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中华诊断学电子杂志 ›› 2018, Vol. 06 ›› Issue (02) : 80 -83. doi: 10.3877/cma.j.issn.2095-655X.2018.02.003

所属专题: 文献

超声诊断

超声造影在急危重症中的应用
刘宁1, 洪玉才1, 章仲恒1,()   
  1. 1. 310016 杭州,浙江大学医学院附属邵逸夫医院急诊科
  • 收稿日期:2018-03-01 出版日期:2018-05-26
  • 通信作者: 章仲恒
  • 基金资助:
    浙江省自然科学基金(LGF18H150005)

Application of contrast-enhanced ultrasound in emergency and critical care medicine

Ning Liu1, Yucai Hong1, Zhongheng Zhang1,()   

  1. 1. Department of Emergency, Sir Run Run Shaw Hospital of Zhejiang University, Hangzhou 310016, China
  • Received:2018-03-01 Published:2018-05-26
  • Corresponding author: Zhongheng Zhang
  • About author:
    Corresponding author: Zhang Zhongheng, Email:
引用本文:

刘宁, 洪玉才, 章仲恒. 超声造影在急危重症中的应用[J/OL]. 中华诊断学电子杂志, 2018, 06(02): 80-83.

Ning Liu, Yucai Hong, Zhongheng Zhang. Application of contrast-enhanced ultrasound in emergency and critical care medicine[J/OL]. Chinese Journal of Diagnostics(Electronic Edition), 2018, 06(02): 80-83.

传统的二维超声及彩色多普勒超声是近年来急危重症领域的研究热点,但是该方法不能定量地评估微循环灌注,因此对评估急危重症患者的预后准确性欠佳。超声造影(CEUS)是在二维超声及彩色多普勒超声的基础上,应用超声造影剂增强回声与信号强度,可以更加清晰、动态地观察组织的病变特点,现已广泛应用在急危重症领域,如创伤病变的定位及动态评估、急性肾损伤患者的肾脏微循环灌注监测及中心静脉置管准确性评估等方面。超声造影技术为急危重患者的临床诊断及治疗提供了简单、无创、高效的新思路。

The conventional ultrasound and color doppler ultrasound have been a focus in the field of emergency and critical care medicine in recent years, but cannot evaluate the microcirculation perfusion quantitatively. Thus, their diagnostic accuracy in predicting clinical outcomes for critically ill patients is suboptimal. Contrast-enhanced ultrasound (CEUS) is based on conventional ultrasound in which ultrasound contrast agent is used to enhance echo and signal intensity, and helps to characterize tissue perfusion more clearly and dynamically. It has been widely used in the field of emergency and critical care medicine, such as the location and dynamic evaluation of traumatic lesions, renal microcirculation monitoring for the acute kidney injury (AKI) and accuracy evaluation of central venous catheterization. CEUS provides a simple, non-invasive and effective way for clinical diagnosis and treatment of critically ill patients.

