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Gastroenterologie up2date 2014; 10(02): 113-128
DOI: 10.1055/s-0034-1365466
Endoskopie/Gastrointestinale Radiologie/Sonografie
© Georg Thieme Verlag KG Stuttgart · New York

Kontrastmittelsonografie (CEUS) der Leber

Christoph F. Dietrich
,
Christian Jenssen
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Publication History

Publication Date:
05 June 2014 (online)

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Kernaussagen

  • CEUS ermöglicht eine mit der CT und der MRT vergleichbare Detektion von Lebermetastasen.

  • CEUS erlaubt eine zuverlässige Einschätzung der Dignität von Leberläsionen in der gesunden Leber. Einschränkungen sind degenerative Veränderungen, Abszesse, fortgeschrittene Leberparenchymerkrankungen, cholangiozelluläre Adenome und hochdifferenzierte Leberzellkarzinome.

  • Durch CEUS können die prognostisch unterschiedlich bewerteten benignen hypervaskulären Lebertumoren FNH und hepatozelluläres Adenom voneinander unterschieden werden.

  • Die Differenzialdiagnose von Hämangiomen wird durch CEUS erleichtert.

  • In der zirrhotisch umgebauten Leber können Leberzellkarzinome mittels CEUS besser charakterisiert werden.

  • Der Einsatz von Echosignalverstärkern kann zur Punktionssteuerung und zur Überwachung ablativer Eingriffe hilfreich sein.

 

