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Ultraschall Med 2012; 33(1): 76-84
DOI: 10.1055/s-0031-1299056
Pictorial Essay
© Georg Thieme Verlag KG Stuttgart · New York

Endocavitary Contrast Enhanced Ultrasound (CEUS) – Work in Progress

Endokavitäre Kontrastsonografie (CEUS) – Work in Progress
A. Heinzmann
,
T. Müller
,
J. Leitlein
,
B. Braun
,
S. Kubicka
,
W. Blank
Further Information

Publication History

20 August 2011

22 September 2011

Publication Date:
19 December 2011 (online)

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Zusammenfassung

Ziel: Darstellung der diagnostischen Möglichkeiten der endokavitären Anwendung von Ultraschallkontrastmittel über Drainagen, im biliären System sowie bei oraler Gabe zur Untersuchung des GI-Traktes.

Material und Methoden: Kochsalzlösung unter Zumischung eines Tropfens SonoVue® wurde über die Drainage bzw. pro-/retrograd in das biliäre System eingebracht. Bei der oralen Anwendung wurden unterschiedliche Mischungsverhältnisse von Wasser mit SonoVue® verabreicht.

Ergebnisse: Die Kontrastmittelzumischung in Kochsalzlösung erleichtert die Lagekontrolle der Drainage und liefert zusätzliche Informationen zur Ausdehnung des zu drainierenden Prozesses. Komplikationen wie Fisteln zu den Gallengängen, Gefäßen, Darmschlingen, anderen Organen oder in die freie Bauchhöhle sind sensitiv erkennbar. Das biliäre System lässt sich gut darstellen. Bei der Gabe per os lässt sich das Kontrastmittel im Gastrointestinaltrakt verfolgen. Auch lassen sich Anastomoseninsuffizienzen und Perforationsstellen erkennen.

Schlussfolgerung: Die Gabe eines verdünnten Ultraschallkontrastmittels über eine Drainage bringt wertvolle Informationen über Lage, die Ausdehnung und Kommunikation des drainierten Prozesses zur Umgebung. Das biliäre System ist darstellbar. Die Gabe von Ultraschallkontrastverstärker per os ist möglich und kann Anastomoseninsuffizienzen und Perforationsstellen darstellen.

Abstract

Purpose: To demonstrate the benefit concerning localisation, measurement and visualisation of complications of drained fluid collections in the abdomen by applying ultrasound contrast agent via drainage catheters. In addition, to investigate the usefulness of CEUS in applying the agents in the biliary tract or when given orally.

Materials and Methods: A single drop of SonoVue® was added to 0.9 % saline solution and instilled via drainage catheters. Location, dimensions and complications of drained fluid collections were recorded and compared to the results of sonographic examination using saline solution alone and fluoroscopic examination using iodinated contrast agents. The biliary system was visualised by applying the solution via nasobiliary drains or via ERC catheterisation. Orally administered solutions consisted of one drop of SonoVue® in 50 ml aqua.

Results: Admixture of an ultrasound contrast agent to saline solution facilitates position monitoring of the drains in fluid collections and provides reliable information on the dimensions of the drained collection. Complications like fistulae to the biliary system, blood vessels, small or large intestine or to the peritoneal cavity are precisely displayed. The biliary system is shown in detailed description. Orally administered, the contrast agent is visible after intake long unto the colon. Insufficient anastomoses or spontaneous perforations become detectable.

Conclusion: The application of ultrasound contrast agents via drainage catheters provides substantial information on location and dimensions of drained fluid collections and their communication with surrounding organ structures. The biliary system can be visualised. Oral administration is feasible and provides important additional information.

Key words

abdomen - thorax - drainage - ultrasound - abscess
 

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