Контрастное усиление изображения препаратом SonoVue®: пути усовершенствования ультразвуковой диагностики очаговой патологии органов брюшной полости и забрюшинного пространства

За последние годы в зарубежных странах ультразвуковое контрастное исследование с применением препарата SonoVue стало широко распространенным и клинически значимым. В России до настоящего времени данную методику визуализации не применяли, однако с государственной регистрацией препарата SonoVue появилась перспектива его внедрения в широкую клиническую практику. Из поисковой системы PubMed по ключевым словам “sonovue”, “contrast enhanced ultrasound”, “sonovue liver”, “sonovue pancreas”, “sonovue kidney” отобрано 65 публикаций последнего времени, которые были сгруппированы соответственно разделам этой статьи. Проанализирован опыт зарубежных коллег в ультразвуковой диагностике с контрастным усилением заболеваний печени, поджелудочной железы и почек, обобщены имеющиеся результаты и определены основные направления использования методики в многопрофильной хирургической клинике. Систематизирована ультразвуковая семиотика очаговой патологии брюшной полости, описаны показания и противопоказания к применению ультразвукового контрастного исследования с препаратом SonoVue. Применение контрастного вещества второго поколения SonoVue в ультразвуковой диагностике заболеваний печени, поджелудочной железы и почек является перспективным, безопасным и точным методом, благодаря чему будет уменьшаться потребность в более дорогих методах визуализации, таких как КТ и МРТ, особенно у пациентов, требующих постоянного динамического контроля эффективности лечения.

ультразвуковое исследование, Соновью, контраст, контрастное усиление, печень, поджелудочная железа, почки, ultrasound, SonoVue, contrast enhancement, liver, pancreas, kidneys

1. Alexandra von H., Julia W., Michael G. Contrast-Enhanced Ultrasound with SonoVue: Differentiation between Benign and Malignant Focal Liver Lesions in 317 patients. J. Clin. Ultrasound. 2010; 38: 1-9.

2. Sporea I., Sirli R., Martie A. et al. How useful is contrast enhanced ultrasonography for the characterization of focal liver lesions? J. Gastrointestin. Liver Dis. 2010; 19 (4): 393-398.

3. Reinhold C., Hammers L., Taylor C. et al. Characterization of focal hepatic lesions with duplex sonography: findings in 198 patients. Am. J. Roentgenol. 1995; 164 (5): 1131-1135.

4. Lee M., Auh Y., Cho K. et al. Color Doppler flow imaging of hepatocellular carcinomas. Comparison with metastatic tumors and hemangiomas by three-step grading for color hues. Clin. Imaging. 1996; 20 (3): 199-203.

5. Tateishi U., Hasegawa T., Muramatsu Y. et al. Hepatic metastases of soft tissue angiosarcoma: CT and MR imaging findings. Abdom. Imaging. 2003; 28 (5): 660-664.

6. Lencioni R., Cioni D., Crocetti L. et al. Ultrasound imaging of focal liver lesions with a second-generation contrast agent. Acad. Radiol. 2002; 9 (2): 371-374.

7. Trillaud H., Bruel J., Valette P. et al. Characterization of focal liver lesions with SonoVue-enhanced sonography: international multicenter-study in comparison to CT and MRI. Wld J. Gastroenterol. 2009; 15 (30): 3748-3756.

8. 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 (5): 492-429.

9. Morel D., Schwieger I., Hohn L. et al. Human pharmacokinetics and safety evaluation of SonoVue, a new contrast agent for ultrasound imaging. Invest. Radiol. 2000; 35 (1): 80-85.

10. Wilson S., Greenbaum L., Goldberg B. Contrast-enhanced ultrasound: what is the evidence and what are the obstacles? Am. J. Roentgenol. 2009; 193 (1): 55-60.

11. SonoVue International non-proprietary name: sulfur hexafluoride. Assessment report. Ed. Committee for Medicinal Products for Human Use (CHMP). UK: EMA, 2014: 1-33.

