ReviewTranscutaneous contrast-enhanced sonography of pleural-based pulmonary lesions
Introduction
In the chest, the value of ultrasound has traditionally been limited to the evaluation of pleural effusion and pleural-based lesions. Based on the dual arterial supply of the lung, this organ is, similar to the liver, suited for evaluation of arterial vascularity by contrast-enhanced sonography (CES) [1], [2], [3]. CES enables to differentiate and classify pulmonary from systemic bronchial arterial supply of lung lesions regarding time to enhancement and extend of enhancement after contrast agent infusion [4], [5]. The aim of this review is to describe CES patterns with a transcapillary second-generation contrast agent (SonoVue®, Braco) in patients with pleural-based lung lesions and to discuss possible indications for CES in patients with suspected chest diseases.
Section snippets
General considerations of CES
CES studies were performed immediately after baseline sonography with a contrast-devoted unit (Acuson-Sequoia GI, Siemens medical solution) that had contrast-specific, continuous-mode software. A low mechanical index was used. A sulfur hexafluoride-based microbubble contrast medium (SonoVue®) was injected intravenously within 2 s via a 20-gauge cannula. A volume of 2, 4 ml was administered, followed by a 5 ml saline flush. This contrast medium contains a low-solubility gas and is therefore
Pleurisy
Clinical sign of pleurisy is characterized by a breath dependent localized pleural pain, but the final diagnosis presents a considerable challenge and requires a high index of clinical suspicion from the attending physician. B-mode sonographic patterns as well as color Doppler sonographic (CDS) patterns of pleurisy/pleuropneumonia has been described [1], [2]. In a recent study [9], all patients with breath dependent pain due to pleurisy/pleuropneumonia do have a high specific CES pattern
Conclusion
CES of the chest is limited to pleural-based lesions. CES in peripheral lung lesions is feasible and depending on underlying diseases lesions may show a variable TE and EE. CES enables to distinguish pulmonary arterial supply from bronchial arterial supply by TE. First experiences with CES have shown that various peripheral lung lesions do have a characteristic CES pattern regarding TE and EE. First clinical data show that there are clinical conditions which may show a diagnostic advantage of
References (19)
- et al.
Contrast enhanced sonography for differential diagnosis of pleurisy and focal pleural lesions of unknown cause
Chest
(2005) - et al.
Transcutaneous colour Doppler sonography of lung consolidations review and pictorial essay. Part 1. Pathophysiologic and colour Doppler sonographic basics of pulmonary vascularity
Ultraschall Med
(2004) - et al.
Transcutaneous colour Doppler sonography of lung consolidations review and pictorial essay. Part 2. Colour Doppler sonograhic patterns of pulmonary consolidations
Ultraschall Med
(2004) - et al.
Color Doppler sonographic mapping of pulmonary lesions: evidence of dual arterial supply by spectral analysis
J Ultrasound Med
(2003) - et al.
Transcutaneous contrast enhanced sonography of the chest for evaluation of pleural based pulmonary lesions: experience in 137 patients
Ultraschall Med
(2006) - et al.
Transcutaneous contrast-enhanced sonography of peripheral lung lesions
AJR
(2006) Diagnostic efficacy of SonoVue
Am J Cardiol
(2000)- et al.
Guidelines for the use of contrast agents in ultrasound
Ultraschall Med
(2004) - et al.
Tissue-specific US contrast agent for evaluation of hepatic and splenic parenchyma
Radiology
(1999)
Cited by (67)
WFUMB Technological Review: How to Perform Contrast-Enhanced Ultrasound of the Lung
2022, Ultrasound in Medicine and BiologyLung Ultrasonography and Cardiac Surgery: A Narrative Review
2020, Journal of Cardiothoracic and Vascular AnesthesiaCitation Excerpt :In a recent study, the combination of A-lines, deep venous thrombosis, and subpleural consolidation (corresponding to pulmonary infarction) provided 90% sensitivity and 86% specificity for diagnosing PE in the emergency department.69 It may also be helpful to consider contrast-enhanced LUS for diagnosing PE, which may help identity embolic lung consolidation, especially in patients with indeterminate chest CT findings.70 During the perioperative period, the diaphragm is exposed to multiple potential injuries that can lead to dysfunction.
Application of quantitative contrast-enhanced ultrasound for evaluation and guiding biopsy of peripheral pulmonary lesions: a preliminary study
2020, Clinical RadiologyCitation Excerpt :Ultrasound contrast agents (UCA), in conjunction with contrast-specific imaging techniques, are increasingly being used for post-interventional work-up of several organs. Similar to the liver, the lung has a dual blood supply: the bronchial arterial system, which provides nutrition for the bronchi, pulmonary vessels, alveoli, interstitial tissue, and visceral pleura, and the pulmonary arterial system, which is responsible for gas exchange.11–15 Unlike the contrast agents used in CT and MRI, UCAs are blood pool agents.
Contrast-Enhanced Ultrasound of the Chest in Children and Adolescents: A Pilot Study for Assessment of Added Diagnostic Value
2024, Journal of Ultrasound in MedicineCONTRAST-ENHANCED CHEST ULTRASOUND - MODERN ACHIEVEMENTS OF PULMONOLOGY IN BULGARIA
2024, Comptes Rendus de L'Academie Bulgare des SciencesContrast-enhanced Chest Ultrasound in the Control of Transthoracic Tru-cut Needle Biopsies: A Case Report
2024, Current Medical Imaging