  • Literatur

  • 1 Claudon M, Dietrich CF, Choi BI et al. Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS) in the liver – update 2012: a WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS. Ultraschall Med 2013; 34: 11-29
    Article in Thieme ConnectPubMedGoogle Scholar
  • 2 Dietrich CF, Hocke M. Kontrastverstärkte Sonografie (CEUS). Gastroenterologie Up2Date 2011; 7: 103-122
    Article in Thieme ConnectPubMedGoogle Scholar
  • 3 Dietrich CF, Jenssen C. [Focal liver lesion, incidental finding]. Dtsch Med Wochenschr 2012; 137: 2099-2116
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Dietrich CF, Sharma M, Gibson RN et al. Fortuitously discovered liver lesions. World J Gastroenterol 2013; 19: 3173-3188
    CrossrefPubMedGoogle Scholar
  • 5 Dietrich CF, Ignee A, Hocke M et al. Pitfalls and artefacts using contrast enhanced ultrasound. Z Gastroenterol 2011; 49: 350-356
    Article in Thieme ConnectPubMedGoogle Scholar
  • 6 Dietrich CF, Ignee A, Greis C et al. Artefakte und Fallgruben der Kontrastmittelsonografie der Leber. Ultraschall Med 2013; 34: 2-22
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Sparchez Z, Radu P, Zaharia T et al. Usefulness of contrast enhanced ultrasound guidance in percutaneous biopsies of liver tumors. J Gastrointestin Liver Dis 2011; 20: 191-196
    PubMedGoogle Scholar
  • 8 Dietrich CF, Schreiber-Dietrich D, Hocke M. [Comments on the EFSUMB non-liver Guidelines 2011]. Praxis (Bern 1994) 2012; 101: 1175-1181
    CrossrefPubMedGoogle Scholar
  • 9 Dietrich CF, Cui XW, Boozari B et al. Contrast-enhanced ultrasound (CEUS) in the diagnostic algorithm of hepatocellular and cholangiocellular carcinoma, comments on the AASLD guidelines. Ultraschall Med 2012; 33: 57-S66
    PubMedGoogle Scholar
  • 10 Dietrich CF. Liver tumor characterization – comments and illustrations regarding guidelines. Ultraschall Med 2012; 33: 22-S30
    Article in Thieme ConnectPubMedGoogle Scholar
  • 11 Dietrich CF, Cui XW, Schreiber-Dietrich DG et al. EFSUMB guidelines 2011: comments and illustrations. Ultraschall Med 2012; 33: 11-S21
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Barreiros AP, Piscaglia F, Dietrich CF. Contrast enhanced ultrasound for the diagnosis of hepatocellular carcinoma (HCC): comments on AASLD guidelines. J Hepatol 2012; 57: 930-932
    CrossrefPubMedGoogle Scholar
  • 13 Cui XW, Friedrich-Rust M, De Molo C et al. Liver elastography, comments on EFSUMB elastography guidelines 2013. World J Gastroenterol 2013; 19: 6329-6347
    CrossrefPubMedGoogle Scholar
  • 14 Dietrich CF, Averkiou MA, Correas JM et al. An EFSUMB introduction into Dynamic Contrast-Enhanced Ultrasound (DCE-US) for quantification of tumour perfusion. Ultraschall Med 2012; 33: 344-351
    Article in Thieme ConnectPubMedGoogle Scholar
  • 15 Cui XW, Ignee A, Jedrzejczyk M et al. Dynamic Vascular Pattern (DVP), a quantification tool for contrast enhanced ultrasound. Z Gastroenterol 2013; 51: 427-431
    Article in Thieme ConnectPubMedGoogle Scholar
  • 16 Westwood M, Joore M, Grutters J et al. Contrast-enhanced ultrasound using SonoVue(R) (sulphur hexafluoride microbubbles) compared with contrast-enhanced computed tomography and contrast-enhanced magnetic resonance imaging for the characterisation of focal liver lesions and detection of liver metastases: a systematic review and cost-effectiveness analysis. Health Technol Assess 2013; 17: 1-243
    PubMedGoogle Scholar
  • 17 Friedrich-Rust M, Klopffleisch T, Nierhoff J et al. Contrast-Enhanced Ultrasound for the differentiation of benign and malignant focal liver lesions: a meta-analysis. Liver Int 2013; 33: 739-755
    CrossrefPubMedGoogle Scholar
  • 18 Xie L, Guang Y, Ding H et al. Diagnostic value of contrast-enhanced ultrasound, computed tomography and magnetic resonance imaging for focal liver lesions: a meta-analysis. Ultrasound Med Biol 2011; 37: 854-861
