Developments in the application of high resolution ultrasound in clinical diagnostics

Abstract

This issue of Clinical Hemorheology and Microcirculation is dedicated to the developments in the application of high resolution ultrasound in clinical diagnostics.The editors sought to provide information on the latest procedures for ultrasound bringing together outstanding original articles and reviews about new diagnostic information obtained by recent technological advances but also clarify well-established or controversial subjects. A very important step forward in ultrasound technology towards clinical application was the introduction of microbubbles as contrast enhancer. Contrast enhanced ultrasound (CEUS), performed with the intravenous injection of microbubble contrast agents applying the low mechanical index (MI) technique of contrast harmonic imaging has expanded the horizon for ultrasound imaging. CEUS provides a technique with superb sensitivity from early arterial phase up to late venous enhancement in dynamic realtime vascular imaging. For the first time, this ultrasound technology allows the non-invasive demonstration of blood flow of inner organs at a microcirculatory level [1,2]. Further, the purely intravascular microbubbles enable ultrasound to be used to monitor changes in the blood flow of tumors and in inflamed areas in a diagnostic approach but also for therapy control. Its performance without any requirement for ionizing radiation and with no nephrotoxicity makes it a compelling choice in many clinical arenas and is now FDA approved for liver imaging, and also for children [1][2][3][4][5][6][7][8].In this special issue, a first study evaluated factors which are associated with the initial incomplete ablation in radiofrequency ablation (RFA) for thyroid nodules [2]. Recent intraoperative studies reported the results of CEUS for immediate assessment of ablation status after RFA of hepatic malignancies [3]. These two articles showed the benefit of CEUS in the treatment control for ablation of solid nodules in various organs in terms of the virtues of CEUS such as real-time scanning, easy performance, and immediate assessment. In addition to qualitative evaluation for characterization [4,5], quantitative evaluation of blood flow perfusion is also available with use of CEUS [6]. Other important applications are the assessment of vascular diseases such as vascular complications after liver transplantation or the detection of endoleaks after endovascular aortic repair (EVAR) [7,8] or post-operative complications [9].