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肝脏超声造影：如何避免伪像

Contrast-Enhanced Sonography of the Liver: How to Avoid Artifacts.

作者信息

Naganuma Hiroko, Ishida Hideaki, Nagai Hiroshi, Uno Atushi

机构信息

Department of Gastroenterology, Yokote Municipal Hospital, Yokote 013-8602, Japan.

Department of Gastroenterology, Akita Red Cross Hospital, Akita 010-1495, Japan.

出版信息

Diagnostics (Basel). 2024 Aug 20;14(16):1817. doi: 10.3390/diagnostics14161817.

DOI:10.3390/diagnostics14161817
PMID:39202305
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11353835/
Abstract

Contrast-enhanced sonography (CEUS) is a very important diagnostic imaging tool in clinical settings. However, it is associated with possible artifacts, such as B-mode US-related artifacts. Sufficient knowledge of US physics and these artifacts is indispensable to avoid the misinterpretation of CEUS images. This review aims to explain the basic physics of CEUS and the associated artifacts and to provide some examples to avoid them. This review includes problems related to the frame rate, scanning modes, and various artifacts encountered in daily CEUS examinations. Artifacts in CEUS can be divided into two groups: (1) B-mode US-related artifacts, which form the background of the CEUS image, and (2) artifacts that are specifically related to the CEUS method. The former includes refraction, reflection, reverberation (multiple reflections), attenuation, mirror image, and range-ambiguity artifacts. In the former case, the knowledge of B-mode US is sufficient to read the displayed artifactual image. Thus, in this group, the most useful artifact avoidance strategy is to use the reference B-mode image, which allows for a simultaneous comparison between the CEUS and B-mode images. In the latter case, CEUS-specific artifacts include microbubble destruction artifacts, prolonged heterogeneous accumulation artifacts, and CEUS-related posterior echo enhancement; these require an understanding of the mechanism of their appearance in CEUS images for correct image interpretation. Thus, in this group, the most useful artifact avoidance strategy is to confirm the phenomenon's instability by changing the examination conditions, including the frequency, depth, and other parameters.

摘要

超声造影（CEUS）是临床环境中非常重要的诊断成像工具。然而，它可能会出现一些伪像，如与B型超声相关的伪像。充分了解超声物理学和这些伪像对于避免CEUS图像的误判是必不可少的。本综述旨在解释CEUS的基本物理学原理和相关伪像，并提供一些避免伪像的示例。本综述包括与帧率、扫描模式以及日常CEUS检查中遇到的各种伪像相关的问题。CEUS中的伪像可分为两组：（1）与B型超声相关的伪像，它们构成了CEUS图像的背景；（2）与CEUS方法特异性相关的伪像。前者包括折射、反射、混响（多次反射）、衰减、镜像和距离模糊伪像。在前一种情况下，对B型超声的了解足以解读显示的伪像图像。因此，在这一组中，最有用的避免伪像策略是使用参考B型图像，它可以同时比较CEUS图像和B型图像。在后一种情况下，CEUS特异性伪像包括微泡破坏伪像、长时间不均匀积聚伪像和CEUS相关的后方回声增强；为了正确解读图像，需要了解它们在CEUS图像中出现的机制。因此，在这一组中，最有用的避免伪像策略是通过改变检查条件（包括频率、深度和其他参数）来确认现象的不稳定性。

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