12. Bartolotta T., Taibbi A., Midiri M. et al. Indeterminate focal liver lesions incidentally discovered at gray-scale US: role of contrast-enhanced sonography. Invest. Radiol. 2011; 46 (2): 106-115.

13. Sporea I., Martie A., Bota S. et al. Characterization of focal liver lesions using contrast enhanced ultrasound as a first line method: a large monocentric experience. J. Gastrointestin. Liver Dis. 2014; 23 (1): 57-63.

14. Albrecht T., Blomley M., Bolondi L. et al. Guidelines for the use of contrast agents in ultrasound. Ultraschall Med. 2004; 25 (4): 249-256.

15. Claudon M., Cosgrove D., Albrecht T. et al. Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS) - update 2008. Ultraschall Med. 2008; 29 (1): 28-44.

16. Piscaglia F., Nolsoe C., Dietrich C. et al. The EFSUMB Guidelines and Recommendations on the Clinical Practice of Contrast Enhanced Ultrasound (CEUS): update 2011 on non-hepatic applications. Ultraschall Med. 2012; 33 (1): 33-59.

17. Claudon M., Dietrich C., Choi B. 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. Ultrasound Med. Biol. 2013; 39 (2): 187-210.

18. Tranquart F., Le Gouge A., Correas J. et al. Role of contrast-enhanced ultrasound in the blinded assessment of focal liver lesions in comparison with MDCT and CEMRI: Results from a multicentre clinical trial. EJC. 2008; 6: 9-15.

19. Giesel F., Delorme S., Sibbel R. et al. Contrast-enhanced ultrasound for the characterization of incidental liver lesions - an economical evaluation in comparison with multi-phase computed tomography. Ultraschall Med. 2009; 30 (3): 259-268.

20. Piscaglia F., Bolondi L. The safety of Sonovue in abdominal applications: retrospective analysis of 23188 investigations. Ultrasound Med. Biol. 2006; 32 (9): 1369-1375.

21. Gaibazzi N., Squeri A., Ardissino D. et al. Safety of contrast flash-replenishment stress echocardiography in 500 patients with a chest pain episode of undetermined origin within the last 5 days. Eur. J. Echocardiogr. 2009; 10 (6): 726-732.

22. 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 (6): 854-861.

23. Sporea I., Badea R., Martie A. et al. Contrast Enhanced Ultrasound for the evaluation of focal liver lesions in daily practice. A multicentre study. Med. Ultrason. 2012; 14 (2): 95-100.

24. 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 (5): 739-755.

25. Sporea I., Badea R., Martie A. et al. Contrast enhanced ultrasound for the characterization of focal liver lesions. Med. Ultrason. 2011; 13 (1): 38-44.

26. Von Herbay A., Westendorff J., Gregor M. Contrast-enhanced ultrasound with SonoVue: differentiation between benign and malignant focal liver lesions in 317 patients. J. Clin. Ultrasound. 2010; 38 (1): 1-9.

27. Ooi C., Low S., Schneider-Kolsky M. et al. Diagnostic accuracy of contrast-enhanced ultrasound in differentiating benign and malignant focal liver lesions: a retrospective study. J. Med. Imaging Radiat. Oncol. 2010; 54 (5): 421-430.

28. Li R., Guo Y., Hua X. et al. Characterization of focal liver lesions: comparison of pulse-inversion harmonic contrast-enhanced sonography with contrast-enhanced CT. J. Clin. Ultrasound. 2007; 35 (3): 109-117.

29. Ryu S., Bok G., Jang J. et al. Clinically useful diagnostic tool of contrast enhanced ultrasonography for focal liver masses: comparison to computed tomography and magnetic resonance imaging. Gut. Liver. 2014; 8 (3): 292-297.

30. Valentino M., Galloni S., Rimondi M. et al. Contrastenhanced ultrasound in non-operative management of pancreatic injury in childhood. Pediatr. Radiol. 2006; 36 (6): 558-560.

