Contrast-enhanced ultrasound (CEUS) in abdominal intervention

Abstract

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.

Application of Contrast‐Enhanced Real‐time 3‐Dimensional Ultrasound in Solid Abdominal Organ Trauma

“…This is particularly critical to the physician for assessing the severity of an injury when treating patients with blunt abdominal trauma . However, 2DUS, especially based on the contrast‐enhanced technology, still plays a basic and necessary role in the primary identification and evaluation of solid abdominal organ trauma …”

Can Contrast-Enhanced Ultrasonography Document Both an Iatrogenic Bleeding and the Stop of the Bleeding? A Case Report

“…CEUS is increasingly recommended as a reliable additional tool when differentiation on grayscale US is challenging, for instance in the differential diagnosis between phlegmon and abscess [2]. Moreover, when the abdominal collections can be confidently depicted, US and CEUS are considered the imaging techniques of choice to guide their percutaneous drainage, enabling both the detection of septations and loculations, and the real-time monitoring of the needle advancement [2][3][4]. Complications of percutaneous drainage, such as bleeding and perforation, occur in 5% of cases [3].…”

“…Moreover, when the abdominal collections can be confidently depicted, US and CEUS are considered the imaging techniques of choice to guide their percutaneous drainage, enabling both the detection of septations and loculations, and the real-time monitoring of the needle advancement [2][3][4]. Complications of percutaneous drainage, such as bleeding and perforation, occur in 5% of cases [3]. US can document the presence of hematomas, but it cannot detect whether the bleeding is still ongoing, and CECT is the first-choice imaging technique to detect active bleeding.…”

“…Moreover, it can be used to guide percutaneous drainage of the abscess collections [1]. Recently, contrast-enhanced US (CEUS) has been reported to improve the US assessment of the bowel pathology, enabling to better evaluate and quantify the presence of bowel inflammation and its complications [2], as well as to guide more reliably and safely the percutaneous treatment [3]. However, abscess drainage carries an inherent risk of bleeding complications also with CEUS guidance, even though they are often self-limited and can usually be managed conservatively [3].…”

“…Recently, contrast-enhanced US (CEUS) has been reported to improve the US assessment of the bowel pathology, enabling to better evaluate and quantify the presence of bowel inflammation and its complications [2], as well as to guide more reliably and safely the percutaneous treatment [3]. However, abscess drainage carries an inherent risk of bleeding complications also with CEUS guidance, even though they are often self-limited and can usually be managed conservatively [3]. We report a case in which CEUS played a key role in both detecting active bleeding following CEUS-guided drainage of a tubo-ovarian abscess, and documenting its self-limited course.…”