Ultrasonography of the biliary tract â€“ up to date. The importance of correlation between imaging methods and patientsâ€™ signs and symptoms.

Badea, Radu; Zaro, Razvan; Tanţău, Marcel; Chiorean, Liliana

doi:10.11152/mu.2013.2066.173.rbd

Cited by 9 publications

(4 citation statements)

References 62 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Remarkable advances have been made in the equipment and methods used for diagnostic imaging . However, even though new technologies and knowledge are steadily accumulating, we are still unable to directly diagnose AC based on imaging findings.…”

Section: Diagnostic Criteria For Acute Cholangitismentioning

confidence: 99%

Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholangitis (with videos)

Kiriyama

Kozaka

Takada

et al. 2018

J Hepato Biliary Pancreat

503

425

View full text Add to dashboard Cite

Although the diagnostic and severity grading criteria on the 2013 Tokyo Guidelines (TG13) are used worldwide as the primary standard for management of acute cholangitis (AC), they need to be validated through implementation and assessment in actual clinical practice. Here, we conduct a systematic review of the literature to validate the TG13 diagnostic and severity grading criteria for AC and propose TG18 criteria. While there is little evidence evaluating the TG13 criteria, they were validated through a large-scale case series study in Japan and Taiwan. Analyzing big data from this study confirmed that the diagnostic rate of AC based on the TG13 diagnostic criteria was higher than that based on the TG07 criteria, and that 30-day mortality in patients with a higher severity based on the TG13 severity grading criteria was significantly higher. Furthermore, a comparison of patients treated with early or urgent biliary drainage versus patients not treated this way showed no difference in 30-day mortality among patients with Grade I or Grade III AC, but significantly lower 30-day mortality in patients with Grade II AC who were treated with early or urgent biliary drainage. This suggests that the TG13 severity grading criteria can be used to identify Grade II patients whose prognoses may be improved through biliary drainage. The TG13 severity grading criteria may therefore be useful as an indicator for biliary drainage as well as a predictive factor when assessing the patient's prognosis. The TG13 diagnostic and severity grading criteria for AC can provide results quickly, are minimally invasive for the patients, and are inexpensive. We recommend that the TG13 criteria be adopted in the TG18 guidelines and used as standard practice in the clinical setting. Free full articles and mobile app of TG18 are available at: http://www.jshbps.jp/modules/en/index.php?content_id=47. Related clinical questions and references are also included.

show abstract

Section: Diagnostic Criteria For Acute Cholangitismentioning

confidence: 99%

Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholangitis (with videos)

Kiriyama

Kozaka

Takada

et al. 2018

J Hepato Biliary Pancreat

503

425

View full text Add to dashboard Cite

show abstract

“…1 They have no renal or cardiac toxicity and can be safely administered in patients with renal insufficiency. 2 In Europe, the contrast agent SonoVue (Bracco Spa, Milano, Italy) is mainly used. It consists of sulfur hexafluoride bubbles enclosed in a phospholipid membrane shell.…”

Section: Physics Of Us Contrast Agentsmentioning

confidence: 99%

“…Contrast agents are composed of microbubbles of gas contained in a shell of protein, lipid, or polymer . They have no renal or cardiac toxicity and can be safely administered in patients with renal insufficiency . In Europe, the contrast agent SonoVue (Bracco Spa, Milano, Italy) is mainly used.…”

Section: Physics Of Us Contrast Agentsmentioning

confidence: 99%

Contrast‐enhanced ultrasound examination of the gallbladder and bile ducts: A pictorial essay

Cokkinos

Antypa

Tsolaki

et al. 2017

J of Clinical Ultrasound

View full text Add to dashboard Cite

The gallbladder and bile ducts are usually assessed initially with conventional gray-scale ultrasound (US). Contrast enhanced US (CEUS) is used when a diagnosis cannot be reached with conventional US. CEUS is easy to learn and perform. US contrast agents can be safely administered in patients with renal function impairment. In this pictorial essay the physics, examination technique and indications of CEUS for examining the gallbladder and bile ducts are reviewed. Gallbladder indications include elucidating normal variants, differentiating sludge from neoplastic lesions, benign and malignant pathology, infection, wall rupture and hemobilia. In the biliary tree CEUS is used for studying benign and malignant tumors, including metastases and cholangiocarcinoma, as well as intrabiliary injection. K E Y W O R D Sbile ducts, CEUS, contrast agents, gallbladder, ultrasound | I N TR ODU C TI ONThe gallbladder and bile ducts are usually adequately imaged with grayscale sonography (US) and often no additional imaging is required. In cases when further imaging is needed to elucidate US findings, contrast-enhanced ultrasound (CEUS) overcomes the limitations of color Doppler imaging and can be used immediately after grayscale US examination. | PHYSICS OF US CONTRAST AGENTSContrast agents are composed of microbubbles of gas contained in a shell of protein, lipid, or polymer. 1 They have no renal or cardiac toxicity and can be safely administered in patients with renal insufficiency. CEUS examination requires dedicated contrast agent-specific techniques. 5,6 One of these techniques is phase inversion, where 2 different US pulses in opposite phases are emitted by the scanner sequentially. This achieves optimal contrast resolution and minimal stationary tissue signal. 7 A split-screen setting of the machine's monitor (dual view mode) allows simultaneous display of contrast-enhanced and conventional gray-scale images. However, a common artifact results from strongly reflective structures (eg, the diaphragm, vessel walls, the abdominal wall, or gas-filled structures) appearing as contrast enhancement on the CEUS part of the screen. 8

show abstract

“…The excretion of the gas is pulmonary, while the excretion of the phospholipid component is by the liver [5]. Their lack of renal impact makes them appropriated for use in kidney impairment [6]. CEUS can detect blood flow in far smaller vessels, compared to Doppler US i.e.…”

Section: Introductionmentioning

confidence: 99%

Intracavitary Applications for CEUS in PTCD

Atanasova,

Pentchev,

Nolsøe

2024

Preprint

View full text Add to dashboard Cite

Background: Intracavitary contrast-enhanced ultrasound is widely accepted as a highly informative, safe and easily reproducible technique for diagnosis, treatment and follow- up of different pathologies of the biliary tree. Methods: This article reports the combined conclusions of personal experience with pictorial examples and literature review of applications for CEUS in intracavitary biliary scenarios. Different methodologies, choices of equipment, indications for the procedure and expected complications were identified and described from the authors’ own experience as well as from a review of published studies with total of 208 patients for the period between 2009 and 2015. Results: Indications were biliary obstruction by various etiologies, including postoperative strictures, evaluation of the biliary tree of liver donors (n=12) and evaluation of localization of a drainage catheter. One of the studies found a statistically significant difference in the diagnostic accuracy of PTC and PUSC. Conclusion: Intracavitary CEUS brings all the positive features of US together with the virtues of contrast- enhanced imaging, proving comparable accuracy to the listed techniques for diagnostics of biliary tree diseases.

show abstract

Ultrasonography of the biliary tract â€“ up to date. The importance of correlation between imaging methods and patientsâ€™ signs and symptoms.

Cited by 9 publications

References 62 publications

Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholangitis (with videos)

Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholangitis (with videos)

Contrast‐enhanced ultrasound examination of the gallbladder and bile ducts: A pictorial essay

Intracavitary Applications for CEUS in PTCD

Contact Info

Product

Resources

About