RESUMEN
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.
Asunto(s)
Carcinoma Hepatocelular/ultraestructura , Medios de Contraste/administración & dosificación , Aumento de la Imagen/métodos , Interpretación de Imagen Asistida por Computador/métodos , Hepatopatías/diagnóstico por imagen , Neoplasias Hepáticas/diagnóstico por imagen , Hígado/diagnóstico por imagen , Anafilaxia/inducido químicamente , Anafilaxia/mortalidad , Biopsia con Aguja/métodos , Carcinoma Hepatocelular/patología , Carcinoma Hepatocelular/cirugía , Transformación Celular Neoplásica/patología , Contraindicaciones , Medios de Contraste/efectos adversos , Diagnóstico Diferencial , Hipersensibilidad a las Drogas/etiología , Hipersensibilidad a las Drogas/mortalidad , Interacciones Farmacológicas , Compuestos Férricos/efectos adversos , Fluorocarburos/efectos adversos , Humanos , Hierro/efectos adversos , Hígado/patología , Hígado/cirugía , Cirrosis Hepática/diagnóstico por imagen , Cirrosis Hepática/patología , Hepatopatías/patología , Hepatopatías/cirugía , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/secundario , Neoplasias Hepáticas/cirugía , Trasplante de Hígado/patología , Óxidos/efectos adversos , Fosfolípidos/efectos adversos , Factores de Riesgo , Hexafluoruro de Azufre/efectos adversos , Ultrasonografía Doppler/métodos , Ultrasonografía Intervencional/métodosRESUMEN
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.