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Liver Contrast Poster

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ACUSON Sequoia ultrasound system Cases and images courtesy of Dirk-André Clevert, MD Professor of Radiology, Improved diagnostic confidence in abdominal Honorary Doctor (TSM-Univ.) Section Chief of the Interdisciplinary Ultrasound Center at the Department of Clinical Radiology, imaging using innovative technologies University of Munich Hospitals, Grosshadern Campus Case 1 81-year-old male patient with chronic obstructive pulmonary Baseline ultrasound scan shows a single isoechoic lesion Power Doppler shows no major vascularity of the lesion Dual-view contrast-enhanced ultrasound (CEUS) Dual-view CEUS (yellow arrow) and B-mode ultrasound disease (COPD) and dyspnea. Multi-slice computer (yellow arrow) with a hyperechoic margin and a maximum (yellow arrow). demonstrating the lesion in contrast (yellow arrow) and (red arrow) image. During the late phase, the lesion tomography (MS-CT) highly suspicious of lung cancer diameter of 1 cm in segment V of the right liver lobe. B-mode ultrasound (red arrow). In the arterial phase, the demonstrated a hypoechoic, sharply circumscribed (yellow arrow) in the right upper lobe in the coronal view. lesion displayed moderate enhancement. enhanced defect. CEUS confirmed a small liver metastases. In addition, a small liver lesion was detected (red arrow). Case 2 80-year-old female patient with a known moderate myxoid Color Doppler examination of the lesion (yellow arrow) Virtual Touch™ Shear Wave Elastography (SWE) CEUS using 2D mix-mode in the arterial phase. The lesion Dual-view of CEUS (yellow arrow) and B-mode ultrasound liposarcoma on the right thigh. In MS-CT, an unclear lesion demonstrated no major vascularity. demonstrating lesion (yellow arrow) in dual-view mode. demonstrated moderate enhancement (yellow arrow) in (yellow arrow). Lesion (yellow arrow) demonstrates slight (yellow arrow) of the left liver lobe was detected. The lesion appears to be more stiff (1.43 m/s [6.1 kPa]) comparison to the surrounding liver (red arrow). wash-out to the surrounding liver (red arrow). CEUS in comparison to the surrounding tissue of the liver confirmed a liver metastases. Histologically report showed (0.97 m/s [2.8 kPa]). a liver metastasis of a myxoid sarcoma. Case 3 51-year-old male patient with suspicion of a hemorrhagic Color Doppler examination of the lesion (yellow arrow) Virtual Touch™ Shear Wave Elastography (SWE) CEUS using 2D mix-mode in the arterial phase. The lesion CEUS using 2D mix-mode in the late phase. The lesion kidney cyst (yellow arrow), detected in an abdominal demonstrated no major vascularity. demonstrating lesion in dual-view mode. The renal lesion demonstrated a moderate amount of enhancement (yellow (yellow arrow) demonstrated a slight wash out defect MS-CT examination. seems to be less stiff (0.93 m/s [2.6 kPa]) in comparison to arrow) in comparison to the surrounding tissue of the right in comparison to the surrounding tissue of the kidney. the surrounding tissue of the kidney (1.44 m/s [6.2 kPa]). kidney. Due to the contrast uptake, the diagnosis of a Histologically, it was proven as papillary renal hemorrhagic kidney cyst is not consistent with the finding. carcinoma. Case 4 51-year-old male patient with squamous cell carcinoma of Baseline ultrasound scan shows both cysts (red and yellow Color Doppler examination of cysts (red and yellow arrows) CEUS using 2D mix mode in the cortical phase. Both CEUS using 2D mix-mode in the parenchymal phase. One the left ear. For oncological staging, the patient undergoes arrows). The findings may correspond to a complex renal demonstrated no major vascularity. cysts (red and yellow arrows) demonstrated no contrast cyst (red arrow) demonstrated no enhancement, but the MS-CT. The left kidney shows a couple of renal cysts (red cyst (red arrow). enhancement. second cyst (yellow arrow) demonstrated complete contrast arrow), one of these cysts (yellow arrow) seems to have an enhancement. Due to the contrast uptake, the diagnosis was increased density. not consistent with a hemorrhagic cyst. Ultrasound indicates papillary renal