Kallenbach Michael, Qvartskhava Natalia, Weigel Christian, Dörffel Yvonne, Berger Jens, Kunze Georg, Luedde Tom
Department of Gastroenterology Hepatology and Infectious Diseases, University Hospital of Düsseldorf, Düsseldorf, Germany.
Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Düsseldorf, Germany.
Z Gastroenterol. 2024 Jun;62(6):952-970. doi: 10.1055/a-2145-7461. Epub 2023 Oct 5.
Due to the trend towards increased use of imaging and rising awareness among high-risk patients, gastroenterologists and hepatologists are more frequently confronted with patients with focal liver lesions. In the differentiation of these lesions, CT and MRI have increasingly found their way into primary diagnostic steps in everyday clinical practice. Contrast-enhanced sonography, on the other hand, is a very effective and cost-efficient method for assessing focal liver lesions. The success of the method is not only based on the visualisation of microvascularisation in real time. If sonography is performed by the treating physician, he can use the exact knowledge of history and clinical findings to specifically adapt the examination procedure and to interpret the sonographic findings with greater accuracy ("clinical sonography"). At the same time, the method enables the practitioner to combine diagnostics and management decisions in his or her own hands. To achieve excellent results with contrast-enhanced sonography-as with any other imaging method-it is necessary that the examiner is sufficiently qualified.This article systematically presents the sonographic characteristics of the most common liver lesions and clearly shows their contrast patterns using videos (available via QR code). The article illustrates that CEUS could-and from the authors' point of view, should-have an even greater significance in the future.
由于影像学检查使用增加的趋势以及高危患者意识的提高,胃肠病学家和肝病学家越来越频繁地面对有肝脏局灶性病变的患者。在这些病变的鉴别诊断中,CT和MRI在日常临床实践中越来越多地成为主要诊断步骤。另一方面,超声造影是评估肝脏局灶性病变的一种非常有效且经济高效的方法。该方法的成功不仅基于实时微血管成像。如果由主治医生进行超声检查,他可以利用对病史和临床发现的确切了解来专门调整检查程序,并更准确地解释超声检查结果(“临床超声检查”)。同时,该方法使从业者能够在自己手中将诊断和管理决策结合起来。要像使用任何其他成像方法一样通过超声造影取得优异结果,检查者必须具备足够的资质。本文系统地介绍了最常见肝脏病变的超声特征,并通过视频(可通过二维码获取)清晰展示了它们的造影模式。本文表明,超声造影在未来可能——从作者的角度来看,也应该——具有更大的意义。