Abstract TMP47: The Clinical Utility of Contrast Enhanced Ultrasound Detecting Disrupted Carotid Plaques

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Shuichi Tonomura ◽  
Kozue Saito ◽  
Hatsue Ishibashi-Ueda ◽  
Soichiro Abe ◽  
Kota Mori ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Carotid Plaque ◽  
Plaque Rupture ◽  
Color Doppler ◽  
Color Doppler Ultrasound ◽  
Contrast Enhanced Ultrasound ◽  
Histopathological Findings ◽  
Carotid Plaques ◽  
Contrast Enhanced

Introduction: Contrast-enhanced ultrasound (CEUS) using new contrast agents which offer a stable contrast effect in vivo is a noninvasive modality to detect vulnerability of carotid plaque, ulceration and neovascularization. A recent study showed the superiority for the detection of small ulcers using CEUS to color-Doppler ultrasound (CDUS), which used computed tomographic angiography (CTA) as the reference technique. Hypothesis: We assumed CEUS enables us to detect disruption of carotid plaques that could not be detected by CDUS and CTA. We aimed to investigate the diagnostic accuracy for detecting the disruption of the carotid plaques comparing with histopathological findings. Methods: From July 2010 to July 2015, we enrolled 68 internal carotid stenosis (ICS) patients undergoing carotid endarterectomy (CEA) and preoperatively examined CEUS using Perflubutane (Sonazoid), CDUS and CTA. We compared the findings of the plaque disruptions detected by these three modalities with the histopathological findings of ulceration and present/recent plaque rupture. Results: Of 68 subjects (age 72±6.6years old, 66 men), 44 (64%) had symptomatic ICS. Pathologically, ulceration and present/recent plaque rupture were found in 58 cases (85.3%). The diagnostic accuracy for detecting the disruption of carotid plaque by CEUS was significantly superior to other modalities (Table 1). CEUS could find disrupted carotid plaque more accurately than CTA. Conclusions: The assessment of the disruption of the plaques using CEUS was well correlated with pathological findings of plaque rupture, which may help us to evaluate the plaque vulnerability in vivo real time.

scholarly journals Gray Scale Ultrasound, Color Doppler Ultrasound, and Contrast-Enhanced Ultrasound in Renal Parenchymal Diseases

2018 ◽  
Vol 34 (4) ◽  
pp. 250-267 ◽  
Author(s):  
Emilio Quaia ◽  
Jean Michel Correas ◽  
Maithili Mehta ◽  
John T. Murchison ◽  
Antonio Giulio Gennari ◽  
...  
Keyword(s):  
Doppler Ultrasound ◽  
Color Doppler ◽  
Color Doppler Ultrasound ◽  
Contrast Enhanced Ultrasound ◽  
Gray Scale ◽  
Contrast Enhanced

Abstract TMP44: Contrast Enhanced Ultrasound Can Detect Small Disruption of Carotid Plaques Related to Symptomatic Internal Carotid Artery Stenosis

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Soichiro Abe ◽  
Kozue Saito ◽  
Hatsue Ishibashi-Ueda ◽  
Shuichi Tonomura ◽  
Kota Mori ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Carotid Plaque ◽  
Internal Carotid ◽  
Color Doppler ◽  
Internal Carotid Artery Stenosis ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced

Background: The ulcerated atheroma of the carotid artery is a risk factor of ipsilateral ischemic stroke. Contrast-enhanced ultrasound (CEUS) is a novel noninvasive technique useful for evaluating the morphology of carotid plaques, and can detect small disruptions on plaque surface. However, it remains unclear whether the disrupted carotid plaque detected by CEUS is related to the symptomatic internal carotid artery stenosis (ICS). Methods: A total of 79 ICS patients who underwent carotid endarterectomy (CEA) were enrolled from July 2010 to July 2015. Before operation, ICA lesions were examined by color Doppler ultrasound (CDUS) and CEUS using perflubutane. The ulceration was diagnosed when both of the color Doppler signal on CDUS and the pooling of microbubbles on CEUS were observed within the plaque. The disruption was diagnosed only by CEUS when microbubbles pooled through the fissured surface, unlike the linear delineation of neovessels. We validated findings on ultrasound compared with the histopathological findings of ulceration and present/recent plaque rupture. The associations between ulceration/disruption on ultrasound and symptomatic ICS (with a history of ipsilateral transient ischemic attack and/or ischemic stroke) were investigated. Results: Of 79 subjects (mean age 71.2±6.8 years old, 78 men), 55 had symptomatic ICS. The ulceration by CEUS and CDUS was recognized in 20 patients (25%), and the disruption on plaque surface was seen by CEUS solitary in 26 patients (33%). The sensitivity and specificity of detecting plaque ulceration or disruption using CEUS compared with histopathological findings were 0.57 (45/66) and 1.00 (13/13), respectively. The detection rate of ulceration or disruption using CEUS was higher in symptomatic ICS than in asymptomatic ICS (66% vs 42%, P=0.049). Compared to plaques without ulceration/disruption on ultrasound, prevalence of symptomatic ICS was higher in plaques with the disruption (88% vs 58%, P=0.01), whereas it was similar in plaques with the ulceration (65% vs 58%, P=0.77) Conclusion: Small disruptions on carotid plaque surface detected by CEUS were significantly related to symptomatic ICS and this results may help the detailed assessment of plaque vulnerability.

