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Contrast-Enhanced Endoscopic US
Christian Jenssen, MD; André Ignee, MD
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KEY FACTS

  • Terminology

    • Clinical Implications

      • CEUS Technique

        TERMINOLOGY

        • Definitions

          • Endoscopic US (EUS), a.k.a. endosonography, is minimally invasive procedure combining endoscopy of digestive tract with high-frequency US of gastrointestinal (GI) wall and surrounding organs and tissues
          • Sometimes, term EUS is also used to include endobronchial US (EBUS) and intracavitary (vaginal, anorectal) US using rigid transducers (linear and radial)
          • For contrast-enhanced EUS techniques using low MI, terms contrast-enhanced low mechanical index (MI) EUS (CELMI-EUS), contrast-enhanced harmonic EUS (CEH-EUS), and contrast harmonic EUS (CH-EUS) are in use

        CEUS TECHNIQUE

        • Echoendoscopes and US Platforms

          • Application, Set-Up of US Systems and Dosing of US Contrast Agents

            • Limitations

              IMAGING

              • General Discussion

                • Solid Pancreatic Lesions

                  • Cystic Pancreatic Lesions

                    • Gastrointestinal Tumors

                      • Lymph Nodes

                        • Gallbladder

                          • Abdominal Vessels

                            SUMMARY

                            • Conclusion

                              Selected References

                              1. Malmstrøm ML et al: Dynamic contrast-enhanced EUS for quantification of tumor perfusion in colonic cancer: a prospective cohort study. Gastrointest Endosc. 87(6):1530-1538, 2018
                              2. Sidhu PS et al: The EFSUMB Guidelines and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound (CEUS) in Non-Hepatic Applications: Update 2017 (Long Version). Ultraschall Med. 39(2):e2-e44, 2018
                              3. Yamashita Y et al: Value of contrast-enhanced harmonic EUS with enhancement pattern for diagnosis of pancreatic cancer: a meta-analysis. Dig Endosc. ePub, 2018
                              4. Dietrich CF et al: Dynamic contrast-enhanced endoscopic ultrasound: A quantification method. Endosc Ultrasound. 6(1):12-20, 2017
                              5. Hocke M et al: Role of contrast-enhanced endoscopic ultrasound in lymph nodes. Endosc Ultrasound. 6(1):4-11, 2017
                              6. Kitano M et al: New Imaging Techniques for Endoscopic Ultrasonography: Contrast-Enhanced Endoscopic Ultrasonography. Gastrointest Endosc Clin N Am. 27(4):569-583, 2017
                              7. Dietrich CF et al: Differential diagnosis of small solid pancreatic lesions. Gastrointest Endosc. 84(6):933-940, 2016
                              8. Fusaroli P et al: The clinical impact of ultrasound contrast agents in EUS: a systematic review according to the levels of evidence. Gastrointest Endosc. 84(4):587-596.e10, 2016
                              9. Săftoiu A et al: Contrast-enhanced harmonic endoscopic ultrasound. Endoscopy. 44(6):612-7, 2012
                              Related Anatomy
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                              Related Differential Diagnoses
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                              References
                              Tables

                              Tables

                              KEY FACTS

                              • Terminology

                                • Clinical Implications

                                  • CEUS Technique

                                    TERMINOLOGY

                                    • Definitions

                                      • Endoscopic US (EUS), a.k.a. endosonography, is minimally invasive procedure combining endoscopy of digestive tract with high-frequency US of gastrointestinal (GI) wall and surrounding organs and tissues
                                      • Sometimes, term EUS is also used to include endobronchial US (EBUS) and intracavitary (vaginal, anorectal) US using rigid transducers (linear and radial)
                                      • For contrast-enhanced EUS techniques using low MI, terms contrast-enhanced low mechanical index (MI) EUS (CELMI-EUS), contrast-enhanced harmonic EUS (CEH-EUS), and contrast harmonic EUS (CH-EUS) are in use

                                    CEUS TECHNIQUE

                                    • Echoendoscopes and US Platforms

                                      • Application, Set-Up of US Systems and Dosing of US Contrast Agents

                                        • Limitations

                                          IMAGING

                                          • General Discussion

                                            • Solid Pancreatic Lesions

                                              • Cystic Pancreatic Lesions

                                                • Gastrointestinal Tumors

                                                  • Lymph Nodes

                                                    • Gallbladder

                                                      • Abdominal Vessels

                                                        SUMMARY

                                                        • Conclusion

                                                          Selected References

                                                          1. Malmstrøm ML et al: Dynamic contrast-enhanced EUS for quantification of tumor perfusion in colonic cancer: a prospective cohort study. Gastrointest Endosc. 87(6):1530-1538, 2018
                                                          2. Sidhu PS et al: The EFSUMB Guidelines and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound (CEUS) in Non-Hepatic Applications: Update 2017 (Long Version). Ultraschall Med. 39(2):e2-e44, 2018
                                                          3. Yamashita Y et al: Value of contrast-enhanced harmonic EUS with enhancement pattern for diagnosis of pancreatic cancer: a meta-analysis. Dig Endosc. ePub, 2018
                                                          4. Dietrich CF et al: Dynamic contrast-enhanced endoscopic ultrasound: A quantification method. Endosc Ultrasound. 6(1):12-20, 2017
                                                          5. Hocke M et al: Role of contrast-enhanced endoscopic ultrasound in lymph nodes. Endosc Ultrasound. 6(1):4-11, 2017
                                                          6. Kitano M et al: New Imaging Techniques for Endoscopic Ultrasonography: Contrast-Enhanced Endoscopic Ultrasonography. Gastrointest Endosc Clin N Am. 27(4):569-583, 2017
                                                          7. Dietrich CF et al: Differential diagnosis of small solid pancreatic lesions. Gastrointest Endosc. 84(6):933-940, 2016
                                                          8. Fusaroli P et al: The clinical impact of ultrasound contrast agents in EUS: a systematic review according to the levels of evidence. Gastrointest Endosc. 84(4):587-596.e10, 2016
                                                          9. Săftoiu A et al: Contrast-enhanced harmonic endoscopic ultrasound. Endoscopy. 44(6):612-7, 2012