CEUS – How to get an enhanced and optimized contrast image


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Contrast enhanced ultrasound (CEUS) is the application of contrast medium to traditional medical sonography. The currently used contrast agents (second generation) are gas filled (sulfur hexafluoride) microbubbles stabilized by a shell by albumin, surfactants or phospholipids. They are designed in small granules so that they can freely circulate in capillary beds, showing both microvasculature and macrovasculature, with no interstitial phase because they are exclusively intravascular.

Actually, Microbubbles have a high degree of echogenicity. Because bubbles resist compression better than expansion, when they are insonated at a low mechanical index the expansion and contraction phases are no longer equal and the returning signal shows nonlinear characteristics resulting in generation multiple harmonics from bubble filled vessels, at higher energy levels of insonation, disruption of bubbles occurs, producing strong but transient harmonic signal. Contrast-specific software integrated in ultrasound scanners cancels the linear ultra-sound signal from tissues and uses the nonlinear response from microbubbles.

Mechanism of sonoluminescence
Wikiwand.com

The bubbles oscillate when exposed to high frequency ultrasound beam. The compression and expansion of microbubbles creates the echo. This greatly affects ultrasound backscatter and increases vascular contrast in a similar manner to IV contrast used in CT and MRI. This produces a sonogram with increased contrast due to high echogenicity difference.

There are incredible benefits of using CEUS in clinical applications.

Clinical applications:

  • SonoVue is an IV contrast agent which allows assessment of vascularity and non-specific contrast agent retention of lesions, it improves the characterization of focal lesions that are indeterminate on conventional ultrasound.
  • CEUS can be used to image ventricular septal diseases, blood perfusion in organs, measure blood flow rate in heart and other organs.
  • CEUS can use for evaluation of focal nodular hyperplasia, adenomas focal fatty deposit or sparing and metastatic diseases.
  • CEUS can also useful for examination of vesicoureteral reflux in voiding urosonography.
  • CEUS is common imaging modality for Hepatocellular carcinoma surveillance in high risk patients because of its availability, efficiency and noninvasiveness.
  • Non targeted contrast-enhanced ultrasound is use for dynamic evaluation of vascularity of a target lesions, most commonly in liver and kidney and also used to measure organ perfusion which is useful in diagnosis of liver cirrhosis.
  • CEUS is a valuable and powerful tool for evaluation of focal liver lesions. In CEUS approach to diagnosis of focal lesions, the presence or absence of washout is important for differencing between malignant and benign lesions like hemangioma. It also important to recognize that benign lesions may infrequently show washout.

So you are wondering, how to get tuned your ultrasound machines and get contrast-enhanced images. Here, you can easily contact numerous application specialist, providing their customers with all basic techniques and methodologies so that you can get an optimized image.

Want more tips?

Click HERE to learn more about what a dedicated expert and Application Specialist can teach you.

You can also book a personalized consultation for your daily CEUS exams.

Conclusion:

CEUS is an imaging method used to improve the accuracy of ultrasound study. Ultrasound contrast agents are safe with an extremely low incidence of side effects. Microbubbles are eliminated partly by means of metabolization in liver and partly by patient breathing out of lungs with no nephrotoxicity. Contrast enhanced ultrasound has the advantage over MRI and CT in patients with contraindications such as renal failure or iodinated contrast allergy. CEUS is the most economically appropriate second-line imaging method after inconclusive baseline ultrasound for diagnosis of benign focal lesions.

Great resources to learn more about CEUS principles

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