Department of Radiology, School of Medicine, Stanford University, Stanford, CA, USA.
Department of Radiology, University of Calgary, Calgary, AB, Canada.
Abdom Radiol (NY). 2018 Apr;43(4):819-847. doi: 10.1007/s00261-017-1360-8.
Contrast-enhanced ultrasound (CEUS) is a safe, relatively inexpensive, and widely available imaging technique using dedicated imaging ultrasound sequences and FDA-approved contrast microbubbles that allow detection and characterization of malignant focal liver lesions with high diagnostic accuracy. CEUS provides dynamic real-time imaging with high spatial and temporal capability, allowing for unique contributions to the already established protocols for diagnosing focal liver lesions using CT and MR imaging. In patients with lesions indeterminate on CT and MRI, CEUS is a helpful problem-solving complementary tool that improves patient management. Furthermore, CEUS assists guidance of liver biopsies and local treatment. Variations of CEUS such as DCE-US and ultrasound molecular imaging are emerging for quantitative monitoring of treatment effects and possible earlier detection of cancer. In this review, basic principles of CEUS techniques and ultrasound contrast agents along with a description of the enhancement patterns of malignant liver lesions are summarized. Also, a discussion of the role of CEUS for treatment guidance and monitoring, intraoperative CEUS, and an outlook on emerging applications is provided.
超声造影（CEUS）是一种安全、相对廉价且广泛应用的成像技术，使用专用的成像超声序列和 FDA 批准的造影微泡，可以高准确度检测和定性恶性局灶性肝病变。CEUS 提供具有高空间和时间分辨率的实时动态成像，为使用 CT 和 MR 成像诊断局灶性肝病变的既定方案提供独特的贡献。对于 CT 和 MRI 不确定的病变患者，CEUS 是一种有助于解决问题的补充工具，可以改善患者管理。此外，CEUS 还可以辅助指导肝活检和局部治疗。CEUS 的一些变体，如 DCE-US 和超声分子成像，正在用于治疗效果的定量监测和可能更早地检测癌症。在这篇综述中，总结了 CEUS 技术和超声造影剂的基本原理，以及恶性肝病变的增强模式描述。还讨论了 CEUS 在治疗指导和监测、术中 CEUS 以及新兴应用方面的作用。
