Dynamic Contrast-Enhanced Ultrasound Highly Useful For Interventions

The exploration of contrast agents in medical imaging continues to advance, especially in the field of ultrasound. Recent studies have demonstrated that using contrast in ultrasound significantly enhances the ability to distinguish liver abnormalities and improves the effectiveness of ovarian lesion assessments, among other benefits. A recent presentation at the European Congress of Radiology (ECR) 2024 has shed light on the utility of dynamic contrast-enhanced ultrasound (CEUS) in various medical interventions.

In the presentation, Dean Huang, MD, from King’s College London (London, UK) highlighted innovative uses for CEUS in both vascular and nonvascular imaging, therapeutic procedures, and its potential for future applications. Huang discussed CEUS's broad utility in both diagnostic and interventional settings, emphasizing its capability to enhance the visualization of vascular structures and assist in the evaluation of peripheral vessels and potential bleeding or endoleaks. A notable study co-authored by Huang in 2013 on the use of CEUS for angioplasty in hemodialysis arteriovenous fistulas revealed that CEUS provides a clearer view of the anatomy compared to traditional ultrasound, improving the safety of interventions by enabling precise monitoring for halting vessel bleeding.

CEUS has proven effective in imaging type 4 endoleaks during aortic vascular repair interventions and enhancing imaging of the dissolving of endoleaks, thus improving diagnostic confidence. It also plays a crucial role in verifying catheter placement and defining the treatment area in embolization procedures. The presentation referenced studies where CEUS was successfully applied in cases of prostatic bleeding, penile trauma, and hypervascular bone metastases. In nonvascular applications, CEUS facilitates preoperative identification of sentinel lymph nodes in breast cancer and improves needle visibility for kidney diagnostics via nephrostomy insertion.

Additionally, it enhances the assessment of physiological or pathological spaces, such as for gauging volume needs for the ablation of renal cysts. In terms of therapeutic and future applications, CEUS shows promise in localized clot treatment by combining ultrasound energy with contrast agent microbubbles to produce a thrombolytic effect and increase cell membrane and blood-brain barrier permeability for localized drug delivery. Huang also highlighted CEUS's suitability for pregnant women and children due to its non-radiative nature, making it an ideal imaging modality for these sensitive groups.

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King’s College London