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World Journal of Gastroenterology 2014年第43期20卷 16191-16196页

作者： Barbara Braden christoph f dietrich Translational Gastroenterology Unit Oxford University Hospitals NHS TrustOxford OX3 9DUUnited Kingdom Med.Klinik 2 Caritas HospitalUhlandstr.797980 Bad MergentheimGermany

In the last decades,the treatment of pancreatic pseudocysts and necrosis occurring in the clinical context of acute and chronic pancreatitis has shifted towards minimally invasive endoscopic *** procedures can be avoided in many cases by using endoscopically placed,Endoscopic ultrasonography-guided techniques and *** ultrasound enables the placement of transmural plastic and metal stents or nasocystic tubes for the drainage of peripancreatic fluid *** development of selfexpanding metal stents and exchange free delivering systems have simplified the drainage of pancreatic fluid *** review will discuss available therapeutic techniques and new developments.

关键词： Pancreatic pseudocyst Walled-off necrosis Endoscopic ultrasonography-guided drainage Self-expanding metal stent Acute pancreatitis

Sonographic signs of neutropenic enterocolitis

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World Journal of Gastroenterology 2006年第9期12卷 1397-1402页

作者： christoph f dietrich Stella Hermann Stefan Klein Barbara Braden Department of Internal Medicine Cari-tas Hospital Bad Mergentheim Bad MergentheimGermany Medical Department University Hospital Frankfurt/MainGermany

AIM： To investigate the sonographic features at time of diagnosis and follow-up in patients with neutropenic enterocolitis. METHODS： The sonographic findings in 14 patients with neutropenic enterocolitis were described and evaluated regarding symptoms and clinical outcome. RESULTS： In all patients with neutropenic enterocolitis, the ileocoecal region was involved with wall thickening 〉10 mm. A transmural inflammatory pattern, hypervascularity of the thickened bowel wall and free abdominal fluid were the common findings. The sonographically revealed thickness of the bowel wall was associated with lethal outcome （P〈0.03）. In the 11 surviving patients, the improvement of clinical symptoms was accompanied by progressive reduction of intestinal wall thickness. CONCLUSION： High-end sonography of the bowel is a helpful tool for diagnosis, assessment of prognosis and follow-up of patients with neutropenic enterocolitis. The ultrasonographically revealed bowel thickness reflects the severity and the course of the disease, and seems to be predictive for the clinical outcome.

关键词： Neutropenia Bowel wall thickness Ultrasonography

Contrast-enhanced endoscopic ultrasound in discrimination between focal pancreatitis and pancreatic cancer

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World Journal of Gastroenterology 2006年第2期12卷 246-250页

作者： Michael Hocke Ewald Schulze Peter Gottschalk Theodor Topalidis christoph f dietrich Department of Internal Medicine Ⅱ Friedrich Schiller University JenaErlanger Allee 10107740 JenaGermany Department of Pathology Friedrich Schiller University JenaErlanger Allee 10107740 JenaGermany Cytologic Institute Doehrbruch 6230559 HannoverGermany Caritas Hospital Department of Internal Medicine ⅡUhlandstraBe 797980 Bad MergentheimGermany

AIM： To evaluate the contrast-enhanced endosonography as a method of differentiating inflammation from pancreatic carcinoma based on perfusion characteristics of microvessels. METHODS： In 86 patients with suspected chronic pancreatitis （age： 62± 12 years; sex： f/m 38/48）, pancreatic lesions were examined by conventional endo- scopic B-mode, power Doppler ultrasound and contrastenhanced power mode （Hitachi EUB 525, SonoVue, 2.4 mL, Bracco） using the following criteria for malignant lesions： no detectable vascularisation using conventional power Doppler scanning, irregular appearance of arterial vessels over a short distance using SonoVue contrastenhanced technique and no detectable venous vessels inside the lesion. A malignant lesion was assumed if all criteria were detectable [gold standard endoscopic ultrasound （EUS）-guided fine needle aspiration cytology, operation]. The criteria of chronic pancreatitis without neoplasia were defined as no detectable vascularisation before injection of SonoVue, regular appearance of vessels over a distance of at least 20 mm after injection of SonoVue and detection of arterial and venous vessels. RESULTS： The sensitivity and specifidty of conventional EUS were 73.2% and 83.3% respectively for pancreatic cancer. The sensitivity of contrast-enhanced EUS increased to 91.1% in 51 of 56 patients with malignant pancreatic lesion and the specificity increased to 93.3% in 28 of 30 patients with chronic inflammatory pancreatic ***： Contrast-enhanced endoscopic ultrasound improves the differentiation between chronic pancreatitis and pancreatic carcinoma.

