Stellenwert der kontrastmittelunterstützten Sonographie (CEUS) im Vergleich zur konventionellen B-Bild Sonographie und der Referenzprozedur (KM-CT) in der Abgrenzung eines zentralen Lungentumors von einer nachgeschalteten Atelektase: eine retrospektive Studie

Purpose: Transthoracic contrast enhanced ultrasound (CEUS) is the first line imaging method for the evaluation of thoracic lesions. We performed a retrospective study on patients with the aim to evaluate the performance of CEUS for the differentiation of central bronchial tumor formations (CTF) and focal lesions (FL) from tumor associated atelectasis (AT) in comparison to B-mode-sonography (US) and computed tomography (CT) as reference method. Material and Methods: N=47 patients with CTF and AT have been investigated via US and CEUS (Sonovue, Bracco) from May 2004 till December 2009. We evaluated if CTF and FL could be distinguished against the AT. Ultrasound evaluations were performed by 2 physicians, who were blinded for each other; discordant result were evaluated by a third physician. CT-pictures were evaluated blinded against sonographic results by a radiologist. Results: We could see significant difference favouring CEUS and CT against US for CTF differentiation, but no significant difference between CEUS and CT. CTF could be differentiated in 24/47 cases with US; in 38/47 cases with CEUS and in 34/47 cases in CT (US vs CEUS p=<0,05, US vs CT p=<0,05, CEUS vs CT p=0,38). FL could be seen with US in 6/47 cases, with CEUS in 15/47 cases and with CT in 8/47 cases (US vs CEUS p=<0,05, US vs CT p=0,69, CEUS vs CT p=0,09), showing a significant difference only for CEUS against US. Conclusion: CEUS is aquivalent to CT for the differentiation of an obstructive AT from CTF and more qualified than conventional US. We can even see a slight favoring of CEUS against CT.