By Dirk-André Clevert, Mirko D'Onofrio, Emilio Quaia
With assistance from an intensive sequence of top of the range photos, this atlas describes the entire strength purposes of elastosonography in regimen medical perform. After a short creation on technical and actual elements, the diagnostic advantages of elastosonography in a variety of settings are illustrated by using a number of consultant situations. The assurance encompasses pathologies of the liver, spleen, pancreas, kidney, breast, thyroid, testis, musculoskeletal method, and vascular approach. additionally, useful correlations with imaging appearances on ultrasound and computed tomography are integrated. Elastosonography is a robust, rather new diagnostic process that assesses the pliability of tissues as a trademark of malignancy. Readers will locate this ebook to be a good reduction to take advantage of and interpretation of the technique.
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Extra resources for Atlas of Elastosonography: Clinical Applications with Imaging Correlations
19 m/s a b c 2 Liver and Spleen 27 Fig. 8 (continued) d e f E. Quaia et al. 28 Fig. 8 (continued) g 2 Liver and Spleen Fig. 9 HCC in the focal liver nodule is softer (a) and brighter (b) at elastography in respect to the stiff liver cirrhotic parenchyma (c) 29 a b c E. Quaia et al. 30 Fig. 10 HCC. (a) B-mode ultrasound demonstrates a hyper- until isoechoic liver lesion. (b) Colour Doppler ultrasound demonstrates some peripheral and central vessels inside the liver lesion. (c) Contrast-enhanced ultrasound depicted an intense enhancement of the tumour in the arterial phases, in comparison to the surrounding liver tissue.
To make diagnosis of pseudocyst of course is very important to know the patient medical history. This kind of pancreatic cyst has a fibrotic wall and is filled by fluid that can be different for hemorrhage or necrosis presence. For these reasons, at ARFI quantification imaging, it is possible to obtain different values of share waves depending on fluid contents, from serous type to very complex one [49, 52]. 3 Clinical Indications and Guidelines Transabdominal and endoscopic elastography can sufficiently and reproducibly distinguish between normal pancreatic parenchyma and most pancreatic tumors dominated by stiff (blue) areas.
2 Ductal adenocarcinoma. (a–e) Complete US study: round-shaped hypoechoic mass (a) located in the pancreatic body resulting stiff (marginally red in b, inhomogeneously black in c) due to the rich desmoplastic stroma in the elastogram. 74 m/s is detected (d). At color Doppler analysis (a), no Doppler signal is visible 57 b d f within the lesion according to the very low vascular density of the neoplastic tissue. At CEUS the lesion typically shows markedly hypovascular pattern (calipers in e). (f) CT study: typical appearance of a pancreatic ductal adenocarcinoma, presenting as a hypovascular lesion (f) in comparison to the adjacent pancreatic parenchyma at venous phase V.
Atlas of Elastosonography: Clinical Applications with Imaging Correlations by Dirk-André Clevert, Mirko D'Onofrio, Emilio Quaia