scholarly journals Application of contrast enhanced ultrasound in gallbladder lesion: is it helpful to improve the diagnostic capabilities?

2018 ◽  
Vol 20 (4) ◽  
pp. 420 ◽  
Author(s):  
Wen-Tao Kong ◽  
Hi-Yun Shen ◽  
Yu-Dong Qiu ◽  
Hao Han ◽  
Bao-Jie Wen ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Diagnostic Performance ◽  
Color Doppler ◽  
Final Diagnosis ◽  
Wall Thickening ◽  
Contrast Enhanced Ultrasound ◽  
Color Doppler Flow Imaging ◽  
Imaging Characteristics ◽  
Contrast Enhanced ◽  
Significant Difference

The aim of this study is to evaluate if contrast enhanced ultrasound (CEUS) can improve the differential diagnostic performance of gallbladder (GB) lesions.Materials and methods: Forty-nine patients (18 men, 31 women; mean age, 54.8±14.4 years, range age, 22-78 years) with GB lesions (mass-forming and wall-thickened types) were enrolled in this study. All patients underwent conventional ultrasonography (US) and CEUS examination. The imaging characteristics of GB lesions were analyzed to compare the diagnostic performance of US and CEUS. The final diagnosis was obtained by histopathology.Results: There were significant differences between benign and malignant GB lesions with regards to size, shape, vascularity, the integrity and margin of GB wall and time to iso-enhancement on CEUS (p<0.05). However, no significant difference was found concerning the enhancement patterns between the two groups (p>0.05). Logistic regression analysis showed that the boundary between liver and GB wall (p=0.017) and vascularity on color Doppler flow imaging (p=0.013) were two independent predictors of malignancy. The diagnostic accuracy of US could be improved in combination with CEUS (65.3% vs 83.7%). The diagnostic accuracy of the GB wall thickening type was higher than the mass forming type.Conclusion: CEUS could improve the diagnostic performance of GB lesions, especially for wall-thickened type lesions

scholarly journals Contrast-Enhanced and Microvascular Ultrasound Imaging Features of Testicular Lymphoma: Report of Five Cases and Review Literature

2021 ◽  
Author(s):  
Li Yang ◽  
Yuan Tao ◽  
Bao Meiling ◽  
Zhang Weixin ◽  
Hang Jing
Keyword(s):  
Color Doppler ◽  
Color Doppler Ultrasound ◽  
Review Literature ◽  
Ultrasound Images ◽  
Imaging Features ◽  
Contrast Enhanced Ultrasound ◽  
Testicular Lymphoma ◽  
Contrast Enhanced ◽  
Conventional Ultrasound ◽  
Primary Testicular Lymphoma

Abstract Background: To retrospectively investigate the grey-scale, Doppler, contrast-enhanced and microvascular ultrasound of five patients with primary testicular lymphoma of our institute through review literature analysis.Methods: From January to November 2020, five patients with primary testicular lymphoma confirmed by histology were preoperatively investigated with a standardized sonographic protocol including contrast-enhanced and microvascular ultrasound.Results: Conventional ultrasound showed localized hypoechogenicity represented with solitary lesions(2 of 5), multiple lesions (2 of 5), or entire testicular involvement (1 of 5). And increased blood flow appeared by color Doppler ultrasound with straight vascular sign(4 of 5). In contrast-enhanced ultrasound images confirmed this pattern(4 of 5) and presented incresaed enhancement with enlarged range. On microvascular ultrasound imagings, all lesions were presented with straight and parallel course of intralesional vessels(5 of 5).Conclusions: Here, we identified the increased vascularity with enlarged range on contrast-enhanced ultrasound along with a linear nonbranching pattern by vascular sign on microvascular ultrasonographic of testicular lymphoma.

scholarly journals Incidentally detection of non-palpable testicular nodules at scrotal ultrasound: What is new?