carcinoma; patient referred for surgery. Case 5 Siemens   Medical Solutions USA, Inc., 2019 ©   ·   7452 07191.0   ·     in Germany Printed ·   73-year-old male patient with a known endoleak in the Follow up ultrasound in a patient after endoleak treatment, Power Doppler examination of the stent graft (red arrow) CEUS using 2D mix-mode as the superior imaging The type 2 endoleak was stable over time, the left lumbar past. Due to this known type 2 endoleak with feeding showing the endoluminal stents (red arrow) inside the show vascularization inside the partly thrombotic technique shows persistent endoleak (yellow arrow). feeding artery however remained patent. In conclusion, the vessel over the left lumbal artery, the patient underwent partly thrombotic aneurysmal sac (yellow arrow). No aneurysmal sac (yellow arrow). No vascularization outside The stent graft (red arrow) inside the partly thrombotic interventional treatment was incomplete. Order No.   A91US-609-1C-4A00   Order interventional treatment during which Onyx (glue) was suspicion of an endoleak. the lumen of the stent could be detected. aneurysmal sac shows a complete perfusion. ·   injected in the aneurysmal sac for treatment. No leak was visible in the interventional suite. All clinical images acquired using the ACUSON Sequoia™ ultrasound Published by Siemens Medical Solutions USA, Inc.   Published by system in April 2019. Latest developments in ultrasound technology expand precision medicine using high-resolution imaging that adapts to patients’ size and personal characteristics, contributing to a more confident diagnosis. Innovative clinical applications like elastography and contrast-enhanced ultrasound (CEUS) address the BioAcoustic variations of each patient, such as tissue density, stiffness, and attenuation. Non-invasive elastography ultrasound imaging allows clinicians to assess tissue by visualizing shear wave speed, a parameter correlated with tissue stiffness which can correlate to chronic disease progression. Latest advancements in contrast- enhanced ultrasound enable improved visualization and assessment of lesions with increased sensitivity and penetration. ACUSON Sequoia ultrasound system Cases and images courtesy of Dirk-André Clevert, MD Professor of Radiology, Improved diagnostic confidence in abdominal Honorary Doctor (TSM-Univ.) Section Chief of the Interdisciplinary Ultrasound Center at the Department of Clinical Radiology, imaging using innovative technologies University of Munich Hospitals, Grosshadern Campus Case 1 81-year-old male patient with chronic obstructive pulmonary Baseline ultrasound scan shows a single isoechoic lesion Power Doppler shows no major vascularity of the lesion Dual-view contrast-enhanced ultrasound (CEUS) Dual-view CEUS (yellow arrow) and B-mode ultrasound disease (COPD) and dyspnea. Multi-slice computer (yellow arrow) with a hyperechoic margin and a maximum (yellow arrow). demonstrating the lesion in contrast (yellow arrow) and (red arrow) image. During the late phase, the lesion tomography (MS-CT) highly suspicious of lung cancer diameter of 1 cm in segment V of the right liver lobe. B-mode ultrasound (red arrow). In the arterial phase, the demonstrated a hypoechoic, sharply circumscribed (yellow arrow) in the right upper lobe in the coronal view. lesion displayed moderate enhancement. enhanced defect. CEUS confirmed a small liver metastases. In addition, a small liver lesion was detected (red arrow). Case 2 80-year-old female patient with a known moderate myxoid Color Doppler examination of the lesion (yellow arrow) Virtual Touch™ Shear Wave Elastography (SWE) CEUS using 2D mix-mode in the arterial phase. The lesion Dual-view of CEUS (yellow arrow) and B-mode ultrasound liposarcoma on the right thigh. In MS-CT, an unclear lesion demonstrated no major vascularity. demonstrating lesion (yellow arrow) in dual-view mode. demonstrated moderate enhancement (yellow arrow) in (yellow arrow). Lesion (yellow arrow) demonstrates slight (yellow arrow) of the left liver lobe was detected. The lesion appears to be more stiff (1.43 m/s [6.1 kPa]) comparison to the surrounding liver (red arrow). wash-out to the surrounding liver (red