Subscribe to RSS
Please copy the URL and add it into your RSS Feed Reader.
https://www.thieme-connect.de/rss/thieme/en/10.1055-s-00000066.xml
CC BY-NC-ND 4.0 · Rofo 2024; 196(08): 807-818
DOI: 10.1055/a-2219-4726
DOI: 10.1055/a-2219-4726
Review
Kontrastmittelunterstützte Sonografie der Leber: Grundlagen und Interpretation häufiger fokaler Läsionen
Article in several languages: English | deutsch
Zusammenfassung
Hintergrund
Die kontrastunterstützte Sonografie (CEUS) hat sich innerhalb der letzten 20 Jahren als ergänzendes Verfahren zur B-Bild-Sonografie und Farb-Doppler-Sonografie etabliert.
Methode
Ziel der vorliegenden Übersicht ist, das notwendige Grundwissen zur Untersuchung der Leber mit Ultraschallkontrastmittel zu ermitteln. Darüber hinaus werden die klassischen CEUS-Muster häufiger fokaler Leberläsionen beschrieben.
Ergebnisse und Schlussfolgerung
Unter Berücksichtigung der Limitationen des Ultraschalls ist die CEUS bei Beurteilung der fokalen Leberläsionen eine gleichwertige Alternative zu anderen bildgebenden Verfahren wie Computertomografie und Magnetresonanztomografie und sollte bei fehlender Strahlenbelastung und rascher Verfügbarkeit primär eingesetzt werden.
Kernaussagen
-
Bei der Detektion und Charakterisierung von zufällig entdeckten Leberherden spielt die CEUS eine bedeutende Rolle.
-
Unter Berücksichtigung der Limitationen des Ultraschalls ist die CEUS bei Beurteilung der fokalen Leberläsionen eine gleichwertige Alternative zu anderen bildgebenden Verfahren wie CT und MRT.
Zitierweise
-
Safai Zadeh E, Prosch H, Ba-Ssalamah A et al. Contrast-enhanced ultrasound of the liver: basics and interpretation of common focal lesions. Fortschr Röntgenstr 2024; 196: 807 – 818
Publication History
Received: 15 August 2023
Accepted: 24 October 2023
Article published online:
04 January 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Dietrich CF, Nolsøe CP, Barr RG. et al. Guidelines and Good Clinical Practice Recommendations for Contrast Enhanced Ultrasound (CEUS) in the Liver – Update 2020 – WFUMB in Cooperation with EFSUMB, AFSUMB, AIUM, and FLAUS. Ultraschall in Med 2020; 41: 562-585 DOI: 10.1055/a-1177-0530.
- 2 Safai ZadehE, Baumgarten MA, Dietrich CF. et al. Frequency of synchronous malignant liver lesions initially detected by ultrasound in patients with newly diagnosed underlying non-hematologic malignant disease: a retrospective study in 434 patients. Z Gastroenterol 2021; DOI: 10.1055/a-1649-8857.
- 3 Schmidt G, Görg C. Kursbuch Ultraschall. 2015. DOI: 10.1055/b-003-124669
- 4 Greis C. Grundlagen. In: Teichgräber U, Fischer T, Clevert DA. Hrsg. Praxisbuch Kontrastmittelsonografie: Kursbuch des CEUS-Kurs-Zertifikats der DRG. Berlin, Heidelberg: Springer Berlin Heidelberg; 2022: 1-20 DOI: 10.1007/978-3-662-61686-4_1
- 5 Michels G, Horn R, Helfen A. et al. [Standardized contrast-enhanced ultrasound (CEUS) in clinical acute and emergency medicine and critical care (CEUS Acute): Consensus statement of DGIIN, DIVI, DGINA, DGAI, DGK, ÖGUM, SGUM and DEGUM]. Med Klin Intensivmed Notfmed 2022; 117: 1-23 DOI: 10.1007/s00063-021-00891-4.
- 6 Sidhu PS, Cantisani V, Deganello A. et al. Role of Contrast-Enhanced Ultrasound (CEUS) in Paediatric Practice: An EFSUMB Position Statement. Ultraschall in Med 2017; 38: 33-43 DOI: 10.1055/s-0042-110394.
- 7 Sidhu PS, Huang DY, Fang C. Contrast enhanced ultrasound (CEUS) in Pregnancy: Is this the last frontier for microbubbles?. Ultraschall in Med 2020; 41: 8-11 DOI: 10.1055/a-0964-9827.
