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- •Foreword
- •Preface
- •Contents
- •Abbreviations
- •Introduction
- •References
- •References
- •4.1 Liver Tumors
- •References
- •4: Liver
- •4.1.1 Benign Liver Lesions
- •4.2 Non-neoplastic Liver Lesions
- •4.5 Liver Transplant
- •References
- •5: Gallbladder
- •References
- •6: Pancreas
- •6.1 Pancreatic Tumors
- •6.2 Pancreatic Cystic Lesions
- •References
- •7: Spleen
- •References
- •8.3 Renal Cysts
- •8.4 Renal Tumors
- •8.5 Adrenals
- •References
- •References
- •10: Bladder
- •References
- •11: Prostate
- •References
- •12.1 Uterus
- •12.2 Ovary
- •12.3 Hystero-Salpingo-Contrast Sonography
- •References
- •References
- •14: Breast
- •References
- •15: Salivary Glands
- •References
- •References
- •17: Lymph Nodes
- •References
- •18: Major Blood Vessels
- •References
- •References
- •References

Contrast-Enhanced
Ultrasound
From Simple toComplex
AlexanderN.Sencha
YuryN.Patrunov
Editors
123

Contrast-Enhanced Ultrasound

Alexander N. Sencha • Yury N. Patrunov
Editors
Contrast-Enhanced
Ultrasound
From Simple toComplex

Editors
Alexander N. Sencha
Department of Visual and Functional
Diagnostics
Federal State Budget Institution
National Medical Research Center for
Obstetrics
Moscow, Russia
Yury N. Patrunov
Department of Ultrasound Diagnostics
Clinical Hospital “RZD-Medicina”
Yaroslavl, Russia
ISBN 978-3-030-91763-0 ISBN 978-3-030-91764-7 (eBook)
https://doi.org/10.1007/978-3-030-91764-7
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature
Switzerland AG 2022
This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher,
whether the whole or part of the material is concerned, specically the rights of translation,
reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microlms or in any
other physical way, and transmission or information storage and retrieval, electronic adaptation,
computer software, or by similar or dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this
publication does not imply, even in the absence of a specic statement, that such names are
exempt from the relevant protective laws and regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information in
this book are believed to be true and accurate at the date of publication. Neither the publisher nor
the authors or the editors give a warranty, expressed or implied, with respect to the material
contained herein or for any errors or omissions that may have been made. The publisher remains
neutral with regard to jurisdictional claims in published maps and institutional afliations.
This Springer imprint is published by the registered company Springer Nature Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

Foreword
Current imaging techniques suggest great opportunities. New diagnostic
modalities demonstrate fantastic capabilities. Now, the diagnostic aims may
be achieved with simpler and safer methods. Modern ultrasound options
make the diagnosis more efcient and cost-effective. Contrast-enhanced
ultrasound (CEUS) is a young, rapidly developing entity. It not only provides
accurate real-time noninvasive assessment of the body anatomy but also supplies physiologic data on blood supply and perfusion. It has already proven
its efciency and has further prospects for development and improvement.
Many aspects of CEUS are still not completely studied, some issues are
debatable, and some data are ambiguous or contradictory. It still undergoes
verication, systemic analysis, and general recognition by radiologists.
CEUS attracts the attention of not only radiologists but practitioners of
other elds of medicine due to its availability and simple performance on an
outpatient basis.
This book is created by a team of highly qualied doctors from the leading
Russian clinics, who have implemented CEUS in their routine practice. They
accurately demonstrate the current value of CEUS for early and differential
diagnosis of a wide range of abnormalities in surgery, therapy, and gynecology. They share their extensive experience and offer tips and tricks that make
the study smooth and reliable.
The original material, large number of own observations, and substantial
analysis of related publications allowed the authors to create a book for practical use in the diagnosis of the pathology of the liver, pancreas, kidneys,
thyroid, parathyroids, mammary glands, uterus, ovaries, bladder, prostate,
and other organs. Extravascular applications of ultrasound contrast agents,
hystero-salpingo-contrast sonography in particular, are also well discussed.
This application has recently been introduced into practice and is increasingly being used to assess the patency of the fallopian tubes, analyze the state
of the uterine cavity, and differentiate defects and anomalies of the female
reproductive system. The unique images and video material illustrate the text
that enables a clear understanding of the numerous visual features detected
with CEUS in normal and pathological conditions.
v

vi
The book gives a full understanding of the possibilities of CEUS and motivates the reader to start its practical use or continue the professional way of
perfection.
PeterM.KotlyarovScientic-Research Department of New
Technologies and Imaging Semiotics of the
Diseases of Organs and Tissues
Federal State Budgetary Institution
“Russian Scientic Center of Rentgenoradiology”
of the Ministry of Healthcare of the
Russian Federation
Moscow Russia
Russian Federation
Moscow Russia
Foreword