arrow). CEUS in comparison to the surrounding tissue of the liver confirmed a liver metastases. Histologically report showed (0.97 m/s [2.8 kPa]). a liver metastasis of a myxoid sarcoma. Case 3 51-year-old male patient with suspicion of a hemorrhagic Color Doppler examination of the lesion (yellow arrow) Virtual Touch™ Shear Wave Elastography (SWE) CEUS using 2D mix-mode in the arterial phase. The lesion CEUS using 2D mix-mode in the late phase. The lesion kidney cyst (yellow arrow), detected in an abdominal demonstrated no major vascularity. demonstrating lesion in dual-view mode. The renal lesion demonstrated a moderate amount of enhancement (yellow (yellow arrow) demonstrated a slight wash out defect MS-CT examination. seems to be less stiff (0.93 m/s [2.6 kPa]) in comparison to arrow) in comparison to the surrounding tissue of the right in comparison to the surrounding tissue of the kidney. the surrounding tissue of the kidney (1.44 m/s [6.2 kPa]). kidney. Due to the contrast uptake, the diagnosis of a Histologically, it was proven as papillary renal hemorrhagic kidney cyst is not consistent with the finding. carcinoma. Case 4 51-year-old male patient with squamous cell carcinoma of Baseline ultrasound scan shows both cysts (red and yellow Color Doppler examination of cysts (red and yellow arrows) CEUS using 2D mix mode in the cortical phase. Both CEUS using 2D mix-mode in the parenchymal phase. One the left ear. For oncological staging, the patient undergoes arrows). The findings may correspond to a complex renal demonstrated no major vascularity. cysts (red and yellow arrows) demonstrated no contrast cyst (red arrow) demonstrated no enhancement, but the MS-CT. The left kidney shows a couple of renal cysts (red cyst (red arrow). enhancement. second cyst (yellow arrow) demonstrated complete contrast arrow), one of these cysts (yellow arrow) seems to have an enhancement. Due to the contrast uptake, the diagnosis was increased density. not consistent with a hemorrhagic cyst. Ultrasound indicates papillary renal carcinoma; patient referred for surgery. Case 5 Siemens   Medical Solutions USA, Inc., 2019 ©   ·   7452 07191.0   ·     in Germany Printed ·   73-year-old male patient with a known endoleak in the Follow up ultrasound in a patient after endoleak treatment, Power Doppler examination of the stent graft (red arrow) CEUS using 2D mix-mode as the superior imaging The type 2 endoleak was stable over time, the left lumbar past. Due to this known type 2 endoleak with feeding showing the endoluminal stents (red arrow) inside the show vascularization inside the partly thrombotic technique shows persistent endoleak (yellow arrow). feeding artery however remained patent. In conclusion, the vessel over the left lumbal artery, the patient underwent partly thrombotic aneurysmal sac (yellow arrow). No aneurysmal sac (yellow arrow). No vascularization outside The stent graft (red arrow) inside the partly thrombotic interventional treatment was incomplete. Order No.   A91US-609-1C-4A00   Order interventional treatment during which Onyx (glue) was suspicion of an endoleak. the lumen of the stent could be detected. aneurysmal sac shows a complete perfusion. ·   injected in the aneurysmal sac for treatment. No leak was visible in the interventional suite. All clinical images acquired using the ACUSON Sequoia™ ultrasound Published by Siemens Medical Solutions USA, Inc.   Published by system in April 2019. Latest developments in ultrasound technology expand precision medicine using high-resolution imaging that adapts to patients’ size and personal characteristics, contributing to a more confident diagnosis. Innovative clinical applications like elastography and contrast-enhanced ultrasound (CEUS) address the BioAcoustic variations of each patient, such as tissue density, stiffness, and attenuation. Non-invasive elastography ultrasound imaging allows clinicians to assess tissue by visualizing shear wave speed, a parameter correlated with tissue stiffness which can correlate to chronic disease progression. Latest advancements in contrast- enhanced ultrasound enable improved visualization and assessment of lesions with increased sensitivity and penetration.