    CrossrefPubMedGoogle Scholar
  • 19 Dietrich CF, Kratzer W, Strobe D et al. Assessment of metastatic liver disease in patients with primary extrahepatic tumors by contrast-enhanced sonography versus CT and MRI. World J Gastroenterol 2006; 12: 1699-1705
    CrossrefPubMedGoogle Scholar
  • 20 Dietrich CF, Hocke M. Stellenwert und Techniken des transabdominellen Ultraschalls in der Diagnostik gastroenterologischer Erkrankungen. Gastroenterologie Up2Date 2010; 6: 189-210
    Article in Thieme ConnectPubMedGoogle Scholar
  • 21 Dietrich CF, Ignee A, Trojan J et al. Improved characterization of histologically proven liver tumours by contrast enhanced ultrasonography during the portal venous and specific late phase of SHU 508A. Gut 2004; 53: 401-405
    CrossrefPubMedGoogle Scholar
  • 22 Schuessler G, Fellbaum C, Fauth F et al. [The inflammatory pseudotumour – an unusual liver tumour]. Ultraschall Med 2006; 27: 273-279
    Article in Thieme ConnectPubMedGoogle Scholar
  • 23 Dietrich CF, Schuessler G, Trojan J et al. Differentiation of focal nodular hyperplasia and hepatocellular adenoma by contrast-enhanced ultrasound. Br J Radiol 2005; 78: 704-707
    CrossrefPubMedGoogle Scholar
  • 24 Ignee A, Piscaglia F, Ott M et al. A benign tumour of the liver mimicking malignant liver disease – cholangiocellular adenoma. Scand J Gastroenterol 2009; 44: 633-636
    CrossrefPubMedGoogle Scholar
  • 25 Laumonier H, Cailliez H, Balabaud C et al. Role of contrast-enhanced sonography in differentiation of subtypes of hepatocellular adenoma: correlation with MRI findings. AJR Am J Roentgenol 2012; 199: 341-348
    CrossrefPubMedGoogle Scholar
  • 26 Dietrich CF, Mertens JC, Braden B et al. Contrast-enhanced ultrasound of histologically proven liver hemangiomas. Hepatology 2007; 45: 1139-1145
    CrossrefPubMedGoogle Scholar
  • 27 Trojan J, Hammerstingl R, Engels K et al. Contrast-enhanced ultrasound in the diagnosis of malignant mesenchymal liver tumors. J Clin Ultrasound 2010; 38: 227-231
    PubMedGoogle Scholar
  • 28 Mork H, Ignee A, Schuessler G et al. Analysis of neuroendocrine tumour metastases in the liver using contrast enhanced ultrasonography. Scand J Gastroenterol 2007; 42: 652-662
    CrossrefPubMedGoogle Scholar
  • 29 Hirche TO, Ignee A, Hirche H et al. Evaluation of hepatic steatosis by ultrasound in patients with chronic hepatitis C virus infection. Liver Int 2007; 27: 748-757
    CrossrefPubMedGoogle Scholar
  • 30 Dietrich CF. Letter to the editor: Kratzer W et al. Prevalence and risk factors of focal sparing in hepatic steatosis. Ultraschall in Med 2010; 31: 37–42. Ultraschall Med 2010; 31: 417-419
    Article in Thieme ConnectPubMedGoogle Scholar
  • 31 Dietrich CF. Comments and illustrations regarding the guidelines and good clinical practice recommendations for contrast-enhanced ultrasound (CEUS) – update 2008. Ultraschall Med 2008; 29: 188-S202
    Article in Thieme ConnectPubMedGoogle Scholar
  • 32 Goertz RS, Janka R, Nagel A et al. Eosinophilic infiltration of the liver and pancreas mimicking metastatic disease. Z Gastroenterol 2010; 48: 1138-1140
    Article in Thieme ConnectPubMedGoogle Scholar
  • 33 Dietrich CF, Maddalena ME, Cui XW et al. Liver tumor characterization – review of the literature. Ultraschall Med 2012; 33: 3-10
    Article in Thieme ConnectPubMedGoogle Scholar
  • 34 Trenker C, Kunsch S, Michl P et al. Contrast-Enhanced Ultrasound (CEUS) in Hepatic Lymphoma: Retrospective Evaluation in 38 Cases. Ultraschall Med 25.07.2013; [Epub ahead of print]
    PubMedGoogle Scholar
  • 35 Cui XW, Jenssen C, Saftoiu A et al. New ultrasound techniques for lymph node evaluation. World J Gastroenterol 2013; 19: 4850-4860
    CrossrefPubMedGoogle Scholar
  • 36 Dietrich CF, Hocke M, Jenssen C. [Ultrasound for abdominal lymphadenopathy]. Dtsch Med Wochenschr 2013; 138: 1001-1018
    Article in Thieme ConnectPubMedGoogle Scholar
