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DOI: 10.1055/s-0036-1593381
A New Era in Diagnostic Ultrasound, Superb Microvascular Imaging: Preliminary Results in Pediatric Hepato-Gastrointestinal Disorders
Publication History
18 March 2016
15 August 2016
Publication Date:
03 October 2016 (online)
![](https://www.thieme-connect.de/media/ejps/201701/lookinside/thumbnails/10-1055-s-0036-1593381_163817oa-1.jpg)
Abstract
Introduction Superb microvascular imaging is a new ultrasound image processing technique that uses advanced clutter suppression to extract flow signals from vessels and which helps us visualize very small vascular structures that were not previously visible without the use of a contrast agent. We herein analyzed the usefulness of superb microvascular imaging in the diagnosis of hepato-gastrointestinal disorders in pediatric patients.
Materials and Methods Fifty-six pediatric patients who underwent a total of 81 superb microvascular imaging examinations with an Aplio 300 ultrasound system (Toshiba Medical Systems, Tokyo, Japan) were enrolled in this study. The subjects underwent conventional ultrasound examinations, including Doppler imaging followed by superb microvascular imaging. The superb microvascular imaging findings and standard imaging were compared. All of the examinations were performed without sedation.
Results The average age of the patients (male, n = 38; female, n = 18) was 4 years. The clinical diagnoses included hepatobiliary disorders (n = 29), acute appendicitis (n = 10), and other intestinal disorders (n = 17). The target organs for superb microvascular imaging were the liver, appendix, rectum, intestine, gallbladder, and lymph node. In most of the patients, superb microvascular imaging achieved the excellent visualization of microvascular structures, revealing abnormal vasculature in 21 out of 46 (45.7%) examinations of the liver, 9/9 (100%) examinations of the appendix, 0/11 (0%) examinations of the rectum, 9/11 (81.8%) examinations of the intestine, 0/1 (0%) examinations of the gallbladder, and 3/3 (100%) examinations of the lymph nodes. Superb microvascular imaging was superior to Doppler imaging for depicting the microvascular structures.
Conclusions Superb microvascular imaging is especially useful for depicting the microvascular flow and can aid in the diagnosis and treatment planning for pediatric patients with hepato-gastrointestinal disorders.
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References
- 1 Hata J. Toshiba Medical System. Seeing the Unseen New Techniques in Vascular Imaging, Superb Micro-Vascular Imaging. Available from: URL: http://www.toshibamedicalsystems.com . Accessed July 15, 2016
- 2 Gabriel M, Tomczak J, Snoch-Ziółkiewicz M, Dzieciuchowicz Ł, Strauss E, Oszkinis G. Comparison of superb micro-vascular ultrasound imaging (SMI) and contrast-enhanced ultrasound (CEUS) for detection of endoleaks after endovascular aneurysm repair (EVAR). Am J Case Rep 2016; 17: 43-46
- 3 Yi DY, Kim JY, Choi EY, Choi JY, Yang HR. Hepatobiliary risk factors for clinical outcome of Kawasaki disease in children. BMC Pediatr 2014; 14: 51
- 4 Eladawy M, Dominguez SR, Anderson MS, Glodé MP. Kawasaki disease and the pediatric gastroenterologist: a diagnostic challenge. J Pediatr Gastroenterol Nutr 2013; 56 (3) 297-299
- 5 Hotta N, Tagaya T, Maeno T , et al. Advanced dynamic flow imaging with contrast-enhanced ultrasonography for the evaluation of tumor vascularity in liver tumors. Clin Imaging 2005; 29 (1) 34-41
- 6 Nino-Murcia M, Ralls PW, Jeffrey Jr RB, Johnson M. Color flow Doppler characterization of focal hepatic lesions. AJR Am J Roentgenol 1992; 159 (6) 1195-1197
- 7 Blomley M, Claudon M, Cosgrove D. WFUMB safety symposium on ultrasound contrast agents: clinical applications and safety concerns. Ultrasound Med Biol 2007; 33 (2) 180-186
- 8 Yang W, Yan K, Wang S , et al. Differential diagnosis of arterial phase enhanced hepatic inflammatory lesions and hepatocellular carcinomas with contrast-enhanced ultrasound. Ultrasound Med Biol 2016; 42 (1) 82-91
- 9 Van Beers BE, Daire JL, Garteiser P. New imaging techniques for liver diseases. J Hepatol 2015; 62 (3) 690-700
- 10 Frampas E, Lassau N, Zappa M, Vullierme MP, Koscielny S, Vilgrain V. Advanced hepatocellular carcinoma: early evaluation of response to targeted therapy and prognostic value of perfusion CT and dynamic contrast enhanced-ultrasound. preliminary results. Eur J Radiol 2013; 82 (5) e205-e211
- 11 Rosado E, Riccabona M. Off-label use of ultrasound contrast agents for intravenous applications in children: analysis of the existing literature. J Ultrasound Med 2016; 35 (3) 487-496
- 12 Pschierer K, Grothues D, Rennert J , et al. Evaluation of the diagnostic accuracy of CEUS in children with benign and malignant liver lesions and portal vein anomalies. Clin Hemorheol Microcirc 2015; 61 (2) 333-345
- 13 Ma Y, Li G, Li J, Ren WD. The diagnostic value of superb microvascular imaging (SMI) in detecting blood flow signals of breast lesions: a preliminary study comparing SMI to color Doppler flow imaging. Medicine (Baltimore) 2015; 94 (36) e1502
- 14 Machado P, Segal S, Lyshchik A, Forsberg F. A novel microvascular flow technique: initial results in thyroids. Ultrasound Q 2016; 32 (1) 67-74
- 15 Yongfeng Z, Ping Z, Wengang L, Yang S, Shuangming T. Application of a novel microvascular imaging technique in breast lesion evaluation. Ultrasound Med Biol 2016; 42 (9) 2097-2105
- 16 Lee YS, Kim MJ, Han SW , et al. Superb microvascular imaging for the detection of parenchymal perfusion in normal and undescended testes in young children. Eur J Radiol 2016; 85 (3) 649-656
- 17 Wu L, Yen HH, Soon MS. Spoke-wheel sign of focal nodular hyperplasia revealed by superb micro-vascular ultrasound imaging. QJM 2015; 108 (8) 669-670
- 18 Zhan J, Diao XH, Jin JM, Chen L, Chen Y. Superb microvascular imaging—a new vascular detecting ultrasonographic technique for avascular breast masses: a preliminary study. Eur J Radiol 2016; 85 (5) 915-921