- 8 Dietrich CF, Averkiou M, Nielsen MB. et al. How to perform Contrast-Enhanced Ultrasound (CEUS). Ultrasound Int Open 2018; 4: e2-e15 DOI: 10.1055/s-0043-123931.
- 9 Friedrich-Rust M. Kontrastmittelsonografie der Leber: Literatur-Update und systematische Befundung. https://www.pkd-am-staedel.de/Fortbildung_PKD/fortbildung/2009_06_23_Sonografie.pdf
- 10 Lim AKP, Patel N, Eckersley RJ. et al. Evidence for Spleen-specific Uptake of a Microbubble Contrast Agent: A Quantitative Study in Healthy Volunteers. Radiology 2004; 231: 785-788 DOI: 10.1148/radiol.2313030544.
- 11 Yamaguchi A, Taniguchi H, Kunishima S. et al. Correlation between angiographically assessed vascularity and blood flow in hepatic metastases in patients with colorectal carcinoma. Cancer 2000; 89: 1236-1244 DOI: 10.1002/1097-0142(20000915)89:6<1236::aid-cncr7>3.0.co;2-k.
- 12 Nagy JA, Chang SH, Dvorak AM. et al. Why are tumour blood vessels abnormal and why is it important to know?. British Journal of Cancer 2009; 100: 865-869 DOI: 10.1038/sj.bjc.6604929.
- 13 Kaltenbach TE-M, Engler P, Kratzer W. et al. Prevalence of benign focal liver lesions: ultrasound investigation of 45,319 hospital patients. Abdominal Radiology 2016; 41: 25-32 DOI: 10.1007/s00261-015-0605-7.
- 14 Lantinga MA. Evaluation of hepatic cystic lesions. World Journal of Gastroenterology 2013; 19: 3543 DOI: 10.3748/wjg.v19.i23.3543.
- 15 Larsen LP. Role of contrast enhanced ultrasonography in the assessment of hepatic metastases: A review. World J Hepatol 2010; 2: 8-15 DOI: 10.4254/wjh.v2.i1.8.
- 16 Dietrich CF, Douira-Khomsi W, Gharbi H. et al. Cystic and alveolar echinococcosis of the hepatobiliary tract – the role of new imaging techniques for improved diagnosis. Med Ultrason 2020; 22: 75-84 DOI: 10.11152/mu-2421.
- 17 Brunetti E, Tamarozzi F, Macpherson C. et al. Ultrasound and Cystic Echinococcosis. Ultrasound Int Open 2018; 4: e70-e78 DOI: 10.1055/a-0650-3807.
- 18 [Anonym]. International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings. Acta Trop 2003; 85: 253-261 DOI: 10.1016/s0001-706x(02)00223-1.
- 19 Kratzer W, Weimer H, Schmidberger J. Echinococcosis: a Challenge for Liver Sonography. Ultraschall in Med 2022; 43: 120-145 DOI: 10.1055/a-1694-5552.
- 20 Chung JJ, Kim MJ, Kim JH. et al. Fat sparing of surrounding liver from metastasis in patients with fatty liver: MR imaging with histopathologic correlation. Am J Roentgenol 2003; 180: 1347-1350 DOI: 10.2214/ajr.180.5.1801347.
- 21 Fröhlich E, Jenssen C, Schuler A. et al. [Contrast-enhanced ultrasound for characterisation of focal liver lesions, practical advice]. Z Gastroenterol 2015; 53: 1099-1107 DOI: 10.1055/s-0035-1553491.
- 22 Tamada T, Ito K, Ueki A. et al. Peripheral low intensity sign in hepatic hemangioma: diagnostic pitfall in hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI of the liver. J Magn Reson Imaging 2012; 35: 852-858 DOI: 10.1002/jmri.23514.
- 23 Bauditz JFK, Wermke W. Sonomorphologie und Kontrastverhalten von Fokal Nodulären Hyperplasien der Leber im Langzeitverlauf. Ultraschall in Med 2006; DOI: 10.1055/s-2006-953916.
- 24 Vidili G, Piscaglia F, Ainora ME. et al. Focal nodular hyperplasia: new findings at Doppler ultrasonography. Eur Rev Med Pharmacol Sci 2020; 24: 12288-12295 DOI: 10.26355/eurrev_202012_24020.
