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Contrast-Enhanced Ultrasound
From Simple toComplex
AlexanderN.Sencha YuryN.Patrunov
Editors
123
Alexander N. Sencha • Yury N. Patrunov
Editors
Contrast-Enhanced Ultrasound
From Simple toComplex
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, specically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microlms 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 specic 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 afliations.
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 efcient 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 efciency 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 verication, 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 qualied 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.
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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.
PeterM.KotlyarovScientic-Research Department of New Technologies and Imaging Semiotics of the Diseases of Organs and Tissues Federal State Budgetary Institution “Russian Scientic 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 selessly 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 benet 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 efciency (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. Specic features for the use in pediatric practice with a special focus on its safety, indications, and monitoring are presented in detail.
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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 efcient way for oncologists, surgeons, therapists, gynecologists, and other practitioners to make complex early and differential diagnosis of various dis­eases even better.
Moscow, Russia AlexanderN.Sencha Yaroslavl, Russia YuryN.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
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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