31. Lee T., Cheon Y., Shim C. Clinical role of contrast-enhanced harmonic endoscopic ultrasound in differentiating solid lesions of the pancreas: a single-center experience in Korea. Gut. Liver. 2013; 7 (5): 599-604.

32. Brand B., Pfaff T., Binmoeller K. et al. Endoscopic ultrasound for differential diagnosis of focal pancreatic lesions, confirmed by surgery. Sсand. J. Gastroenterol. 2000; 35: 1221-1228.

33. Eloubeidi M., Jhala D., Chhieng D. et al. Yield of endoscopic ultrasound-guided fine-needle aspiration biopsy in patients with suspected pancreatic carcinoma. Cancer. 2003; 99 (5): 285-292.

34. Kitano M., Kudo M., Yamao K. et al. Characterization of small solid tumors in the pancreas: the value of contrast-enhanced harmonic endoscopic ultrasonography. Am. J. Gastroenterol. 2012; 107 (2): 303-310.

35. Park J., Kim H., Bang B. et al. Effectiveness of contrast-enhanced harmonic endoscopic ultrasound for the evaluation of solid pancreatic masses. Wld J. Gastroenterol. 2014; 20 (2): 518-524.

36. Tang S., Huang L., Wang Y. et al. Solid pseudopapillary tumors of the pancreas: contrast-enhanced sonographic features. J. Ultrasound Med. 2012; 31 (2): 257-263.

37. Cantisani V., Mortele K., Levy A. et al. MR imaging features of solid pseudopapillary tumor of the pancreas in adult and pediatric patients. Am. J. Roentgenol. 2003; 181 (2): 395-401.

38. D'Onofrio M., Crosara S., Signorini M. et al. Comparison between CT and CEUS in the diagnosis of pancreatic adenocarcinoma. Ultraschall Med. 2013; 34 (4): 377-381.

39. D'Onofrio M., Malago R., Zamboni G. et al. Contrast-enhanced ultrasonography better identifies pancreatic tumor vascularization than helical CT. Pancreatology. 2005; 5 (4-5): 398-402.

40. Numata K., Ozawa Y., Kobayashi N. et al. Contrast-enhanced sonography of pancreatic carcinoma: correlations with pathological findings. J. Gastroenterol. 2005; 40 (6): 631-640.

41. Fan Z., Li Y., Yan K. et al. Application of contrast-enhanced ultrasound in the diagnosis of solid pancreatic lesions-a comparison of conventional ultrasound and contrast- enhanced CT. Eur. J. Radiol. 2013; 82 (9): 1385-1390.

42. Hocke M., Ignee A., Dietrich C. Advanced endosonographic diagnostic tools for discrimination of focal chronic pancreatitis and pancreatic carcinoma--elastography, contrast enhanced high mechanical index (CEHMI) and low mechanical index (CELMI) endosonography in direct comparison. Z. Gastroenterol. 2012; 50 (2): 199-203.

43. Dietrich C., Ignee A., Braden B. et al. Improved differentiation of pancreatic tumors using contrast-enhanced endoscopic ultrasound. Clin. Gastroenterol. Hepatol. 2008; 6 (5): 590-597.

44. Saftoiu A., Dietrich C.F., Vilmann P. Contrast-enhanced harmonic endoscopic ultrasound. Endoscopy. 2012; 44 (6): 612-617.

45. Wei K., Le E., Bin J. et al. Quantification of renal blood flow with contrast-enhanced ultrasound. J. Am. Coll. Cardiol. 2001; 37 (4): 1135-1140.

46. Tranquart F., Correas J., Martegani A. et al. Feasability of real time contrast enhanced ultrasound in renal disease. J. Radiol. 2004; 85 (1): 31-36.

47. Setola S., Catalano O., Sandomenico F., et al. Contrast-enhanced sonography of the kidney. Abdom. Imaging. 2007; 32 (1): 21-28.