- 25 Hussain SM, Terkivatan T, Zondervan PE. et al. Focal nodular hyperplasia: findings at state-of-the-art MR imaging, US, CT, and pathologic analysis. Radiographics 2004; 24: 3-17 DOI: 10.1148/rg.241035050.
- 26 Chandler CM, Labadie KP, Park JO. et al. Hepatocellular carcinoma arising within a β-catenin mutated inflammatory hepatic adenoma. Human Pathology: Case Reports 2021; 24: 200501 DOI: 10.1016/j.ehpc.2021.200501.
- 27 Goltz D, Fischer HP. Hepatozelluläre Tumoren im nichtzirrhotischen Lebergewebe. Der Pathologe 2015; 36: 597-608 DOI: 10.1007/s00292-015-0113-0.
- 28 Laumonier H, Bioulac-Sage P, Laurent C. et al. Hepatocellular adenomas: magnetic resonance imaging features as a function of molecular pathological classification. Hepatology 2008; 48: 808-818 DOI: 10.1002/hep.22417.
- 29 Alhyari A, Görg C, Alakhras R. et al. HCC or Something Else? Frequency of Various Benign and Malignant Etiologies in Cirrhotic Patients with Newly Detected Focal Liver Lesions in Relation to Different Clinical and Sonographic Parameters. Diagnostics (Basel) 2022; 12 DOI: 10.3390/diagnostics12092079.
- 30 Laniado M. Bildgebung der Leberzirrhose und ihrer Komplikationen. In: Vogl TJ, Mack MG, Balzer JO. Hrsg. LeberMetastasen: Diagnose – Intervention – Therapie. Berlin, Heidelberg: Springer Berlin Heidelberg; 2002: 175-179 DOI: 10.1007/978-3-642-59385-7_14
- 31 Rickes S, Ocran K, Schulze S. et al. [Evaluation of Doppler sonographic criteria for the differentiation of hepatocellular carcinomas and regenerative nodules in patients with liver cirrhosis]. Ultraschall in Med 2002; 23: 83-90 DOI: 10.1055/s-2002-25197.
- 32 Dănilă M, Sporea I, Sirli R. et al. The role of contrast enhanced ultrasound (CEUS) in the assessment of liver nodules in patients with cirrhosis. Med Ultrason 2010; 12: 145-149
- 33 Jeong YY, Yim NY, Kang HK. Hepatocellular carcinoma in the cirrhotic liver with helical CT and MRI: imaging spectrum and pitfalls of cirrhosis-related nodules. Am J Roentgenol 2005; 185: 1024-1032 DOI: 10.2214/ajr.04.1096.
- 34 Lee DH, Lee JM. Primary malignant tumours in the non-cirrhotic liver. Eur J Radiol 2017; 95: 349-361 DOI: 10.1016/j.ejrad.2017.08.030.
- 35 Meitner-Schellhaas B, Jesper D, Goertz RS. et al. Washout appearance of hepatocellular carcinomas using standardized contrast-enhanced ultrasound (CEUS) including an extended late phase observation – Real-world data from the prospective multicentre DEGUM study. Clin Hemorheol Microcirc 2023; DOI: 10.3233/ch-231740.
- 36 Sabrina V, Michael B, Jörg A. et al. [Not Available]. Z Gastroenterol 2022; 60: e56-e130 DOI: 10.1055/a-1589-7568.
- 37 Trenker C, Görg C, Burchert A. et al. Presentation of Chloromas in B-Mode Ultrasound and Contrast-Enhanced Ultrasound. Ultrasound in Medicine & Biology 2022; DOI: 10.1016/j.ultrasmedbio.2022.05.024.
- 38 Valla DC, Condat B. Portal vein thrombosis in adults: pathophysiology, pathogenesis and management. J Hepatol 2000; 32: 865-871 DOI: 10.1016/s0168-8278(00)80259-7.
- 39 Fang C, Anupindi SA, Back SJ. et al. Contrast-enhanced ultrasound of benign and malignant liver lesions in children. Pediatric Radiology 2021; 51: 2181-2197 DOI: 10.1007/s00247-021-04976-2.
- 40 Claudon M, Dietrich CF, Choi BI. et al. Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS) in the liver--update 2012: a WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS. Ultraschall in Med 2013; 34: 11-29 DOI: 10.1055/s-0032-1325499.