关键词： Endoscopic ultrasound Contrast enhancer Chronic pancreatitis Pancreatic cancer

Ultrasound findings in autoimmune hepatitis

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World Journal of Gastroenterology 2018年第15期24卷 1583-1590页

作者： Yi Dong Andrej Potthoff christoph Klinger Ana Paula Barreiros Dariusz Pietrawski christoph f dietrich Department of Ultrasound Zhongshan Hospital Fudan University Department of Gastroenterology Hepatology and Endocrinology Medizinische Hochschule Hannover Department of Internal Medicine 1 Klinikum Ludwigsburg German Organ Transplantation foundation Region Mitte Department of Internal Medicine 2 Caritas-Krankenhaus Bad Mergentheim

Ultrasound findings in autoimmune hepatitis(AIH) have not been reported systematically so far. The use of reliable and accurate noninvasive methods for determining fibrosis stage is important in evaluation of treatment efficacy and fibrosis regression in AIH. Imaging plays an important role in detection of complications and ruling out other possible causes of chronic liver diseases. Ultrasound elastography cutoff values in AIH patients are not the same as those in patients with chronic viral hepatitis or non-alcoholic fatty liver disease. AIH is characterized by wide fluctuations in inflammatory activity. Here we report on current knowledge of ultrasound findings in AIH.

关键词： Autoimmune hepatitis fibrosis stage Ultrasound Elastography Chronic liver diseases

fortuitously discovered liver lesions

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World Journal of Gastroenterology 2013年第21期19卷 3173-3188页

作者： christoph f dietrich Malay Sharma Robert N Gibson Schreiber-dietrich Christian Jenssen Department of Internal Medicine Caritas-Krankenhaus Bad Mergentheim97980 Bad MergentheimGermany Department of Gastroenterology Jaswantrai Speciality HospitalOpposite Sports StadiumMeerut UP 250001India Department of Radiology University of MelbourneRoyal Melbourne HospitalVictoria 3050Australia Dagmar Department of Pediatrics Asklepiosklinik St. AugustinAbt. Neonatologie und P diatrische Intensivmedizin52757 AugustinGermany Klinik für Innere Medizin Krankenhaus Mrkisch Oderland15334 StrausbergGermany

The fortuitously discovered liver lesion is a common problem. Consensus might be expected in terms of its work-up, and yet there is none. This stems in part from the fact that there is no preventive campaign involving the early detection of liver tumors other than for patients with known liver cirrhosis and oncological patients. The work-up (detection and differential diagnosis) of liver tumors comprises theoretical considerations, history, physical examination, laboratory tests, standard ultrasound, Doppler ultrasound techniques, contrastenhanced ultrasound (CEUS), computed tomography and magnetic resonance imaging, as well as imageguided biopsy. CEUS techniques have proved to be the most pertinent method; these techniques became part of the clinical routine about 10 years ago in Europe and Asia and are used for a variety of indications in daily clinical practice. CEUS is in many cases the first and also decisive technical intervention for detecting and characterizing liver tumors. This development is reflected in many CEUS guidelines, e.g. , in the European federation of Societies for Ultrasound in Medicine and Biology (EfSUMB) guidelines 2004, 2008 and 2012 as well as the recently published World federation for Ultrasound in Medicine and Biology-EfSUMB guidelines 2012. This article sets out considerations for making a structured work-up of incidental liver tumors feasible.

