Vincent Schwarze1, Matthias Frank Froelich2, Constantin Marschner3, Thomas Knösel4, Johannes Rübenthaler3, Dirk-André Clevert3. 1. Department of Radiology, University Hospital LMU, Ludwig-Maximilians-University Munich, Grosshadern Campus, Munich, Germany. vincentschwarze@gmx.de. 2. Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany. 3. Department of Radiology, University Hospital LMU, Ludwig-Maximilians-University Munich, Grosshadern Campus, Munich, Germany. 4. Institute of Pathology, University Hospital LMU, Ludwig-Maximilians-University Munich, Grosshadern Campus, Munich, Germany.
Abstract
PURPOSE: Conventional ultrasound is the main imaging modality in obstetrics for assessing the maternal and fetal status. Up to date, contrast-enhanced ultrasound (CEUS) has not found widespread use in gynecology and obstetrics, but recent studies demonstrate promising results. The aim of the present study is to assess safe and valuable application of CEUS during pregnancy to investigate non-obstetric conditions. METHODS: Five pregnant patients on whom CEUS was performed between 2019 and 2020 were included in this retrospective single-center study. A total of six CEUS examinations were performed including one CEUS-guided biopsy (mean age: 31 years, mean weeks of pregnancy: 18 weeks). CEUS examinations were performed by a consultant radiologist (EFSUMB level 3). RESULTS: All included pregnant women safely underwent CEUS. Neither maternal nor fetal adverse effects were detected. CEUS critically helped in the diagnostic workup of a desmoid tumor of the abdominal wall, hepatic hemangioma, amebic hepatic abscess, uncomplicated renal cyst and post-inflammatory alteration of the renal cortex and for excluding active abdominal bleeding. In addition, CEUS-guided biopsy was performed to prevent intratumoral hemorrhage. Findings from CEUS prompted immediate treatment in two women, whereas in three women regular obstetric monitoring of the women could be conducted. CONCLUSION: Our results demonstrate safe and crucial application of off-label CEUS in pregnant women to assess different non-obstetric conditions allowing to prevent additional ionizing CT or application of (gadolinium-based) contrast agent in MRI. Hence, CEUS might add pivotal value for evaluating obstetric and non-obstetric conditions and thereby directing clinical management of pregnant women in the future.
PURPOSE: Conventional ultrasound is the main imaging modality in obstetrics for assessing the maternal and fetal status. Up to date, contrast-enhanced ultrasound (CEUS) has not found widespread use in gynecology and obstetrics, but recent studies demonstrate promising results. The aim of the present study is to assess safe and valuable application of CEUS during pregnancy to investigate non-obstetric conditions. METHODS: Five pregnant patients on whom CEUS was performed between 2019 and 2020 were included in this retrospective single-center study. A total of six CEUS examinations were performed including one CEUS-guided biopsy (mean age: 31 years, mean weeks of pregnancy: 18 weeks). CEUS examinations were performed by a consultant radiologist (EFSUMB level 3). RESULTS: All included pregnant women safely underwent CEUS. Neither maternal nor fetal adverse effects were detected. CEUS critically helped in the diagnostic workup of a desmoid tumor of the abdominal wall, hepatic hemangioma, amebic hepatic abscess, uncomplicated renal cyst and post-inflammatory alteration of the renal cortex and for excluding active abdominal bleeding. In addition, CEUS-guided biopsy was performed to prevent intratumoral hemorrhage. Findings from CEUS prompted immediate treatment in two women, whereas in three women regular obstetric monitoring of the women could be conducted. CONCLUSION: Our results demonstrate safe and crucial application of off-label CEUS in pregnant women to assess different non-obstetric conditions allowing to prevent additional ionizing CT or application of (gadolinium-based) contrast agent in MRI. Hence, CEUS might add pivotal value for evaluating obstetric and non-obstetric conditions and thereby directing clinical management of pregnant women in the future.
Authors: Thomas Geyer; Vincent Schwarze; Constantin Marschner; Moritz L Schnitzer; Matthias F Froelich; Johannes Rübenthaler; Dirk-André Clevert Journal: Medicina (Kaunas) Date: 2020-11-19 Impact factor: 2.430
Authors: Thomas Geyer; Johannes Rübenthaler; Matthias F Froelich; Laura Sabel; Constantin Marschner; Vincent Schwarze; Dirk-André Clevert Journal: Medicina (Kaunas) Date: 2020-12-08 Impact factor: 2.430
Authors: Constantin Arndt Marschner; Johannes Rübenthaler; Matthias Frank Froelich; Vincent Schwarze; Dirk-André Clevert Journal: Ultrasonography Date: 2020-11-19