To illustrate the spectrum of novel clinical applications of contrast-enhanced ultrasound (CEUS) in both non-vascular and vascular radiological interventional procedures.
To outline the advantages and techniques of CEUS guided intervention
Through a problem-orientated approach,
we aim to demonstrate that CEUS not only can be utilised safely and effectively in radiological intervention,
but could also provide unique solutions to complex clinical problems.
‘Interventional Ultrasonography’ – Why?
One of the proven technology in imaging-guided,
minimally invasive procedures is with ultrasound.
Eliminates the need for iodinated contrast agents. This is especially important for patients with renal insufficiency not yet on dialysis in whom iodinated contrast or gadolinium-based MRI contrast exposure could be detrimental,
or those with severe allergy to iodinated contrast medium,
Itavoids the problems associated with radiation exposure for both patients and treating clinicians and Significantly,
in unstable patients where ‘bedside’ procedures can be advantageous....
Imaging findings OR Procedure details
Extravascular (Intracavitary) CEUS Intervention Applications
Ultrasound contrast agentscan be instilled into any physiological or pathological body cavity to assess morphology of the cavity and potential communications with adjacent structures or organs.
Artefacts have to be avoided: This can be achieved by using low concentration of contrast agent with adequate dilution (e.g.0.1 – 0.5 mL SonoVue® in 100 - 500 mL 0.9% saline).
Novel Clinical Applications:
CEUS Guided Percutaneous Nephrostomy (PCN) and Nephrostogram
The major problem with ultrasound-guided PCN is localisation of...
Novel application of CEUS in interventional radiology is frequently performed on demand,
to address specific cllinical questions raised in the individual patient.
Use of CEUS must be decided on a case-by-case basis,
usually resorting to CEUS because of inconclusive standard diagnostic techniques or when patients are not suitable for these or because they have higher risks (for instance,
use of ionising radiation on sensitive organs,
or moving the patient out of intensive care units) or more complex logistic situations.
In appropriate cases,
CEUS not only...
Piscaglia F et al.
The EFSUMB Guidelines and Recommendations on the Clinical Practice of Contrast Enhanced Ultrasound (CEUS): Update 2011 on non-hepatic applications.
Ultraschall in Med 2012; 33: 33 – 59
Contrast-enhanced ultrasound-guided percutaneous cholangiography and cholangiodrainage (CEUS- PTCD).
Endoscopy 2009; 41: 725–726
Usefulness of contrast-enhanced ultrasound in the diagnosis of biliary leakage following T-tube removal.
J Clin Ultra- sound 2009; 38: 38–40
Can a contrast-enhanced ultrasound nephrostogram be used instead of a...
Dean Huang BMedSci BMBS MRCPCH FRCR EBIR
Tel: 0203 2994599/4164
Fax: 0203 2993157
email: [email protected]