关键词： Contrast-enhanced ultrasound Hepatocellular carcinoma Hemangioma focal nodular hyperplasia Metastasis Ultrasonography Recommendations Guidelines

New ultrasound techniques for lymph node evaluation

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World Journal of Gastroenterology 2013年第30期19卷 4850-4860页

作者： Xin-Wu Cui Christian Jenssen Adrian Saftoiu Andre Ignee christoph f dietrich Med.Klinik 2 Caritas-Krankenhaus97980 Bad MergentheimGermany Klinik für Innere Medizin Krankenhaus M rkisch Oderland15334 StrausbergGermany Department of Gastroenterology Research Center of Gastroenterology and HepatologyUniversity of Medicine and Pharmacy Craiova200349 CraiovaRomania

Conventional ultrasound(US)is the recommended imaging method for lymph node(LN)diseases with the advantages of high resolution,real time evaluation and relative low *** indications of transcutaneous ultrasound and endoscopic ultrasound include the detection and characterization of lymph nodes and the guidance for LN *** advances in US technology,such as contrast enhanced ultrasound(CEUS),contrast enhanced endoscopic ultrasound(CE-EUS),and real time elastography show potential to improve the accuracy of US for the differential diagnosis of benign and malignant lymph *** addition,CEUS and CE-EUS have been also used for the guidance of fine needle aspiration and assessment of treatment *** to size criteria,CEUS could also be used to evaluate response of tumor angiogenesis to anti-angiogenic *** this paper we review current literature regarding evaluation of lymphadenopathy by new and innovative US techniques.

关键词： Lymph nodes Ultrasound Endoscopic ultrasound Lymph node metastasis Lymphoma

Liver elastography, comments on EfSUMB elastography guidelines 2013

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World Journal of Gastroenterology 2013年第38期19卷 6329-6347页

作者： Xin-Wu Cui Mireen friedrich-Rust Chiara De Molo Andre Ignee Dagmar Schreiber-dietrich christoph f dietrich Department of Internal Medicine Caritas-Krankenhaus Bad Mergentheim97980 Bad MergentheimGermany Department of Internal Medicine 1 J.W.Goethe University Hospital60590 FrankfurtGermany Department of Pediatrics Asklepiosklinik St. AugustinAbt. Neonatologie und P diatrische Intensivmedizin52757 St. AugustinGermany

Recently the European federation of Societies for Ultrasound in Medicine and Biology Guidelines and Recommendations have been published assessing the clinical use of ultrasound *** document is intended to form a reference and to guide clinical users in a practical *** give practical advice for the use and *** disease forms the largest section,reflecting published experience to date including evidence from meta-analyses with shear wave and strain *** this review comments and illustrations on the guidelines are given.

关键词： Liver Ultrasound Elastography Guidelines fibrosis

Ultrasonographic imaging of inflammatory bowel disease in pediatric patients

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World Journal of Gastroenterology 2015年第17期21卷 5231-5241页

作者： Liliana Chiorean Dagmar Schreiber-dietrich Barbara Braden Xin-Wu Cui Reiner Buchhorn Jian-Min Chang christoph f dietrich Sino-German Research Center of Ultrasound in Medicine the First Affiliated Hospital of Zhengzhou University Department of Ultrasonography "Octavian Fodor" Institute of Gastroenterology and Hepatology400162 Cluj-NapocaRomania Medical Department 2 Caritas-KrankenhausD-97980 Bad MergentheimGermany Translational Gastroenterology Unit Oxford University HospitalsOX3 9DU OxfordUnited Kingdom Department of Pediatrics Caritas-KrankenhausD-97980 Bad MergentheimGermany

Inflammatory bowel disease(IBD) is one of the most common chronic gastrointestinal diseases in pediatric *** the optimal imaging modality for the assessment of gastrointestinal disease in pediatric patients can be *** invasiveness and patient acceptance,the radiation exposure and the quality performance of the diagnostic test need to be *** reviewing the literature regarding imaging in inflammatory bowel disease the value of ultrasound in the clinical management of pediatric patients is *** ultrasound is a useful,noninvasive method for the initial diagnosis of IBD in children;it also provides guidance for therapeutic decisions and helps to characterize and predict the course of the disease in individual *** techniques including color Doppler imaging and contrast-enhanced ultrasound are promising imaging tools to determine disease activity and *** studies between different imaging methods are needed.

