Evaluation of the thrombus of abdominal aortic aneurysms using contrast enhanced ultrasound - preliminary results

Łukasiewicz, Adam; Garkowski, Adam; Rutka, Katarzyna; Janica, Jerzy; Łebkowska, Urszula

doi:10.1038/srep34152

Cited by 4 publications

(4 citation statements)

References 27 publications

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“…It is imperative to differentiate IVL from various ailments such as venous thrombosis, Budd-Chiari syndrome, right atrial myxoma, primary leiomyosarcoma, and endometrial stromal sarcoma ( 35 , 36 ). Venous thrombosis is characterized by the absence of neovascularization and is not amenable to enhancement by CEUS, as it is associated with a dearth of nourished blood vessel proliferation ( 37 ). Budd-Chiari syndrome is characterized by the existence of lesions that occupy space in the hepatic vein and inferior vena cava segment, resulting in a state of partial or competitive vascular obstruction ( 38 ), usually accompanied by hepatosplenomegaly, severe ascites, as well as varicose veins of the thoracic and abdominal wall and lower limbs.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic experience of intravenous leiomyomatosis with emphasis on conventional ultrasonography imaging: a single-center study

Ge,

Wang,

Wang

et al. 2023

Front. Oncol.

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ObjectiveIntravenous leiomyomatosis (IVL) is a rare and aggressive tumor type that has the potential to extend into the inferior vena cava (IVC) and is susceptible to be misdiagnosed and neglected. Despite its clinical significance, there is a paucity of research that has focused on the specific manifestations of IVL on ultrasonography. Therefore, this study aims to systematically analyze the specific ultrasound features of IVL and augment its diagnostic accuracy.Materials and methodProspective inclusion was granted to patients admitted to our hospital between December 2016 and March 2021 for an IVC-occupying lesion. Multi-modal ultrasonography, encompassing gray-scale and color Doppler, was conducted. Lesions were categorized as IVL or non-IVL based on pathological or follow-up data. Two ultrasound sonographers with over 5 years of experience read and recorded ultrasound data for all lesions, which were subsequently comparatively analyzed to identify specific signs of IVL.ResultsA total of 284 patients diagnosed with IVC-occupying lesions were included in the study. The lesion types comprised of IVL (n=67, 23.6%), IVC thrombus (n=135, 47.5%), tumor thrombus of renal carcinoma involving the IVC (n=35, 12.4%), tumor thrombus of liver carcinoma involving the IVC (n=24, 8.5%), leiomyosarcoma of the IVC (n=14, 4.9%), and tumor thrombus of adrenocortical adenocarcinoma (n=9, 4.1%). The presence of “sieve hole” and “multi-track” signs was observed in 20 IVL lesions under the grey-scale modality, while both signs were absent in the non-IVL group (P<0.01). The study found no statistically significant differences in the presentation of “sieve hole” and “multi-track” signs under the grey-scale and color Doppler modalities in cases of intravascular lithotripsy (IVL) (P>0.05). Using these two signs as diagnostic criteria for IVL, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), miss rate, misdiagnosis rate, and accuracy were determined to be 29.9%, 100%, 100%, 82.2%, 70.1%, 0, and 83.5%, respectively (AUC ROC=0.649; 95%CI: 0.537-0.761).ConclusionIVL exhibits distinct ultrasound presentations, including “sieve hole” and “multi-track” signs, which demonstrate high specificity and accuracy as diagnostic indicators. Furthermore, these signs are corroborated by pathological evidence and effectively distinguish IVL from other lesions occupying the IVC.

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Section: Discussionmentioning

confidence: 99%

Diagnostic experience of intravenous leiomyomatosis with emphasis on conventional ultrasonography imaging: a single-center study

Ge,

Wang,

Wang

et al. 2023

Front. Oncol.

