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J Ultrasound. 2013 Aug 3;17(1):57-63. doi: 10.1007/s40477-013-0032-y. eCollection 2014 Mar.

CEUS in the study of bladder, method, administration and evaluation, a technical note.

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1
Dipartimento di Radiologia Università degli studi "La Sapienza" Viale del Policlinico, 155 00161 Rome, Italy.

Abstract

in English, Italian

PURPOSE:

Contrast-enhanced ultrasound (CEUS) is the application of ultrasound contrast agents (UCAs) to traditional medical sonography. The development of UCAs allowed to overcome some of the limitations of conventional B-mode and Doppler ultrasound techniques and enabled the display of the parenchymal microvasculature. Purpose of this paper is to delineate the elements of a solid and science-based technique in the execution of urinary bladder CEUS.

METHODS:

We describe the technical execution of urinary bladder CEUS and the use of perfusion softwares to perform contrast enhancement quantitative analysis with generation of time-intensity curves from regions of interest.

RESULTS:

During CEUS, normal bladder wall shows a wash-in time of 13 s, a time to peak (TTP) >40 s, a signal intensity (SI) <45 % and a wash-out time >80 s; Low-grade urothelial cell carcinoma (UCC) shows a wash-in time of 13 s, a time to peak TTP >28 s, a SI <45 % and a wash-out time of 40 s; High-grade UCC shows a wash-in time of 13 s, a TTP >28 s, a SI >50 % and a wash-out time of 58 s.

CONCLUSIONS:

CEUS is a useful tool for an accurate characterization of bladder UCC although it has some drawbacks. To avoid misunderstandings, a widely accepted classification and a standardized terminology about the most significant parameters of this application should be adopted in the immediate future.

KEYWORDS:

Bladder; CEUS; Time–intensity curves; Urothelial cell carcinoma

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