[1]
陈上仲,胡才宝,蔡国龙.重症心脏超声与血流动力学监测[J/CD].中华诊断学电子杂志,2017,5(3):167-169.
[2]
Piscaglia F,Nolsøe C,Dietrich CF,et al.The EFSUMB guidelines and recommendations on the clinical practice of contrast enhanced ultrasound (CEUS):update 2011 on non-hepatic applications[J].Ultraschall Med,2012,33(1):33-59.
[3]
Piscaglia F,Bolondi L,Italian Society for Ultrasound in Medicine and Biology (SIUMB) Study Group on Ultrasound.The safety of Sonovue in abdominal applications: retrospective analysis of 23 188 investigations[J].Ultrasound Med Biol,2006,32(9):1369-1375.
[4]
Lv F,Tang J,Luo Y,et al.Contrast-enhanced ultrasound imaging of active bleeding associated with hepatic and splenic trauma[J].Radiol Med,2011,116(7):1076-1082.
[5]
Grünherz L,Jensen KO,Neuhaus V,et al.Early computed tomography or focused assessment with sonography in abdominal trauma: what are the leading opinions[J].Eur J Trauma Emerg Surg,2018,44(1):3-8.
[6]
Valentino M,Ansaloni L,Catena F,et al.Contrast-enhanced ultrasonography in blunt abdominal trauma: considerations after 5 years of experience[J].Radiol Med,2009,114(7):1080-1093.
[7]
Zechner PM,Rienmüller S,Dorr K,et al.Contrast-enhanced ultrasound detects gallbladder perforation in a patient with acute abdominal pain[J].Am J Emerg Med,2012,30(3):516,e5-e6.
[8]
Baez AA,Cochon L.Acute care diagnostics collaboration:assessment of a bayesian clinical decision model integrating the prehospital sepsis score and point-of-care lactate[J].Am J Emerg Med,2016,34(2):193-196.
[9]
Miele V,Buffa V,Stasolla A,et al.Contrast enhanced ultrasound with second generation contrast agent in traumatic liver lesions[J].Radiol Med,2004,108(1/2):82-91.
[10]
Tang J, Li W, Lv F, et al. Comparison of gray-scale contrast-enhanced ultrasonography with contrast-enhanced computed tomography in different grading of blunt hepatic and splenic trauma:an animal experiment[J].Ultrasound Med Biol,2009,35(4):566-575.
[11]
Zhang Z, Hong Y, Liu N, et al. Diagnostic accuracy of contrast enhanced ultrasound in patients with blunt abdominal trauma presenting to the emergency department: a systematic review and meta-analysis[J].Sci Rep,2017,7(1):4446.
[12]
Sessa B,Trinci M,lanniello S,et al.Blunt abdominal trauma:role of contrast-enhanced ultrasound (CEUS) in the detection and staging of abdominal traumatic lesions compared to US and CE-MDCT[J].Radiol Med,2015,120(2):180-189.
[13]
Kalantarinia K.Novel imaging techniques in acute kidney injury[J].Curr Drug Targets,2009,10(12):1184-1189.
[14]
Rossi C,Artunc F,Martirosian P,et al.Histogram analysis of renal arterial spin labeling perfusion data reveals differences between volunteers and patients with mild chronic kidney disease[J].Invest Radiol,2012,47(8):490-496.
[15]
McArthur C,Baxter GM.Current and potential renal applications of contrast-enhanced ultrasound[J].Clin Radiol,2012,67(9):909-922.
[16]
Kogan P, Johnson KA, Feingold S, et al. Validation of dynamic contrast-enhanced ultrasound in rodent kidneys as an absolute quantitative method for measuring blood perfusion[J].Ultrasound Med Biol,2011,37(6):900-908.
[17]
Fischer K,Meral FC,Zhang Y,et al.High-resolution renal perfusion mapping using contrast-enhanced ultrasonography in ischemia-reperfusion injury monitors changes in renal microperfusion[J].Kidney Int,2016,89(6):1388-1398.
[18]
Sui F,Zheng Y,Li WX,et al.Renal circulation and microcirculation during intra-abdominal hypertension in a porcine model[J].Eur Rev Pharmaco,2016,20(3):452-461.
[19]
Brabrand K, de Lange C, Emblem KE, et al. Contrast-enhanced ultrasound identifies reduced overall and regional renal perfusion during global hypoxia in piglets[J].Invest Radiol,2014,49(8):540-546.
[20]
Arger PH,Sehgal CM,Pugh CR,et al.Evaluation of change in blood flow by contrast-enhanced power Doppler imaging during norepinephrine-induced renal vasoconstriction[J].J Ultras Med,1999,18(12):843-851.
[21]
Kalantarinia K,Belcik JT,Patrie JT,et al.Real-time measurement of renal blood flow in healthy subjects using contrast-enhanced ultrasound[J].Am J Renal Physiol,2009,297(4):1129-1134.
[22]
Schneider AG,Hofmann L,Wuerzner G,et al.Renal perfusion evaluation with contrast-enhanced ultrasonography[J].Nephrol Dial Transpl,2012,27(2):674-681.
[23]
Kornbau C,Lee KC,Hughes GD,et al.Central line complications[J].Int J Crit Illn Inj Sci,2015,5(3):170-178.
[24]
Midha D,Chawla V,Kumar A,et al.Ultrasound guidance for central venous catheterization: a step further to prevent malposition of central venous catheter before radiographic confirmation[J].Indian J Crit Care Med,2017,21(7):463-465.
[25]
Alrajhi K,Woo MY,Vaillancourt C.Test characteristics of ultrasonography for the detection of pneumothorax: a systematic review and meta-analysis[J].Chest,2012,141(3):703-708.
[26]
刘畅,崔立刚.肺部超声在危重症中的临床应用[J/CD].中华诊断学电子杂志,2017,5(3):145-148.
[27]
Matsushima K, Frankel HL. Detection of central venous catheter insertion-related complication using bedside ultrasound: the CVC sono[J].J Trauma,2011,70(6):1561-1563.
[28]
Gopalakrishna G,Mustafa RA,Davenport C,et al.Applying grading of recommendations assessment,development and evaluation (GRADE) to diagnostic tests was challenging but doable[J].J Clin Epidemiol,2014,67(7):760-768.
[29]
Bou Chebl R, Kiblawi S, El Khuri C, et al. Use of contrast-enhanced ultrasound for confirmation of central venous catheter placement: systematic review and meta-analysis[J].J Ultrasound Med,2017,36(12):2503-2510.
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