关键词： Ultrasonography Guidelines Complication Intestine Pediatrics

Contrast-enhanced ultrasound in portal venous system aneurysms: A multi-center study

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World Journal of Gastroenterology 2014年第48期20卷 18375-18383页

作者： Claudio Tana christoph f dietrich Radu Badea Liliana Chiorean Vincenzo Carrieri Cosima Schiavone Unit of Internistic Ultrasound Department of Medicine and Science of Aging "G. d’Annunzio" University 66100 Chieti Italy Internal Medicine Unit Guastalla Hospital 42122 AUSL Reggio Emilia Italy Med Klinik 2 Caritas-Krankenhaus D-97980 Bad Mergentheim Germany Department of Ultrasonography "Octavian Fodor" Institute of Gastroenterology and Hepatology "Iuliu Hatieganu" University of Medicine and Pharmacy 400162 Cluj-Napoca Romania Department of Radiology and Computed Tomography "Octavian Fodor" Institute of Gastroenterology and Hepatology 400162 Cluj-Napoca Romania

AIM: To investigate contrast-enhanced ultrasound (CEUS) findings in portal venous system aneurysms (PVSAs).

关键词： Venous system Portal vein Aneurysm Contrast-enhanced ultrasound Computed tomography Magnetic resonance imaging

Endoscopic ultrasound elastography: current status and future perspectives

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World Journal of Gastroenterology 2015年第47期21卷 13212-13224页

作者： Xin-Wu Cui Jian-Min Chang Quan-Cheng Kan Liliana Chiorean Andre Ignee christoph f dietrich Sino-German Research Center of Ultrasound in Medicine The First Affiliated Hospital of Zhengzhou University Medical Department 2 Caritas-Krankenhaus Bad Mergentheim Academic Teaching Hospital of the University of Würzburg Institute of Clinical Medicine The First Affiliated Hospital of Zhengzhou University Département d’imagerie médicale Clinique des Cévennes

Elastography is a new ultrasound modality that provides images and measurements related to tissue stiffness. Endoscopic ultrasound(EUS) has played an important role in the diagnosis and management of numerous abdominal and mediastinal diseases. Elastography by means of EUS examination can assess the elasticity of tumors in the proximity of the digestive tract that are hard to reach with conventional transcutaneous ultrasound probes, such as pancreatic masses and mediastinal or abdominal lymph nodes, thus improving the diagnostic yield of the procedure. Results from previous studies have promised benefits for EUS elastography in the differential diagnosis of lymph nodes, as well as for assessing masses with pancreatic or gastrointestinal(GI) tract locations. It is important to mention that EUS elastography is not considered a modality that can replace biopsy. However, it may be a useful adjunct, improving the accuracy of EUSfine needle aspiration biopsy(EUS-fNAB) by selecting the most suspicious area to be targeted. Even more, it may be useful for guiding further clinical management when EUS-fNAB is negative or inconclusive. In the present paper we will discuss the current knowledge of EUS elastography, including the technical aspects, along with its applications in the differential diagnosis between benign and malignant solid pancreatic masses and lymph nodes, as well as its aid in the differentiation between normal pancreatic tissues and chronic pancreatitis. Moreover, the emergent indication and future perspectives are summarized, such as the benefit of EUS elastography in EUS-guided fine needle aspiration biopsy, and its uses for characterization of lesions in liver, biliary tract, adrenal glands and GI tract.

关键词： Elastography Endoscopic ultrasound Characterization Pancreas Lymph nodes