Dynamic contrast enhanced ultrasound in gastrointestinal diseases: A current trend or an indispensable tool?

Abstract

Contrast enhanced ultrasound (CEUS) has been widely implemented in clinical practice because of the enormous quantity of information it provides, along with its low cost, reproducibility, minimal invasiveness, and safety of the second-generation ultrasound contrast agents. To overcome the limitation of CEUS given by the subjective evaluation of the contrast enhancement behaviour, quantitative analysis of contrast kinetics with generation of time-intensity curves has been introduced in recent years. The quantification of perfusion parameters [named as dynamic-CEUS (D-CEUS)] has several applications in gastrointestinal neoplastic and inflammatory disorders. However, the limited availability of large studies and the heterogeneity of the technologies employed have precluded the standardisation of D-CEUS, which potentially represents a valuable tool for clinical practice in management of gastrointestinal diseases. In this article, we reviewed the evidence exploring the application of D-CEUS in gastrointestinal diseases, with a special focus on liver, pancreas, and inflammatory bowel diseases.

Keywords: Quantitative perfusion analysis; Gastrointestinal diseases; Time-intensity curve; Multiparametric ultrasound

Core Tip: Contrast-enhanced ultrasound (CEUS) has been widely implemented in clinical practice in recent years. Despite its several advantages, the qualitative evaluation of this exam and the lack of objectivity could lead to variability between different operators and ultrasound equipments. Dynamic-CEUS (D-CEUS) with the measurement of perfusion parameters is aimed at overcoming this important limitation. The purpose of this review is to explore the usefulness of D-CEUS in gastroenterological diseases.