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单中心研究:评估对比增强超声(CEUS)在评估孕妇肝脏病变中的诊断性能和安全性。

Single-Center Study: Evaluating the Diagnostic Performance and Safety of Contrast-Enhanced Ultrasound (CEUS) in Pregnant Women to Assess Hepatic Lesions.

机构信息

Department of Radiology, Ludwig-Maximilians-University of Munich - Großhadern Campus, Munich, Germany.

出版信息

Ultraschall Med. 2020 Feb;41(1):29-35. doi: 10.1055/a-0973-8517. Epub 2019 Jul 30.

Abstract

BACKGROUND

Ultrasound is an essential imaging tool for evaluating physiological and pathological fetal or maternal conditions during pregnancy. Published data is limited with respect to the application of CEUS during pregnancy. CEUS has already been safely applied for assessing uteroplacental blood flow, cesarean scar pregnancy and invasive placenta percreta. CT and MRI scans during pregnancy must be thoroughly evaluated due to harmful ionizing radiation and cerebral gadolinium deposition, respectively.

PURPOSE

The aim of the present retrospective single-center study is to assess the diagnostic performance and safety of CEUS during pregnancy to evaluate hepatic lesions of unknown entity.

METHODS

6 pregnant patients who underwent CEUS between 2005 and 2014 (mean age: 32 years; mean weeks of pregnancy: 28 weeks) were included in this study. The applied contrast agent was a second-generation blood-pool agent (SonoVue, Bracco, Milan, Italy). CEUS examinations were performed and interpreted by a single radiologist with experience since 2000 (EFSUMB Level 3).

RESULTS

CEUS was safely performed on all included pregnant women without the occurrence of adverse fetal or maternal events. In the context of the present study, CEUS helped to safely differentiate hepatic metastases, focal nodular hyperplasia, atypical hemangioma, hepatic arteriovenous malformation and cystic echinococcosis. In two patients CEUS determined immediate therapy.

CONCLUSION

Although not clinically approved in obstetrics so far, CEUS is a safe imaging modality which, in addition to B-mode and color Doppler ultrasonography, may be applied during pregnancy for further medical indications and to provide helpful information.

摘要

背景

超声是评估妊娠期间胎儿或母体生理和病理状况的重要影像学工具。关于超声造影(CEUS)在妊娠期间的应用,已有相关研究发表,但数据有限。CEUS 已安全应用于评估胎盘血流、剖宫产瘢痕妊娠和侵袭性胎盘植入。由于电离辐射和脑内钆沉积的危害,妊娠期间 CT 和 MRI 检查必须进行全面评估。

目的

本回顾性单中心研究旨在评估 CEUS 在妊娠期间评估不明原因肝病变的诊断性能和安全性。

方法

本研究纳入了 2005 年至 2014 年间进行 CEUS 的 6 例妊娠患者(平均年龄:32 岁;平均妊娠周数:28 周)。所用造影剂为第二代血池造影剂(SonoVue,Bracco,Milan,Italy)。CEUS 检查由一位自 2000 年以来具有丰富经验的放射科医生进行和解读(EFSUMB 分级 3)。

结果

所有纳入的孕妇均安全进行了 CEUS 检查,未发生胎儿或母体不良事件。在本研究背景下,CEUS 有助于安全地区分肝转移、局灶性结节性增生、不典型血管瘤、肝动静脉畸形和肝包虫病。在 2 例患者中,CEUS 确定了即刻治疗方案。

结论

尽管目前在妇产科临床尚未获得批准,但 CEUS 是一种安全的成像方式,除了 B 型和彩色多普勒超声外,还可在妊娠期间用于进一步的医学适应证,并提供有价值的信息。

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