48. Ascenti G., Zimbaro G., Mazziotti S. et al. Usefulness of power Doppler and contrast-enhanced sonography in the differentiation of hyperechoic renal masses. Abdom. Imaging. 2001; 26 (6): 654-660.

49. Kim J., Eun H., Lee H. et al. Renal perfusion abnormality. Coded harmonic angio US with contrast agent. Acta Radiol. 2003; 44 (2): 166-171.

50. Kim B., Lim H., Choi M. et al. Detection of parenchymal abnormalities in acute pyelonephritis by pulse inversion harmonic imaging with or without microbubble ultrasonographic contrast agent: correlation with computed tomography. J. Ultrasound Med. 2001; 20 (1): 5-14.

51. Xu R., Li Y., Li T. et al. Real-time 3-dimensional contrast-enhanced ultrasound in detecting hemorrhage of blunt-5renal trauma. Am. J. Emerg. Med. 2013; 31 (10): 1427-1431.

52. Ogan K., Jacomides L., Dolmatch B. et al. Percutaneous radiofrequency ablation of renal tumors: technique, limitations, and morbidity. Urology. 2002; 60 (6): 954-958.

53. Johnson D., Duchene D., Taylor G. et al. Contrast-enhanced ultrasound evaluation of radiofrequency ablation of the kidney: reliable imaging of the thermolesion. J. Endourol. 2005; 19 (2): 248-252.

54. Schneider A., Goodwin M., Schelleman A. et al. Contrast-enhanced ultrasonography to evaluate changes in renal cortical microcirculation induced by noradrenaline: a pilot study. Crit. Care. 2014; 18 (6): 653.

55. Fischer T., Ebeling V., Giessing M. et al. A new method for standardized diagnosis following renal transplantation. Ultrasound with contrast enhancement. Urologe A. 2006; 45 (1): 38-45.

56. Li X., Liang P., Guo M. et al. Real-time contrast-enhanced ultrasound in diagnosis of solid renal lesions. Discov. Med. 2013; 16 (86): 15-25.

57. Yu J., Liang P., Yu X. et al. Needle track seeding after percutaneous microwave ablation of malignant liver tumors under ultrasound guidance: analysis of 14-year experience with 1462 patients at a single center. Eur. J. Radiol. 2012; 81 (10): 2495-2499.

58. Aneta D., Jacek R., Joanna K. et al. The Effect of Contrast Medium SonoVue on the Electric Charge Density of Blood Cells. J. Membrane Biol. 2012; 245: 15-22.

59. Larsson M., Larsson M., Nowak G. et al. Endocardial border delineation capability of a novel multimodal polymer-shelled contrast agent. Cardiovasc. Ultrasound. 2014; 12: 24.

60. Robbin M., Lockhart M., Barr R. Renal imaging with ultrasound contrast: current status. Radiol. Clin. N. Am. 2003; 41 (5): 963-978.

61. Ascenti G., Gaeta M., Magno C. et al. Contrast-enhanced second-harmonic sonography in the detection of pseudocapsule in renal cell carcinoma. Am. J. Roentgenol. 2004; 182 (6): 1525-1530.

62. Bosniak M. The use of the Bosniak classification system for renal cysts and cystic tumors. J. Urol. 1997; 157 (5): 1852-1853.

63. Kim A., Kim S., Kim Y. et al. Contrast-enhanced power Doppler sonography for the differentiation of cystic renal lesions: preliminary study. J. Ultrasound Med. 1999; 18 (9): 581-588.

64. Schneider A., Goodwin M., Bellomo R. Measurement of kidney perfusion in critically ill patients. Crit. Care. 2013; 17 (2): 220.

65. Grzelak P., Kurnatowska I., Nowicki M. et al. Standard B presentation vs. contrast-enhanced ultrasound (US-CE). A comparison of usefulness of different ultrasonographic techniques in the evaluation of the echo structure and size of haematomas inpost-renal transplant patients: A preliminary report. Pol. J. Radiol. 2012; 77 (3): 14-18.