CEUS, a world to discover. Three clinical cases and literature review

Abstract

Currently, CEUS (Contrast-Enhanced UltraSound) is used in the evaluation of different organs and systems. It offers valuable information about vascular disease, both on a macro- and a micro-vascular level, and has a series of well-established applications in the monitoring of adult patients; official guidelines and recommendations are also available. Its use in a nephrological setting is constantly growing thanks to the lack of nephrotoxicity of the contrast agent, the absence of ionizing radiation and the possibility of characterizing focal pathologies, for diagnosis and in clinical practice. We describe here 3 clinical cases relating to renal diseases and we review the relevant literature with a specific focus on the use of CEUS in a nephro-urological setting.

 

Keywords: Contrast-enhanced ultrasound, CEUS, contrast agents, imaging, microbubbles

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Introduzione

L’ecografia con contrasto, conosciuta anche come CEUS, acronimo di Contrast-Enhanced Ultrasound, è un tipo particolare di ecografia che consente lo studio della microcircolazione dei parenchimi o di una lesione in esame. Sebbene siano presenti alcune limitazioni intrinseche, legate alla metodica in generale (nel caso di scarsa collaborazione del paziente, obesità, localizzazione profonda di alcune lesioni, ecc.) che possono occasionalmente ostacolare una diagnosi accurata, la CEUS offre la possibilità di studiare il pattern della lesione in esame in tempo reale, pur in assenza di una valutazione simultanea dell’intero organo.

 

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Management of the incidental renal masses

Abstract

The diagnosis of renal masses has increased in the last decades owing to the widespread use of imaging (ultrasound, computed tomography and magnetic resonance).

Majority of the renal masses are detected incidentally on routine ultrasound examination.

Solid masses detected on ultrasound require further imaging evaluation with CT and/or MRI for suitable characterization. US-guided renal biopsy is a safe, effective and accurate method for evaluating the small renal masses with ambiguous radiologic findings.

Navigation technology and multimodality image fusion represent an important development in interventional radiology, especially for performing difficult percutaneous biopsies and ablations of small renal masses.

Multidisciplinary approach is required which results from experience and knowledge and in hard cases the use of serial imaging can be helpful.

 

Keywords: renal masses, imaging, ultrasound, renal biopsy, active surveillance

Sorry, this entry is only available in Italian. For the sake of viewer convenience, the content is shown below in the alternative language. You may click the link to switch the active language.

Introduzione

Il riscontro di masse renali durante gli ultimi trent’anni è andato via via aumentando (1) grazie alla diffusione delle tecniche di imaging, in primo luogo l’ecografia (US), ma anche la tomografia assiale computerizzata (TC) e la risonanza magnetica nucleare (MRI).

 

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