Preface
Dear colleagues, dear friends! It is a great honor for us to introduce this new
book on ultrasound diagnostics. We consider that studying ultrasound step by
step from simple to complex is a pleasure. Now we publish a work dedicated
to modern sophisticated ultrasound technology based on ultrasound contrast
enhancement. You, our friends, who are keen on your profession, who sincerely and selessly devote yourself to diagnostic ultrasound, which is quite
young but extremely effective and promising, those professionals who are
just mastering the aces of multiparametric ultrasound or already are perfect in
it, this book is dedicated to …
This book is based on the original studies of our large team that obtained
substantial experience in contrast-enhanced ultrasound (CEUS). We aimed to
analyze our knowledge in association with widely recognized best practices
for the diagnosis of a wide variety of diseases. Meanwhile, we tried to cover
as many aspects of CEUS as possible and felt competent to create a kind of
guidebook for practical use.
We are grateful to our colleagues for their practical assistance in the preparation of this book. Indeed, this publication would be impossible and the content incomplete without the close collaboration and guidance of our friends.
Wise suggestions and recommendations of these professionals of diagnostic
and clinical medicine granted additional illustrations and ideas were of great
benet and are highly appreciated.
The book starts with the basics of CEUS that necessarily include physical
principles and technology of application in various organs. We discuss the
variants of contrast enhancement in normal conditions and decisive features
for early and differential diagnosis of different diseases and illustrate them
with our ultrasound images. The analysis of vascularity of affected organs
provides great opportunities. However, its advantages in practice are sometimes accompanied by a range of drawbacks that limit the capabilities of the
method. We share the tips and tricks to get the best of the examination.
Wide application of contrast agents helped us to assess and describe in
detail the technology, indications and contraindications, data of qualitative
and quantitative analysis, the efciency (with SonoVue®) in the early and differential diagnosis of neoplasms, their role in the evaluation of neoangiogenesis in tumors, and the place in diagnostic algorithms. Specic features for
the use in pediatric practice with a special focus on its safety, indications, and
monitoring are presented in detail.
vii

viii
Along with intravenous administration of ultrasound contrast agents,
intracavitary and rare ways of use are described. A separate chapter is devoted
to sonohysterosalpingography with various ultrasound contrast agents and
their role in the assessment of endometrium and fallopian tubes.
The book will be a helpful tool for both residents and practitioners
approaching ultrasound diagnostics, as well as for more experienced radiologists and other professionals. It is created to promote CEUS as a simple and
efcient way for oncologists, surgeons, therapists, gynecologists, and other
practitioners to make complex early and differential diagnosis of various diseases even better.
Moscow, Russia AlexanderN.Sencha
Yaroslavl, Russia YuryN.Patrunov
Preface

Contents
1 General Aspects of the Use of Contrast Agents in Diagnostic
Ultrasound. History and Current State of the Technology.
Review of Contrast Agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Alexander N. Sencha, Ella I. Peniaeva,
Munir G. Tukhbatullin, Elena A. Zubareva,
Liubov A. Timofeyeva, Yury N. Patrunov, Roman A. Barmin,
and Polina G. Rudakovskaya
2 Physical Principles and Technical Aspects of CEUS . . . . . . . . . . 11
Ella I. Peniaeva, Alexander N. Sencha, Yuly R. Kamalov,
Yury N. Patrunov, Elena P. Fisenko, Natalia N. Vetsheva,
Roman A. Barmin, and Polina G. Rudakovskaya
3 Technique of CEUS and Data Analysis . . . . . . . . . . . . . . . . . . . . . 21
Ella I. Peniaeva, Alexander N. Sencha, Alexey V. Pomortsev,
Liubov A. Timofeyeva, Yury N. Patrunov,
and Ekaterina A. Sencha
4 Liver . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Ella I. Peniaeva and Yuly R. Kamalov
5 Gallbladder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Ella I. Peniaeva, Alexander N. Sencha, and Yury N. Patrunov
6 Pancreas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
Alexander N. Sencha, Elena P. Fisenko, Natalia N. Vetsheva,
and Ella I. Peniaeva
7 Spleen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
Alexander N. Sencha and Ella I. Peniaeva
8 Kidneys and Adrenals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Yury N. Patrunov, Ella I. Peniaeva, Alexander N. Sencha,
and Liubov A. Timofeyeva
9 Small Intestine and Colon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175
Ella I. Peniaeva, Munir G. Tukhbatullin, Alexander N. Sencha,
and Elena E. Fomina
ix

x
10 Bladder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181
Alexander N. Sencha, Munir G. Tukhbatullin,
Ella I. Peniaeva, and Marat Z. Khasanov
11 Prostate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
Munir G. Tukhbatullin, Marat Z. Khasanov, Elena E. Fomina,
and Natalya I. Bayazova
12 CEUS in Gynecology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
Elena P. Fedotkina, Alexander N. Sencha,
Alexey V. Pomortsev, Munir G. Tukhbatullin,
Anatoly G. Bykov, Yulia Y. Dyachenko, Elena E. Fomina,
Natalya I. Bayazova, and Polina L. Sheshko
13 Thyroid and Parathyroid Glands . . . . . . . . . . . . . . . . . . . . . . . . . 241
Ekaterina A. Sencha and Alexander N. Sencha
14 Breast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 261
Alexander N. Sencha, Ekaterina A. Sencha,
and Liubov A. Timofeyeva
15 Salivary Glands . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 283
Alexander N. Sencha and Ella I. Peniaeva
16 Scrotum and Testicles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291
Alexander N. Sencha, Yury N. Patrunov, and Ella I. Peniaeva
Contents
17 Lymph Nodes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301
Alexander N. Sencha, Ekaterina A. Sencha, Ella I. Peniaeva,
and Yury N. Patrunov
18 Major Blood Vessels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 315
Munir G. Tukhbatullin, Elena E. Fomina,
Natalya I. Bayazova, and Marat Z. Khasanov
19 CEUS for Minimally Invasive Procedures: Intracavitary
CEUS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327
Yury N. Patrunov, Inna A. Apolikhina, Ella I. Peniaeva,
Alexander N. Sencha, and Ayna S. Saidova
20 CEUS in Pediatric Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 339
Alexander N. Sencha and Elena A. Zubareva
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