Drudi F M, Di Leo N, Maghella F, Malpassini F, Iera J, Rubini A, Orsogna N, D'Ambrosio F
Dipartimento di Radiologia Università degli studi "La Sapienza" Viale del Policlinico, 155 00161 Rome, Italy.
J Ultrasound. 2013 Aug 3;17(1):57-63. doi: 10.1007/s40477-013-0032-y. eCollection 2014 Mar.
Contrast-enhanced ultrasound (CEUS) is the application of ultrasound contrast agents (UCAs) to traditional medical sonography. The development of UCAs allowed to overcome some of the limitations of conventional B-mode and Doppler ultrasound techniques and enabled the display of the parenchymal microvasculature. Purpose of this paper is to delineate the elements of a solid and science-based technique in the execution of urinary bladder CEUS.
We describe the technical execution of urinary bladder CEUS and the use of perfusion softwares to perform contrast enhancement quantitative analysis with generation of time-intensity curves from regions of interest.
During CEUS, normal bladder wall shows a wash-in time of 13 s, a time to peak (TTP) >40 s, a signal intensity (SI) <45 % and a wash-out time >80 s; Low-grade urothelial cell carcinoma (UCC) shows a wash-in time of 13 s, a time to peak TTP >28 s, a SI <45 % and a wash-out time of 40 s; High-grade UCC shows a wash-in time of 13 s, a TTP >28 s, a SI >50 % and a wash-out time of 58 s.
CEUS is a useful tool for an accurate characterization of bladder UCC although it has some drawbacks. To avoid misunderstandings, a widely accepted classification and a standardized terminology about the most significant parameters of this application should be adopted in the immediate future.
超声造影（CEUS）是将超声造影剂（UCA）应用于传统医学超声检查。超声造影剂的发展使得能够克服传统B型和多普勒超声技术的一些局限性，并能够显示实质微血管系统。本文的目的是阐述在进行膀胱CEUS时基于坚实科学基础的技术要素。
我们描述了膀胱CEUS的技术操作以及使用灌注软件进行造影剂增强定量分析，并从感兴趣区域生成时间-强度曲线。
在CEUS期间，正常膀胱壁的灌注时间为13秒，达峰时间（TTP）>40秒，信号强度（SI）<45%，洗脱时间>80秒；低级别尿路上皮癌（UCC）的灌注时间为13秒，TTP>28秒，SI<45%，洗脱时间为40秒；高级别UCC的灌注时间为13秒，TTP>28秒，SI>50%，洗脱时间为58秒。
尽管CEUS有一些缺点，但它是准确鉴别膀胱UCC的有用工具。为避免误解，应在不久的将来采用关于该应用最重要参数的广泛接受的分类和标准化术语。
