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DOI: 10.1055/s-0034-1398873
High-Resolution Ultrasound Including Contrast-Enhanced Ultrasound (CEUS) for the Detection of Gas Formation during Aspergillus Fumigatus Infection in Mice
Der Einsatz von Kontrastmittel verstärktem, hochauflösenden Ultraschall zum Nachweis von Aspergillus fumigatus Infektionen in MäusenPublication History
17 July 2014
13 December 2014
Publication Date:
05 March 2015 (online)
![](https://www.thieme-connect.de/media/ultraschall/201603/lookinside/thumbnails/uim-1577_10-1055-s-0034-1398873-1.jpg)
Abstract
Purpose: A. fumigatus infections represent a major threat for patients with a suppressed immune system. Early diagnosis is of importance for a favorable outcome but appears to be difficult due to limited diagnostic procedures. Here we investigated the sensitivity of high-resolution ultrasound (HRU) for the detection of A. fumigatus infection in the liver.
Materials and Methods: BALB/c mice were intravenously infected with A. fumigatus and monitored by HRU, Doppler sonography (CCDS), contrast-enhanced ultrasound (CEUS), and real-time strain color-coded elastography (CCE) using a multi-frequency probe (6 – 15 MHz). Contrast media bolus injection of sulfur-hexafluoride micro-bubbles was applied and digital cine-loops from the arterial phase, as well as the portal venous phase up to the late phase of the whole liver were analyzed. All data were correlated to the histopathological findings.
Results: Using HRU and CEUS, a sonic shadow was detected in all infected animals. All Aspergillus-infected nodes from 3 – 6 mm in the liver showed a shadow with rim enhancement and no intranodal enhancement when using CEUS. A. fumigatus infection was confirmed by CFU assessment and histopathological analysis. Granulomas were not associated with shadowing on B-mode. In contrast, granulomas with a diameter above 5 mm and a higher stiffness in CCE generated particularly an arterial rim enhancement and portal venous washout without contrast media uptake in the late phase. In addition, CEUS was able to define dynamic capillary microvascularization of infected liver areas.
Conclusion: Liver lesions associated with A. fumigatus infection can be detected in mice when combined with CEUS and CCE in vivo.
Zusammenfassung
Ziel: A. fumigatus Infektionen stellen eine große Bedrohung für immunsupprimierte Patienten dar. Eine frühe Diagnose ist dabei entscheidend für den Behandlungserfolg, erweist sich bislang allerdings als schwierig. Ziel dieses Projektes war es, die Sensitivität von hochauflösendem Ultraschall (HRU) zur frühen Diagnose einer Pilzinfektion in der Leber zu ermitteln.
Material und Methode: BALB/c Mäuse wurden intravenös mit A. fumigates infiziert und mittels HRU, farbkodierter Sonografie (CCE), Doppler (CCDS) sowie Kontrast-verstärktem Ultraschall (CEUS) unter Einsatz einer Multi-Frequenz Sonde (6 – 15 MHz) untersucht. Kontrastmittel-Bolus-Injektionen von Schwefelhexafluorid Mikrobläschen wurden eingesetzt und digitale Cine-loops von der frühen arteriellen bis zur späten venösen Phase ausgewertet und mit den histopathologischen Ergebnissen korreliert.
Ergebnisse: Mittels HRU und CEUS konnten sonographische Schatten in der Leber aller infizierten Tiere nachgewiesen werden. Die Kontrastmittel-verstärkte Sonografie zeigte bei allen A. fumigatus infizierten Granulomen ab einer Größe von 3 – 6 mm einen Schallschatten in der Leber mit deutlicher Randverstärkung, aber keine Verstärkung im intra-granulären Bereich. Die A. fumigatus-Infektion wurde mittels pathohistologischer Untersuchung und CFU Bestimmung bestätigt. Nicht infizierte Granulome zeigten keinen Schallschatten, aber ab einer Größe von 5 mm und höherer Gewebeverhärtung in CCE induzierten eine Anreicherung von Kontrastmittel im Randbereich in der arteriellen Phase und portal-venöser Auswaschung in der späten Phase (CEUS). Zusätzlich war CEUS in der Lage, dynamische Mikrovaskularisierung in infizierten Leberarealen darzustellen.
Schlussfolgerung: A. fumigatus-Infektionen lassen sich in der Leber mittels HRU in Kombination mit CEUS und CCE in vivo nachweisen.
Key words
Aspergillus fumigatus - inflammation - real-time strain color-coded elastography (CCE) - liver infection - contrast-enhanced ultrasound (CEUS)* Authorship due to equal contribution.
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