Department of Medicine, University of Texas Medical Branch, Galveston, TX 77555-0144, United States.
World J Gastroenterol. 2011 Jan 7;17(1):42-8. doi: 10.3748/wjg.v17.i1.42.
Contrast agents are increasingly being used to characterize the vasculature in an organ of interest, to better delineate benign from malignant pathology and to aid in staging and directing therapeutic procedures. We review the mechanisms of action of first, second and third generation contrast agents and their use in various endoscopic procedures in the gastrointestinal tract. Various applications of contrast-enhanced endoscopic ultrasonography include differentiating benign from malignant mediastinal lymphadenopathy, assessment of depth of invasion of esophageal, gastric and gall bladder cancers and visualization of the portal venous system and esophageal varices. In addition, contrast agents can be used to differentiate pancreatic lesions. The use of color Doppler further increases the ability to diagnose and differentiate various pancreatic malignancies. The sensitivity of power Doppler sonography to depict tumor neovascularization can be increased by contrast agents. Contrast-enhanced harmonic imaging is a useful aid in identifying the tumor vasculature and studying pancreatic microperfusion. In the future, these techniques could potentially be used to quantify tumor perfusion, to assess and monitor the efficacy of antiangiogenic agents, to assist targeted drug delivery and allow molecular imaging.
对比剂越来越多地被用于描述感兴趣器官的血管，以更好地区分良性和恶性病变，并有助于分期和指导治疗程序。我们回顾了第一代、第二代和第三代对比剂的作用机制及其在胃肠道各种内镜检查中的应用。对比增强内镜超声的各种应用包括区分纵隔淋巴结良恶性病变、评估食管、胃和胆囊癌的浸润深度以及显示门静脉系统和食管静脉曲张。此外，对比剂可用于区分胰腺病变。彩色多谱勒技术进一步提高了诊断和区分各种胰腺恶性肿瘤的能力。通过对比剂，可以提高功率多谱勒超声检测肿瘤新生血管的能力。谐波成像的超声造影有助于识别肿瘤血管并研究胰腺微循环。在未来，这些技术可能用于量化肿瘤灌注，评估和监测抗血管生成药物的疗效，帮助靶向药物输送并允许分子成像。
