Evaluation of Lymph Node Perfusion Using Continuous Mode Harmonic Ultrasonography With a Second‐Generation Contrast Agent

Rubaltelli, Léopoldo; Khadivi, Yeganeh; Tregnaghi, Alberto; Stramare, Roberto; Ferro, Federica; Borsato, Simonetta; Fiocco, Ugo; Adami, Fausto; Rossi, Carlo Riccardo

doi:10.7863/jum.2004.23.6.829

Cited by 107 publications

(85 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In lymph node pathologies CEUS shows a high accuracy in distinguishing benign from metastastic lesions as enhancement is intense and homogeneous in more than 90% of benign lesions, whereas enhancement is absent or poor in metastatic lesions [11,12]. Lymphomas present a variable enhancement pattern in the early arterial phase, often showing an overlap with both benign and metastatic lesions.…”

Section: Discussionmentioning

confidence: 99%

“…Ultrasound (US) examination of the mediastinum is an effective imaging method with an elevated sensitivity compared to traditional radiographic examination in patients with mediastinal masses, and it is only outperformed by CT in the examination of the posterior mediastinum and the paravertebral region [3e5]. Moreover, contrast enhanced US (CEUS) is proving increasingly useful in the differential diagnosis of lymph node masses [12,13], and US-guided mediastinal biopsy is a valid alternative to CT-guided mediastinal biopsy and even more to mediastinal biopsy carried out during mediastinoscopy [6].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Sonographic management of mediastinal syndrome

Caremani

Benci

Tacconi

et al. 2009

Journal of Ultrasound

View full text Add to dashboard Cite

Introduction: Mediastinal syndrome is suspected on the basis of clinical symptoms and is generally confirmed by chest radiography or computed tomography (CT). However, also grey scale ultrasound (US) and contrast enhanced US (CEUS) are useful in this hematologic emergency as they provide the possibility to perform US-guided biopsy and histological diagnosis. Materials and methods: 15 Patients affected by mediastinal syndrome were prospectively studied using B-mode US and CEUS; 13 of these patients, who had no other lesions, were proposed for US-guided biopsy of the mediastinal mass, but only in 12 patients biopsy was technically possible. Results: In this study, B-mode US reached an excellent sensitivity (100%) in evidencing the lesions but a low specificity which did not exceed 30e40%. CEUS reached an elevated specificity identifying neoplastic pathologies if both the early and the late phases are considered (90e86.6%). US-guided biopsy was possible in 92.3% of lesions showing a diagnostic adequacy of 91.66%. Conclusions: B-mode US associated with CEUS and US-guided biopsy reached an elevated accuracy in the diagnosis of mediastinal masses. If these results are confirmed by further studies, this diagnostic procedure could be included in the routine management of mediastinal syndrome.Sommario Introduzione: La diagnosi di sindrome mediastinica viene sospettata dai sintomi e confermata da una radiografia standard del torace ed ancor meglio dalla TC, ma anche l'ecografia con e senza mezzo di contrasto (CEUS) può essere utile in questa emergenza ematologica, permettendo oltre tutto una diagnosi istologica tramite biopsia ecoguidata. Materiali e metodi: 15 pazienti affetti da sindrome mediastinica sono stati prospetticamente studiati sia con l'ecografia B-Mode che utilizzando la CEUS. 13 di questi pazienti, senza altre lesioni sono stati proposti per una biopsia ecoguidata della massa mediastinica, che è stata tecnicamente possibile solo in 12. Risultati: L'ecografia B-mode mostra in questo lavoro un'ottima sensibilità (100%), nell'evidenziare le lesioni, ma una bassa specificità che non supera il 30e40%. La CEUS mostra invece una buona specificità per le patologie neoplastiche se viene valutata sia la fase precoce che quella tardiva (90e86,6%). La biopsia ecoguidata è stata possibile nel 92,3%, mostrando un'adeguatezza diagnostica del 91,66%. Conclusioni: L'ecografia B-Mode, associata all'ecografia con mdc ed alla biopsia ecoguidata delle masse mediastiniche, ha un'elevata accuratezza nella diagnosi delle masse mediastiniche, che se confermata da ulteriori lavori, può trovare indicazione nel management della sindrome mediastinica. ª

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sonographic management of mediastinal syndrome

Caremani

Benci

Tacconi

et al. 2009

Journal of Ultrasound

View full text Add to dashboard Cite

show abstract

“…3, scheme 4). branches, give ultrasound the use of second-generation ultrasound contrast agents in scans with a low mechanical index offer new possibilities for the assessment of lymph node vascularity, including parenchymal microperfusion as well as large vessel branches [14].…”

Section: Discussionmentioning

confidence: 99%

Vascular patterns in superficial lymphomatous lymph nodes: A detailed sonographic analysis

