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Purpose: To investigate the extent to which indeterminate lesions of the breast can be differentiated in the early and late phase after bolus injection of the ultrasound contrast medium Optison®. Materials and methods: Fifty female patients (mean age: 49 years) with a altogether 53 preoperatively impalpable indeterminate breast tumors, 20 fibroadenomas and 33 carcinomas, were examined by B-mode imaging and contrast medium-enhanced ultrasound with power Doppler (three patients had multifocal carcinomas). The tumors had a diameter of 5–15 mm (mean diameter: 9 mm). Histological confirmation was performed in all lesions by vacuum biopsies and/or surgical preparation. All examinations were performed with a multifrequency linear array probe (5–10 MHz, Logiq9 and Logiq 7, GE). Power Doppler (PD) and B-mode imaging as well as tissue harmonic imaging (THI) were employed. A bolus of 0.5 ml Optison® was injected intravenously and spreading of the contrast enhancement and washout in the tumors were followed for at least 20 minutes. A low mechanical index was chosen to avoid early destruction of the microbubbles. Maximum tumor size was measured and tumors vessels were evaluated in digital cine ultrasound sequences. Results: Without CM administration, 14 of 19 tumor lesions smaller than 10 mm could be distinguished better from the surrounding tissue with THI compared to fundamental B-mode imaging. Both benign (17/20) and malignant (30/33) tumors exhibited increased tumor marginal vessels or intratumoral vessels in the early phase after CM injection. A diffuse contrast medium accumulation was observed in the late phase (8–18 min, mean: 12 min) in 30 of 33 malignant tumors, but in none of the benign tumors. The diagnostic confirmation for this late enhancement was there with 90% for the malignant tumors. Conclusion: After intravenous bolus administration of Optison®, breast carcinomas appear to have a prolonged diffuse enhancement of central tumor vasularity in the late phase compared to an earlier marginal vascularity of fibroadenomas. [ABSTRACT FROM AUTHOR]

Background: Sonography of the gastrointestinal (GI) tract is a practical, safe, inexpensive, and reproducible diagnostic tool for the evaluation, diagnosis, and follow-up of infectious bowel disease. The modality is rapidly gaining prominence among clinicians on a global scale. In the United States, however, ultrasound of the bowel remains underutilized primarily due to insufficient experience among radiologists and sonographers in performing sonographic bowel assessment. This lack of experience and knowledge results in misinterpretations, missed diagnoses, and underutilization of this modality in patients with acute abdomen, with the majority of GI pathology on sonography discovered incidentally. Objectives: This article aims to demonstrate the characteristic sonographic findings associated with GI infectious processes as well as provide dedicated ultrasound protocols for evaluation of the GI tract. Conclusion: This article serves a twofold purpose, raising awareness of the utility of this imaging modality within the radiology community and also providing practical teaching points for sonographic evaluation of infectious disorders of the GI tract. [ABSTRACT FROM AUTHOR]