  • 37 Strobel D, Bernatik T, Blank W et al. Diagnostic accuracy of CEUS in the differential diagnosis of small (</= 20 mm) and subcentimetric (</= 10 mm) focal liver lesions in comparison with histology. Results of the DEGUM multicenter trial. Ultraschall Med 2011; 32: 593-597
    Article in Thieme ConnectPubMedGoogle Scholar
  • 38 Quaia E, De Paoli L, Angileri R et al. Indeterminate solid hepatic lesions identified on non-diagnostic contrast-enhanced computed tomography: Assessment of the additional diagnostic value of contrast-enhanced ultrasound in the non-cirrhotic liver. Eur J Radiol 2014; 83: 456-462
    CrossrefPubMedGoogle Scholar
  • 39 Piscaglia F, Cucchetti A, Dietrich CF et al. Towards new tools for refined management of patients with advanced hepatocellular carcinoma under systemic therapy: some enthusiasm with a word of caution. J Hepatol 2013; 59: 924-925
    CrossrefPubMedGoogle Scholar
  • 40 Greten TF, Malek NP, Schmidt S et al. [Diagnosis of and therapy for hepatocellular carcinoma]. Z Gastroenterol 2013; 51: 1269-1326
    Article in Thieme ConnectPubMedGoogle Scholar
  • 41 Strobel D, Seitz K, Blank W et al. Contrast-enhanced ultrasound for the characterization of focal liver lesions – diagnostic accuracy in clinical practice (DEGUM multicenter trial). Ultraschall Med 2008; 29: 499-505
    Article in Thieme ConnectPubMedGoogle Scholar
  • 42 Strobel D, Seitz K, Blank W et al. Tumor-specific vascularization pattern of liver metastasis, hepatocellular carcinoma, hemangioma and focal nodular hyperplasia in the differential diagnosis of 1,349 liver lesions in contrast-enhanced ultrasound (CEUS). Ultraschall Med 2009; 30: 376-382
    Article in Thieme ConnectPubMedGoogle Scholar
  • 43 Seitz K, Strobel D, Bernatik T et al. Contrast-Enhanced Ultrasound (CEUS) for the characterization of focal liver lesions – prospective comparison in clinical practice: CEUS vs. CT (DEGUM multicenter trial). Parts of this manuscript were presented at the Ultrasound Dreilandertreffen 2008, Davos. Ultraschall Med 2009; 30: 383-389
    Article in Thieme ConnectPubMedGoogle Scholar
  • 44 Bernatik T, Seitz K, Blank W et al. Unclear focal liver lesions in contrast-enhanced ultrasonography – lessons to be learned from the DEGUM multicenter study for the characterization of liver tumors. Ultraschall Med 2010; 31: 577-581
    Article in Thieme ConnectPubMedGoogle Scholar
  • 45 Seitz K, Bernatik T, Strobel D et al. Contrast-enhanced ultrasound (CEUS) for the characterization of focal liver lesions in clinical practice (DEGUM Multicenter Trial): CEUS vs. MRI – a prospective comparison in 269 patients. Ultraschall Med 2010; 31: 492-499
    Article in Thieme ConnectPubMedGoogle Scholar
  • 46 Seitz K, Greis C, Schuler A et al. Frequency of tumor entities among liver tumors of unclear etiology initially detected by sonography in the noncirrhotic or cirrhotic livers of 1349 patients. Results of the DEGUM multicenter study. Ultraschall Med 2011; 32: 598-603
    Article in Thieme ConnectPubMedGoogle Scholar
  • 47 Niu Y, Huang T, Lian F et al. Contrast-enhanced ultrasonography for the diagnosis of small hepatocellular carcinoma: a meta-analysis and meta-regression analysis. Tumour Biol 2013; 34: 3667-3674
    CrossrefPubMedGoogle Scholar
  • 48 Bota S, Piscaglia F, Marinelli S et al. Comparison of International Guidelines for Noninvasive Diagnosis of Hepatocellular Carcinoma. Liver Cancer 2012; 1: 190-200
    CrossrefPubMedGoogle Scholar
  • 49 Ignee A, Jedrejczyk M, Schuessler G et al. Quantitative contrast enhanced ultrasound of the liver for time intensity curves – Reliability and potential sources of errors. Eur J Radiol 2010; 73: 153-158
    CrossrefPubMedGoogle Scholar
  • 50 Cui XW, Ignee A, Hocke M et al. Prolonged Heterogeneous Liver Enhancement on Contrast-Enhanced Ultrasound. Ultraschall Med 25.07.2013; [Epub ahead of print]
    PubMedGoogle Scholar