhances delineation of necrotic areas and the vascularized target to improve real-time targeting. The ability of CEUS to allow true assessment of vascularity has also been used in follow-up of devascularizing intervention. In macrovascular applications, real-time angiographic images can be obtained with CEUS without nephrotoxic effects or radiation. In endocavitary applications, CEUS can achieve imaging similar to that of iodinated contrast medium-based fluoroscopy; follow-up to intervention (eg, tubography and nephrostography) can be performed at the bedside, which may be advantageous. The use of UCAs is a natural progression in US-guided intervention. The aim of this article is to describe the indications, contraindications, and techniques of using UCAs as an adjunctive tool for US-guided interventional procedures to facilitate effective treatment, improve complication management, and increase the overall success of interventional procedures. Online supplemental material is available for this article. RSNA, 2016.

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Background: There is a genuine interest in the development of probiotic milk and juice based beverages because they are a good-vehicle to deliver probiotic microorganisms to consumers. For this purpose, the viability and metabolism of four probiotic strains (Lactobacillus acidophilus LA5, Bifidobacterium lactis BB12, L. rhamnosus and L. plantarum) were studied in non-fermented milk and carrot juice mix drink. The drinks were evaluated in 5 days interval for viable cell count, pH, acidity, sedimentation and sensory quality during refrigerated storage at 4 ± 2ºC for up to 20 days. Results:The results showed that all strains had good viability in milk/carrot juice drink (88-98%), but L. acidophilus LA5 seemed more stable than three other strains. The levels of pH and acidity were ranged 5.33-6.6 and 0.13-0.31%, respectively. The drinks inoculated with L. rhamnosus and control (nonprobiotic) showed more variation in pH and acidity. The most sedimentation was detected in drinks inoculated with L. rhamnosus, reaching 3.73 mL/10 mL sample. Sensory assessment indicated lowest acceptability in control and milk/carrot juice drink inoculated with L. rhamnosus, respectively. Conclusion: This study indicated that some probiotic bacteria can be applied by food producers to produce functional drinks with an increased shelf-life.

We present a case of a biliary-arterial communication as a consequence of the placement of an internal-external biliary drainage catheter in a liver transplant patient diagnosed on contrast-enhanced ultrasound using a novel application by injecting microbubble contrast into the catheter tube. We postulate that this method may be sensitive in identifying occult communications between the biliary tree and the vascular compartment when a catheter drain is positioned, and there is hemobilia or unexplained sepsis.