Białek

Jakubowski

Szczepanik

et al. 2007

Journal of Ultrasound

View full text Add to dashboard Cite

KEYWORDSLymph nodes; Lymphoma; Ultrasound; Power Doppler; Vessel pattern.Abstract Purpose: To identify the vascular patterns found in superficial lymph nodes with histologically confirmed lymphomatous involvement and to determine their value in the sonographic diagnosis of lymphadenopathy. Methods and materials: The study involved the prospective classification of vascular patterns observed during power Doppler and/or color Doppler studies of superficial lymph nodes scheduled for resection. Forty patients (27 men and 13 women, aged 22e84 years; mean age: 58 years) with pathologically proven lymphoma were selected for this study (26 cervical, 13 axillary and 1 inguinal). Results: A longitudinal vessel with or without branches (pattern I) was found in 14 lymphomatous nodes. Six contained short vessel segments distributed in the hilum area or centrally (pattern II), five had multiple vessels, partially branching, entering the node in a few rows from its longitudinal side (pattern III), seven presented multiple vessels that branched irregularly or chaotically with avascular areas (pattern IV), and eight had a peripheral vessel distribution (pattern V). Therefore, 50% of the lymphomatous nodes had vascular patterns regarded as characteristic of reactive lymph nodes (patterns I and II), and 37.5% had patterns normally described in lymph nodes with metastatic involvement (patterns IV and V); other lymphomatous lymph nodes had ambiguous vascular patterns that have not been previously classified (pattern III). Conclusion: The angioarchitecture of superficial lymphomatous lymph nodes varies widely and is difficult to classify. It may resemble that reported in normal or reactive lymph nodes or patterns that are associated with metastases. The finding of a normal or benign vascular pattern in a lymph node with suspected lymphomatous involvement does not eliminate the need for a diagnostic biopsy. Sommario Scopo: Valutazione dei possibili pattern vascolari dei linfonodi superficiali interessati da linfoma confermato da esame istologico allo scopo di ottenere un elemento aggiuntivo nella diagnosi differenziale ecografica tra patologie interessanti i linfonodi. Materiali e metodi: È stata effettuata una classificazione ecografica prospettica di pattern vascolari color e power Doppler di 55 linfonodi superficiali programmati per resezione. Sono stati selezionati per questo studio 40 pazienti con diagnosi istologica di linfoma (26 linfonodi cervicali, 13 ascellari e 1 inguinale). Il gruppo di pazienti studiato era comprensivo di 27 uomini e 13 donne, età 22e84 anni (età media: 58 anni). Risultati: È stato trovato un vaso lungitudinale con o senza ramificazioni (pattern I) in 14 linfoadenopatie; piccoli segmenti vascolari distribuiti nell'area dell'ilo o nella zona centrale del linfonodo (pattern II) in 6 linfoadenopatie. Vasi multipli, parzialmente ramificati, che entrano nel linfonodo in alcune file dal lato longitudinale (pattern III) sono stati riscontrati in 5 linfonodi mentre vasi multipli che si ramificano irregolarmente o...

show abstract

“…Scant or absent perfusion can be observed in widespread metastatic infiltration, reflecting presence of large areas of necrosis. Based on these features, Rubaltelli et al found a specificity, sensitivity, and accuracy in differentiation between benign and metastatic nodes of 93%, 92%, and 93%, respectively [94]. Furthermore, when signal time-intensity curves are generated and parametric images are calculated the perfusion parameters, such as the arrival time, time to peak, and peak signal intensity, the difference between peak signal intensity in hyper enhancing and hypo enhancing regions are higher in metastatic LN [95].…”

Section: Lymphadenopathymentioning

confidence: 99%

Thyroid Ultrasound: State of the Art. Part 2 – Focal Thyroid Lesions

et al. 2017

View full text Add to dashboard Cite

Accurate differentiation of focal thyroid nodules (FTL) and thyroid abnormalities is pivotal for proper diagnostic and therapeutic work-up. In these two part articles, the role of ultrasound techniques in the characterization of FTL and evaluation of diffuse thyroid diseases is described to expand on the recently published World Federation in Ultrasound and Medicine (WFUMB) thyroid elastography guidelines and review how this guideline fits into a complete thyroid ultrasound exam.

show abstract

Evaluation of Lymph Node Perfusion Using Continuous Mode Harmonic Ultrasonography With a Second‐Generation Contrast Agent

Cited by 107 publications

References 23 publications

Sonographic management of mediastinal syndrome

Sonographic management of mediastinal syndrome

Vascular patterns in superficial lymphomatous lymph nodes: A detailed sonographic analysis

Thyroid Ultrasound: State of the Art. Part 2 – Focal Thyroid Lesions

Contact Info

Product

Resources

About