RESUMO
Initially, a set of guidelines for the use of ultrasound contrast agents was published in 2004 dealing only with liver applications. A second edition of the guidelines in 2008 reflected changes in the available contrast agents and updated the guidelines for the liver, as well as implementing some non-liver applications. Time has moved on, and the need for international guidelines on the use of CEUS in the liver has become apparent. The present document describes the third iteration of recommendations for the hepatic use of contrast enhanced ultrasound (CEUS) using contrast specific imaging techniques. This joint WFUMB-EFSUMB initiative has implicated experts from major leading ultrasound societies worldwide. These liver CEUS guidelines are simultaneously published in the official journals of both organizing federations (i.e., Ultrasound in Medicine and Biology for WFUMB and Ultraschall in der Medizin/European Journal of Ultrasound for EFSUMB). These guidelines and recommendations provide general advice on the use of all currently clinically available ultrasound contrast agents (UCA). They are intended to create standard protocols for the use and administration of UCA in liver applications on an international basis and improve the management of patients worldwide.
Assuntos
Carcinoma Hepatocelular/ultraestrutura , Meios de Contraste/administração & dosagem , Aumento da Imagem/métodos , Interpretação de Imagem Assistida por Computador/métodos , Hepatopatias/diagnóstico por imagem , Neoplasias Hepáticas/diagnóstico por imagem , Fígado/diagnóstico por imagem , Anafilaxia/induzido quimicamente , Anafilaxia/mortalidade , Biópsia por Agulha/métodos , Carcinoma Hepatocelular/patologia , Carcinoma Hepatocelular/cirurgia , Transformação Celular Neoplásica/patologia , Contraindicações , Meios de Contraste/efeitos adversos , Diagnóstico Diferencial , Hipersensibilidade a Drogas/etiologia , Hipersensibilidade a Drogas/mortalidade , Interações Medicamentosas , Compostos Férricos/efeitos adversos , Fluorocarbonos/efeitos adversos , Humanos , Ferro/efeitos adversos , Fígado/patologia , Fígado/cirurgia , Cirrose Hepática/diagnóstico por imagem , Cirrose Hepática/patologia , Hepatopatias/patologia , Hepatopatias/cirurgia , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/cirurgia , Transplante de Fígado/patologia , Óxidos/efeitos adversos , Fosfolipídeos/efeitos adversos , Fatores de Risco , Hexafluoreto de Enxofre/efeitos adversos , Ultrassonografia Doppler/métodos , Ultrassonografia de Intervenção/métodosRESUMO
Intrahepatic biliary cysts are rarely seen in the patients with biliary atresia. We describe a ten-month-old child with biliary atresia in whom the abdominal imaging studies (ultrasonography, computed tomographic scan and magnetic resonance cholangiopancreatography) revealed multiple intrahepatic biliary cysts ('bile lakes'). The child also had intrapulmonary shunting of blood due to pulmonary arteriovenous fistulae, which were demonstrated on contrast-enhanced echocardiography. Both these findings, 'bile lakes' and pulmonary arteriovenous fistulae occur rarely in biliary atresia.