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Thứ Ba, 21 tháng 8, 2018

C D I with C E U S


The use of ultrasonography and especially of contrast-enhanced ultrasonography (CEUS) in the diagnosis of vascular pathologies before and after interventions has significantly increased over the past years due to the broader availability of modern ultrasound systems with CEUS capabilities and more trained user experience in this imaging modality. For the preinterventional and post interventional work-up of carotid diseases, duplex ultrasound as well as CEUS have been established as the standard-of-care examination procedures for diagnosis, evaluation, and follow-up. In addition to its use for carotid arterial diseases, ultrasonography has also become the primary modality for the screening of vascular pathologies. This review describes the most common pathologies found in ultrasonography of the carotid arteries, the abdominal aorta, and the femoral arteries.


For the detection, characterization, and follow-up of vascular pathologies, duplex ultrasonography is the first choice. However, duplex ultrasonography has technical limitations in diagnostic use, for example, due to aliasing artifacts that can complicate diagnosis. The use of CEUS can increase the diagnostic performance in difficult vascular disorders compared to duplex ultrasonography. Thus, CEUS has become a promising, safe, noninvasive imaging tool in different aortic pathologies, particularly for the detection of endoleaks following endovascular treatment of AAAs. Examinations using CEUS of the carotid artery and peripheral vessels improve the delineation of vascular disorders in selected cases. It is a fast, nonionizing, cost effective imaging modality with almost no contraindications. The use of an ultrasound contrast agent increases the sensitivity of ultrasonography in vascular diseases and overcomes some limitations in the detection of blood flow within vascular structures. With the broader availability of contrast modes in modern ultrasound systems and the ongoing distribution of these systems to sonographers, CEUS is an already established, but still emerging imaging technique with a promising future.
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