Peripheral Pulmonary Lesions in Confirmed Pulmonary Arterial Embolism: Follow‐up Study of B‐Mode Ultrasound and of Perfusion Patterns Using Contrast‐Enhanced Ultrasound (CEUS). (25th October 2021)

• Record Type: Journal Article
• Authors: Safai Zadeh, Ehsan; Dietrich, Christoph Frank; Kmoth, Laila; Trenker, Corinna; Alhyari, Amjad; Ludwig, Michael; Görg, Christian
• Is Part Of: Journal of ultrasound in medicine. Volume 41:Number 7(2022)
• Page Start: 1713
• Page End: 1721
• Publication Date: 2021-10-25
• Subjects: CEUS -- follow‐up -- pulmonary embolism -- pulmonary infarction -- ultrasound; Ultrasonics in medicine -- Periodicals; Ultrasonics; Ultrasonography; Ultrasonics in medicine; Electronic journals; Periodicals; Periodicals; 616.07543
• DOI: 10.1002/jum.15852
• Languages: English
• ISSNs: 0278-4297

Abstract

Abstract : Purpose: This retrospective study aimed to describe the B‐mode lung ultrasound (B‐LUS) and contrast‐enhanced ultrasound (CEUS) follow‐up patterns of peripheral pulmonary lesions (PPLs) in patients with confirmed pulmonary embolism (PE). Patients and Methods: Data from 27 patients with a confirmed diagnosis of PE and PPLs over 5 mm from October 2009 to November 2018 were included retrospectively in the study. The inclusion criteria were performance of a baseline CEUS examination, a short‐term B‐LUS and CEUS follow‐up, and a long‐term B‐LUS follow‐up of PPLs. The homogeneity of enhancement of PPLs (homogeneous/inhomogeneous/absent) on CEUS and the presence and size of PPLs on B‐LUS were evaluated. Results: A total of n = 25/27 (92.6%) lesions showed absent or inhomogeneous enhancement during baseline examination or short‐term follow‐up, indicating impaired perfusion. On short‐term CEUS follow‐up, 9/27 cases (33.3%) showed a pattern shift. On B‐LUS long‐term follow‐up, 26/27 lesions (96.3%) were detectable for an average of 10 weeks (range 3–32 weeks). The size of reference lesions was significantly reduced at the time of the final follow‐up examination ( P < .05). Conclusion: B‐LUS follow‐up showed that, in patients with confirmed PE, PPLs had a delayed regression. On CEUS follow‐up examination, various perfusion patterns of PPLs were observed, indicating the different ages and the variable reparative processes of pulmonary infarction. In PPLs independent of the underlying signs and symptoms, follow‐up B‐LUS and CEUS examinations may be helpful for a possible retrospective diagnosis of peripheral pulmonary infarction suggestive of PE.