Abdominal Radiology

, Volume 43, Issue 4, pp 977–997 | Cite as

Artifacts in contrast-enhanced ultrasound: a pictorial essay

  • David T. Fetzer
  • Vasileios Rafailidis
  • Cynthia Peterson
  • Edward G. Grant
  • Paul Sidhu
  • Richard G. Barr
Article
  • 171 Downloads

Abstract

Although contrast-enhanced ultrasound (CEUS) has become a widely utilized and accepted modality in much of the world, the associated contrast agents have only recently received approval in the United States. As with all radiological techniques, image artifacts are encountered in CEUS, some of which relate to commonly encountered ultrasound artifacts, while others are unique to this technique. Image artifacts must be recognized when performing and interpreting examinations to improve technique and diagnostic accuracy. In this article, we review artifacts that may be encountered in CEUS, and where possible discuss how to minimize them or mitigate their effect on image quality and interpretation.

Keywords

CEUS Ultrasound Contrast Artifacts 

Notes

Compliance with Ethical Standards

Disclosures

DTF has a research agreement with Philips Healthcare, and is on the speaker’s bureau for Philips Healthcare. VR has no disclosures. CLP is on the speaker’s bureau for Bracco Diagnostics. EGG has a research grant from GE. RFMPS has no disclosures. RGB has research grants from Siemen’s Ultrasound, Philips Ultrasound, B and K Ultrasound, GE Ultrasound, Bracco Diagnostics, and SuperSonic Imagine. He is on the speaker’s bureau for Philips Ultrasound, Lantheus Medical and Bracco Diagnostics. He is on the advisory of Bracco Diagnostics and Lantheus Medical. He also receives royalties from Thieme Publishers.

Funding

No funding was received for this work.

Ethical Approval

This article does not include data from human research subjects. Images were acquired from clinical patients for education purposes.

References

  1. 1.
    Dietrich CF, et al. (2014) Artifacts and pitfalls in contrast-enhanced ultrasound of the liver. Ultraschall Med 35(2):108–125; quiz 126–127.Google Scholar
  2. 2.
    Dietrich CF, et al. (2011) Pitfalls and artefacts using contrast enhanced ultrasound. Z Gastroenterol 49(3):350–356CrossRefPubMedGoogle Scholar
  3. 3.
    Forsberg F, et al. (1994) Artifacts in ultrasonic contrast agent studies. J Ultrasound Med 13(5):357–365CrossRefPubMedGoogle Scholar
  4. 4.
    Denham SL, Alexander LF, Robbin ML (2016) Contrast-enhanced ultrasound: practical review for the assessment of hepatic and renal lesions. Ultrasound Q 32(2):116–125CrossRefPubMedGoogle Scholar
  5. 5.
    Girard MS, et al. (1999) Assessment of liver and kidney enhancement with a perfluorocarbon vapor-stabilized US contrast agent. Acad Radiol 6(5):273–281CrossRefPubMedGoogle Scholar
  6. 6.
    Sirlin CB, et al. (1999) Effect of acquisition rate on liver and portal vein enhancement with microbubble contrast. Ultrasound Med Biol 25(3):331–338CrossRefPubMedGoogle Scholar
  7. 7.
    Cui W, et al. (2013) Neural progenitor cells labeling with microbubble contrast agent for ultrasound imaging in vivo. Biomaterials 34(21):4926–4935CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Klibanov AL, et al. (2004) Detection of individual microbubbles of ultrasound contrast agents: imaging of free-floating and targeted bubbles. Invest Radiol 39(3):187–195CrossRefPubMedGoogle Scholar
  9. 9.
    ten Kate GL, et al. (2012) Far-wall pseudoenhancement during contrast-enhanced ultrasound of the carotid arteries: clinical description and in vitro reproduction. Ultrasound Med Biol 38(4):593–600CrossRefPubMedGoogle Scholar
  10. 10.
    Ten Kate GL, et al. (2013) Current status and future developments of contrast-enhanced ultrasound of carotid atherosclerosis. J Vasc Surg 57(2):539–546CrossRefPubMedGoogle Scholar
  11. 11.
    Jo PC, et al. (2017) Integration of contrast-enhanced US into a multimodality approach to imaging of nodules in a cirrhotic liver: how i do it. Radiology 282(2):317–331CrossRefPubMedGoogle Scholar
  12. 12.
    Harvey CJ, et al. (2000) Hepatic malignancies: improved detection with pulse-inversion US in late phase of enhancement with SH U 508A-early experience. Radiology 216(3):903–908CrossRefPubMedGoogle Scholar
  13. 13.
    Quaia E (2005) In: Quaia E, (ed) Artefacts from microbubble-based agents, in contrast media in ultrasonography basic principles and clinical applications. New York: Springer, pp. 25–29Google Scholar
  14. 14.
    Dietrich CF, et al. (2007) Contrast-enhanced ultrasound of histologically proven liver hemangiomas. Hepatology 45(5):1139–1145CrossRefPubMedGoogle Scholar
  15. 15.
    Dietrich CF, et al. (2012) Liver tumor characterization–review of the literature. Ultraschall Med 33(Suppl 1):S3–S10PubMedGoogle Scholar
  16. 16.
    Malhi H, Grant EG, Duddalwar V (2014) Contrast-enhanced ultrasound of the liver and kidney. Radiol Clin North Am 52(6):1177–1190CrossRefPubMedGoogle Scholar
  17. 17.
    Gutberlet M, et al. (1997) Contrast agent enhanced duplex ultrasonography: visualization of the hepatic artery after orthotopic liver transplantation. Rofo 166(5):411–416CrossRefPubMedGoogle Scholar
  18. 18.
    Gutberlet M, et al. (1998) Do ultrasonic contrast agents artificially increase maximum Doppler shift? In vivo study of human common carotid arteries. J Ultrasound Med 17(2):97–102CrossRefPubMedGoogle Scholar
  19. 19.
    Terslev L, et al. (2005) Doppler ultrasound findings in healthy wrists and finger joints before and after use of two different contrast agents. Ann Rheum Dis 64(6):824–827CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Kono Y, et al. (2004) Carotid arteries: contrast-enhanced US angiography–preliminary clinical experience. Radiology 230(2):561–568CrossRefPubMedGoogle Scholar
  21. 21.
    Hindi APC, Barr RG (2013) Artifacts in diagnostic ultrasound. Reports in Medical. Imaging 6:29–48Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  • David T. Fetzer
    • 1
  • Vasileios Rafailidis
    • 2
  • Cynthia Peterson
    • 3
  • Edward G. Grant
    • 4
  • Paul Sidhu
    • 2
  • Richard G. Barr
    • 5
    • 6
  1. 1.University of Texas Southwestern Medical CenterDallasUSA
  2. 2.King’s College HospitalLondonUK
  3. 3.Kent State UniversitySalemUSA
  4. 4.University of Southern CaliforniaLos AngelesUSA
  5. 5.Department of RadiologyNortheastern Ohio Medical UniversityRootstownUSA
  6. 6.Southwoods ImagingNortheastern Ohio Medical UniversityYoungstownUSA

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