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Use of second generation contrast-enhanced ultrasound in the assessment of focal liver lesions

World Journal of Gastroenterology 2007年第45期13卷 5963-5970页

作者： Stanislas HX Morin Adrian KP Lim eremy fl cobbold Simon D Taylor-Robinson Sciences Hammersmith Hospital Campus Faculty of Medicine Imperial College London London United Kingdom Liver Unit St Mary's Hospital Campus Faculty of Medicine Imperial College London London United Kingdom Liver Unit St Mary’s Hospital Campus Faculty of Medicine Imperial College London London United Kingdom

Ultrasound (US) is often the first imaging modality employed in patients with suspected focal liver lesions. The role of US in the characterisation of focal liver lesions has been transformed with the introduction of specific contrast media and the development of specialized imaging techniques. Ultrasound now can fully characterise the enhancement pattern of hepatic lesions, similar to that achieved with contrast enhanced multiphasic computed tomography (CT) and magnetic resonance imaging (MRI). US contrast agents are safe, well-tolerated and have very few contraindications. Furthermore, real-time evaluation of the vascularity of focal liver lesions has become possible with the use of the newer microbubble contrast agents. This article reviews the enhancement pattern of the most frequent liver lesions seen, using the second generation US contrast media. The common pitfalls for each type of lesion are discussed. The recent developments in US contrast media and specific imaging techniques have been a major advance and this technique, in view of the intrinsic advantages of US, will undoubtedly gain popularity in the years to come.

关键词： Microbubble contrast agents Ultrasound Focal liver lesions

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Current and future applications of in vitro magnetic resonance spectroscopy in hepatobiliary disease

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World Journal of Gastroenterology 2006年第30期12卷 4773-4783页

作者： I Jane Cox Amar Sharif Jeremy fl cobbold Howard C Thomas Simon D Taylor-Robinson Imaging Sciences Department Division of Clinical Sciences Imperial College London Hammersmith Hospital Campus Du Cane Road London W12 OHS United Kingdom Department of Medicine Division of Medi-cine Imperial College London St Mary's Campus London W2 United Kingdom

Nuclear magnetic resonance spectroscopy allows the study of cellular biochemistry and metabolism, both in the whole body in vivo and at higher magnetic field strengths in vitro. Since the technique is non-invasive and non-selective, magnetic resonance spectroscopy methodologies have been widely applied in biochemistry and medicine. In vitro magnetic resonance spectroscopy studies of cells, body fluids and tissues have been used in medical biochemistry to investigate pathophysiologi- cal processes and more recently, the technique has been used by physicians to determine disease abnormalities in vivo. This highlighted topic illustrates the potential of in vitro magnetic resonance spectroscopy in studying the hepatobiliary system. The role of in vitro proton and phosphorus magnetic resonance spectroscopy in the study of malignant and non-malignant liver disease and bile composition studies are discussed, particularly with reference to correlative in vivo whole-body magnetic resonance spectroscopy applications. In summary, magnetic resonance spectroscopy techniques can provide non-invasive biochemical information on disease severity and pointers to underlying pathophysiological processes. Magnetic resonance spectroscopy holds potential promise as a screening tool for disease biomarkers, as well as assessing therapeutic response.

关键词： Magnetic resonance spectroscopy Liver Hepatobiliary disease Membrane metabolism

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Role of microbubble ultrasound contrast agents in the non-invasive assessment of chronic hepatitis C-related liver disease

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World Journal of Gastroenterology 2006年第22期12卷 3461-3465页

作者： Scott Grier Adrian KP Lim Nayna Patel Jeremy fl cobbold Howard C Thomas Isobel J Cox Simon D Taylor-Robinson Liver Unit St Mary's Hospital Campus Faculty of MedicineImperial College LondonLondonUnited Kingdom Department of Imaging Sciences Hammersmith Hospital Campus Faculty of MedicineImperial College LondonLondonUnited Kingdom

Patients who are chronically infected with the hepatitis C virus often develop chronic liver disease and assessment of the severity of liver injury is required prior to considering viral eradication therapy. This article examines the various assessment methods currently available from gold standard liver biopsy to serological markers and imaging. Ultrasound is one of the most widely used imaging modalities in clinical practice and is already a first-line diagnostic tool for liver disease. Microbubble ultrasound contrast agents allow higher resolution images to be obtained and functional assessments of microvascular change to be carried out. The role of these agents in quantifying the state of hepatic injury is discussed as a viable method of determining the stage and grade of liver disease in patients with hepatitis C. Although currently confined to specialist centres, the availability of microbubble contrast-enhanced ultrasound will inevitably increase in the clinical setting.

关键词： Hepatitis C Microbubble contrast agents Ultrasound

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