2014 ◽  
Vol 86 (4) ◽  
pp. 378 ◽  
Author(s):  
Massimo Valentino ◽  
Michele Bertolotto ◽  
Pasquale Martino ◽  
Libero Barozzi ◽  
Pietro Pavlica
Keyword(s):  
Patient Management ◽  
Color Doppler ◽  
Color Doppler Ultrasound ◽  
Review Article ◽  
Contrast Enhanced Ultrasound ◽  
Correct Interpretation ◽  
New Techniques ◽  
Scrotal Ultrasound ◽  
Contrast Enhanced ◽  
Tissue Elastography

The increased use of ultrasound in patients with urological and andrological symptoms has given an higher detection of intra-testicular nodules. Most of these lesions are hypoechoic and their interpretation is often equivocal. Recently, new ultrasound techniques have been developed alongside of B-mode and color-Doppler ultrasound. Although not completely standardized, contrast-enhanced ultrasound (CEUS) and tissue elastography (TE), added to traditional ultrasonography, can provide useful information about the correct interpretation of incidentally detected non-palpable testicular nodules. The purpose of this review article is to illustrate these new techniques in the patient management.

Abstract WP136: Enhanced Carotid Plaque on Contrast-enhanced Ultrasound is Asociated with Plaque Instability and Symptomatic Patients

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Noriko Matsumoto ◽  
Kazumi Kimura ◽  
Masaaki Uno ◽  
Kenichirou Sakai ◽  
Yoshito Sadahira ◽  
...  
Keyword(s):  
Neurological Symptom ◽  
Carotid Plaque ◽  
Plaque Rupture ◽  
Surrogate Marker ◽  
Intraplaque Hemorrhage ◽  
Contrast Enhanced Ultrasound ◽  
Plaque Instability ◽  
Linear Pattern ◽  
Contrast Enhanced ◽  
Histopathologic Findings

Background: Presence of neovascularization in plaque was reported as a reliable maker of plaque vulnerability. Contrast-enhanced ultrasound (CEUS) can demonstrate the presence of intraplaque neovascularization. The aim of the present study was to investigate the neurological symptom and histopathologic findings of enhanced carotid plaque using CEUS. Methods: We studied consecutive 30 patients (27 men, age 68.2 ± 7.6 years) who underwent carotid endarterectomy. Enhanced plaque (enhanced group) was classified into two subgroups: a spotty pattern as moving bright spots within plaque (spotty subgroup, Figure A); and a linear pattern, where enhanced lesions appeared as a line from intima into plaque (linear subgroup, Figure B).Sonazoid, perflurobutane microbubbles, was used as the contrast agent. We investigated the association between the neurological symptom, CEUS findings and histopathologic findings. Results: CEUS revealed enhanced plaque in 22 (73.3%) of 30 patients. 10 patients were spotty subgroup, and 12 patients were linear subgroup. Symptomatic patients were more frequent in enhanced group than non-enhanced group (82.6% vs. 50%, p=0.037).The amount of neovascularization was larger in enhanced group than in non-enhanced group (6.3±4.2/2.5mm 2 vs. 1.5±1.6/2.5 mm 2 , P=0.001, Figure C). Furthermore, the enhanced group had more macrophage aggregation (11.1±12.5% vs. 4.2±1.5%, P=0.001) and intraplaque hemorrhage (20.2±15.9% vs. 9.4±12.2%, P=0.031) compared with the non-enhanced group. 11 of the linear subgroup (91.7%) had fibrous cap rupture, but this was observed in only 20% of those with a spotty subgroup (P=0.001, Figure D). Symptom and other histopathological findings were not different between the two subgroups. Conclusions: Enhanced plaque on CEUS indicates vulnerable plaque. A linear pattern of enhanced plaque indicates plaque rupture. Enhanced plaque on CEUS should become a new surrogate marker of vulnerable carotid plaque and patients.

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