Overview

In the last few years, the development of sonographic contrast agents - or microbubbles - has stimulated increasingly intensive studies on the rela tionships between ultrasound and contrast media. As a result, contrast -spe cific hardware and software systems have been introduced by different ultra sound manufacturers with impressive speed. This has finally led to the birth of a very new imaging modality - contrast-enhanced sonography (CEUS). Since 1999, the introduction of second-generation contrast agents has represented a decisive step towards the extensive clinical use of CEUS and has simultaneously made obsolete most, if not all, scientific publications available so far. This book is, to our knowledge, the first to deal entirely with second generation contrast agents and the most updated contrast-specific software for noncardiologic uses. The reasons why the liver has been chosen as the only target of the book are easily understandable by radiologists and hepatologists alike. The study of vascularity is the only purpose of CEUS, and the liver has a unique vascular system, with two different inflow systems resulting in a single outflow. Furthermore, the pathologically different focal liver lesions (FLLs) are mostly characterized by different models of vascularity: CEUS can mimic contrast enhanced computed tomography and magnetic resonance imaging, basing differential diagnosis on the morphological and temporal characteristics of enhancement, but with the additional unique advantage of the study being done in real-time.

Full Product Details

Author:   M. Tonolini ,  L. Solbiati ,  A. Martegani ,  L. Aiani
Publisher:   Springer Verlag
Imprint:   Springer Verlag
Edition:   Softcover reprint of the original 1st ed. 2003
ISBN:  

9788847021686

ISBN 10:   8847021685
Pages:   123
Publication Date:   21 January 2004
Audience:   Professional and scholarly ,  Professional & Vocational
Format:   Paperback
Publisher's Status:   Active
Availability:   In Print  
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Table of Contents

1 Contrast Ultrasound Technology.- 1.1 Introduction: The Need for Bubble-Specific Imaging.- 1.1.1 Bubble Behaviour and Incident Pressure.- 1.1.2 The Mechanical Index (MI).- 1.2 Nonlinear Backscatter: Harmonic Imaging.- 1.2.1 Harmonic B-Mode Imaging.- 1.2.2 Harmonc Doppler.- 1.2.3 Harmonic Power Doppler Imaging.- 1.2.4 Tissue Harmonic Imaging.- 1.2.5 Pulse Inversion Imaging.- 1.2.6 Power Pulse Inversion Imaging.- 1.3 Transient Disruption: Intermittent Imaging.- 1.3.1 Triggered Imaging.- 1.3.2 Intermittent Harmonic Power Doppler for Perfusion Imaging.- 1.4 Summary.- 1.5 Safety Considerations.- 1.6 Conclusion.- References.- 2 Ultrasound Contrast Agents.- 2.1 Introduction.- 2.2 Basic Physics and Pharmacology.- 2.3 Commercial Ultrasound Contrast Media.- 2.3.1 Albunex (TM).- 2.3.20ptison (TM).- 2.3.3 Levovist (R).- 2.3.4 Sono Vue (R).- 2.3.5 Definity (TM).- 2.3.6 Imagent (TM).- 2.4 Future Developments in Ultrasound Contrast Media.- References.- 3 Liver Physiology.- 3.1 Introduction.- 3.2 Anatomy.- 3.3 Liver Lobule Structure.- 3.3.1 Liver Cell Plate.- 3.3.2 Nonparenchymal Liver Cells.- 3.3.3 Sinusoidal Endothelial Cells.- 3.3.4 Kupffer Cells.- 3.3.5 Hepatic Stellate Cells.- 3.3.6 Fibrosis and Hepatic Stellate Cells.- 3.3.7 Pit Cells.- 3.4 Hepatocyte Transport.- 3.4.1 Electrolyte and Solute Transport.- 3.4.2 Bile Formation.- 3.5 Functional Organization of the Liver Cell Plate.- 3.5.1 Limiting Plate.- 3.5.2 Hepatocyte Heterogeneity Along the Liver Cell Plate.- 3.5.3 Carbohydrate Metabolism.- 3.5.4 Fatty Acid Metabolism.- 3.5.5 Amino Acid and Ammonia Metabolism.- 3.5.6 Regulation of Hepatocyte Heterogenicity.- 3.5.7 Physiologic Significance of Hepatocyte Heterogenicity.- References.- 4 Macro- and Microcirculation of Focal Liver Lesions.- 4.1 Traumatic Abdominal Lesions.- 4.1.1 Introduction.- 4.1.2 Ultrasound and Abdominal Trauma.- 4.1.3 Contrast-Enhanced Ultrasound Image Gallery.- 4.1.4 Conclusions.- References.- 4.2 Hepatic Hemangiomas.- 4.2.1 Anatomical and Structural Features.- 4.2.2 Diagnostic Imaging.- 4.2.3 Integrated Imaging.- 4.2.4 Contrast-Enhanced Ultrasound Imaging.- 4.2.5 Differential Diagnostic Problems1.- References.- 4.3 Hepatic Adenoma.- References.- 4.4 Macro-and Microcirculation of Focal Nodular Hyperplasia.- References.- 4.5 Other Benign Lesions and Pseudo lesions.- 4.5.1 Inflammatory Pseudotumor of the Liver.- 4.5.2 Hepatic Tuberculoma.- 4.5.3 Focal Fatty Changes.- 4.5.4 Skip Areas in Diffuse Steatosis.- References.- 4.6 Hepatocellular Carcinoma and Dysplastic Lesions.- 4.6.1 Introduction and Epidemiology.- 4.6.2 Pathology and Hepatocarcinogenesis.- 4.6.3 Unenhanced Sonography.- 4.6.4 Contrast-Enhanced Ultrasound.- References.- 4.7 Liver Metastases.- 4.7.1 Anatomical and Structural Features.- 4.7.2 Diagnostic Imaging.- 4.7.3 Integrated Imaging.- 4.7.4 Contrast-Enhanced Ultrasound Imaging.- 4.7.5 Differential Diagnostic Problems.- References.- 4.8 Other Malignancies.- 4.8.1 Peripheral Cholangiocarcinoma.- 4.8.2 Hepatic Sarcoma.- 4.8.3 Hepatic Lymphoma.- References.- 5 Medical Needs.- 5.1 Introduction.- 5.2 Incidental Lesions in Normal Livers.- 5.3 Screening and Surveillance for Hepatocellular Carcinoma.- 5.4 Staging and Follow-up of Cancer Patients1.- References.- 6 Guidance and Control of Percutaneous Treatments.- 6.1 Introduction.- 6.2 Fundamentals and Pathology of Ablative Treatments.- 6.3 Role of Diagnostic Imaging.- 6.4 Detection of Lesions and Selection of Patients.- 6.5 RF Procedures and Targeting of Lesions.- 6.6 Assessment of Therapeutic Response.- References.- Hands-on Contrast Ultrasound.- 7.1 Tips and Tricks.- 7.1.1 Organization of Contrast-Enhanced US.- 7.1.2 Intravenous Access.- 7.1.3 Preparation of the USCA.- 7.1.4 The USCAs.- 7.1.5 Scanning Techniques and Settings.- 7.1.6 Liver CEUS using Levovist (R).- 7.1.7 Liver CEUS using SonoVue (R).- 7.2 Limitations.- 7.3 Artifacts and Pitfalls.- 7.3.1 Heterogeneous Enhancement.

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