Beckmann Steffen, Simanowski Jörg H
Practices Lachem, Hessisch-Oldendorf, Germany.
Clinic for General, Visceral, Vascular and Obesity Surgery and Interdisciplinary Emergency Center of the Nordstadt Clinic of the Hannover Region Clinic, Hannover, Germany.
Visc Med. 2020 Dec;36(6):476-486. doi: 10.1159/000511352. Epub 2020 Nov 26.
The aim of modern medicine is to safely classify diseases for successful therapy without invasive measures. Sonography, computed tomography (CT), and magnetic resonance imaging (MRI) are potent imaging techniques. However, without contrast medium, the informative value of the 3 native methods is limited. The advantages of sonography are: no radiation exposure or previously known physically harmful interactions with tissue, proportionate disappearance of a contrast agent risk, no (probably irreversible) contrast agent deposits, and no risk of renal insufficiency. But, is that enough to compete with of even exceed CT and MRI?
In this review, the state of the art of contrast-enhanced ultrasound (CEUS) in the abdominal cavity is presented. The remarkable diagnostic possibilities can unfortunately only be demonstrated here in a small number of impressive, typical case studies underpinned by the literature, so that, from one's own perspective, the full spectrum of CEUS can be used by oneself or initiated. Within the limits of physics, the real-time dynamics of CEUS enable conclusions to be drawn, so that with the current technology, sonography, including expansion by contrast, can be considered superior to other imaging methods. It is not uncommon for CEUS to have the value of a control and reference method.
Sonography very often enables reliable diagnostics. The introduction of a contrast agent in sonography has led to a quantum leap similar to that of other imaging techniques. Already natively, the real-time representation of dynamic events leads to a certain superiority, i.e., complete observation of the inflow and outflow phases of the contrast medium and the resulting diagnostic; tissue-specific differentiation options provide a unique selling point. Further advantages of the first-choice imaging diagnostic method are: a lack of radiation exposure, repeatability of the examination at any time, local independence, a negligible allergy rate compared to the contrast agents of other methods, and a lack of kidney and thyroid exposure or excluded deposits.
现代医学的目标是在不采取侵入性措施的情况下，对疾病进行安全分类以实现成功治疗。超声检查、计算机断层扫描（CT）和磁共振成像（MRI）都是强大的成像技术。然而，在不使用造影剂的情况下，这三种传统方法的信息价值有限。超声检查的优点包括：无辐射暴露，与组织不存在已知的物理有害相互作用，不存在造影剂风险，不存在（可能不可逆的）造影剂沉积，以及不存在肾功能不全风险。但是，这些优势足以与CT和MRI竞争甚至超越它们吗？
在本综述中，介绍了腹腔内超声造影（CEUS）的最新技术水平。遗憾的是，这里只能通过少数令人印象深刻的典型病例研究并结合文献来展示其显著的诊断可能性，以便从个人角度出发，能够自行使用或启动CEUS的全部功能。在物理学的限制范围内，CEUS的实时动态能够得出结论，因此就当前技术而言，包括造影增强在内的超声检查可被认为优于其他成像方法。CEUS具有作为对照和参考方法的价值并不罕见。
超声检查常常能够实现可靠的诊断。超声检查中引入造影剂带来了类似于其他成像技术的巨大飞跃。其本身就能够实时呈现动态事件，这带来了一定的优势，即能够完整观察造影剂的流入和流出阶段以及由此得出的诊断结果；组织特异性的鉴别选项提供了独特的卖点。这种首选成像诊断方法的其他优点包括：无辐射暴露，可随时重复检查，不受局部限制，与其他方法的造影剂相比过敏率可忽略不计，以及不存在肾脏和甲状腺暴露或排除沉积。