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“…We compared BFl-findings with CEUS and CTA in a considerable subset of our patients. Some studies used CEUS for assessment of mural thrombus volume [ 12 ] and mural thrombus vascularization [ 13 ] in abdominal aortic aneurysms, but to our knowledge sonographic studies on WAFAS of the abdominal aorta have not been published before. We found that in the abdominal aorta, CEUS was less sensitive than CTA for the detection of WAFAS.…”

Section: Discussionmentioning

confidence: 99%

The Flashlight-Sign: A Novel B-Flow Based Ultrasound Finding for Detection of Intraluminal, Wall-Adherent, Floating Structures of the Abdominal Aorta and Peripheral Arteries

et al. 2022

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This study aimed to evaluate the potential diagnostic value of a novel, sonographic, B-Flow (BFl)-based sign (“flashlight sign”, FLS) for the detection of wall-adherent, floating arterial structures (WAFAS). The FLS, characterized by a fast moving, very bright, intraluminal signal, was detected in 28 patients with WAFAS. We divided this cohort into three subgroups according to the affected vascular segments: (1) peripheral arteries (n = 10); (2) native abdominal aorta (n = 8); and (3) abdominal aorta after endovascular aortic repair (EVAR; n = 10). Clinical characteristics were analyzed and BFl-findings were compared with contrast-enhanced ultrasound (CEUS) and computed tomography angiography (CTA). Seven patients (25%) suffered from arterial embolism downstream to the FLS (EVAR, n = 4; native abdominal aorta, n = 1; peripheral arteries, n = 2). WAFAS of the abdominal aorta (native or after EVAR), as indicated by the FLS, were visible by CEUS and CTA in 60% and 93.3%, respectively. Based on the largest cohort (to this point) of patients with WAFAS, we propose a clinically useful, BFl-based sonographic sign for the detection of these underrated arterial pathologies in the abdominal aorta and the peripheral arteries.

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“…We compared BFI-findings with CEUS and CTA in a considerable subset of our patients. Some studies used CEUS for assessment of mural thrombus volume (12) and mural thrombus vascularization (13) in abdominal aortic aneurysms, but to our knowledge sonographic studies on WAFAS of the abdominal aorta have not been published before. We found that in the abdominal aorta, CEUS was less sensitive than CTA for detection of WAFAS.…”

Section: Discussionmentioning

confidence: 99%

The Flashlight-Sign: a Novel B-Flow Based Ultrasound Finding for Detection of Intraluminal, Wall-Adherent, Floating Structures of the Abdominal Aorta and Peripheral Arteries

Lottspeich¹,

Puhr‐Westerheide²,

Stana³

et al. 2022

Preprint

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This study aimed on evaluating the potential diagnostic value of a novel, sonographic, B-Flow Imaging (BFI)-based sign (“flashlight sign”, FLS) for the detection of wall-adherent, floating arterial structures (WAFAS). The FLS, characterized by a fast moving, very bright, intraluminal signal was detected in 28 patients with WAFAS. We divided this cohort into three subgroups, depending on the affected vascular segments: (1) peripheral arteries (n = 10), (2) native abdominal aorta (n = 8), and (3) abdominal aorta after endovascular aortic repair (EVAR; n = 10). Clinical characteristics were analyzed and BFI-findings were compared with contrast enhanced ultrasound (CEUS) and computed tomography angiography (CTA). Seven patients (25%) suffered from arterial embolism downstream to the FLS (EVAR, n = 4; native abdominal aorta, n = 1; peripheral arteries, n = 2). WAFAS of the abdominal aorta (native or after EVAR), as indicated by the FLS, were visible by CEUS and CTA in 60% and 93.3%, respectively. Based on the so far largest cohort of patients with WAFAS, we propose a clinically useful, BFI-based sonographic sign for detection of these so far underrated arterial pathologies in the abdominal aorta and the peripheral arteries.

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Evaluation of the thrombus of abdominal aortic aneurysms using contrast enhanced ultrasound - preliminary results

Cited by 4 publications

References 27 publications

Diagnostic experience of intravenous leiomyomatosis with emphasis on conventional ultrasonography imaging: a single-center study

Diagnostic experience of intravenous leiomyomatosis with emphasis on conventional ultrasonography imaging: a single-center study

The Flashlight-Sign: A Novel B-Flow Based Ultrasound Finding for Detection of Intraluminal, Wall-Adherent, Floating Structures of the Abdominal Aorta and Peripheral Arteries

The Flashlight-Sign: a Novel B-Flow Based Ultrasound Finding for Detection of Intraluminal, Wall-Adherent, Floating Structures of the Abdominal Aorta and Peripheral Arteries

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