Tews, Hauke Christian and Kandulski, A. and Schmid, S. and Schlosser, S. and Schirner, S. and Putz, F. J. and Cosma, L. and Guelow, K. and Mueller, M. and Jung, E. M. (2022) Multimodal ultrasound imaging with conventional B-mode, elastography, and parametric analysis of contrast-enhanced ultrasound (CEUS): A novel approach to assess small bowel manifestation in severe COVID-19 disease. CLINICAL HEMORHEOLOGY AND MICROCIRCULATION, 82 (4). pp. 341-360. ISSN 1386-0291, 1875-8622
Full text not available from this repository. (Request a copy)Abstract
The aim was to describe the small bowel morphology with conventional B-mode and elastography and additionally to evaluate dynamic effects ofCOVID-19 associated small bowel microvascularization usingCEUSwith color coded perfusion parameters. Thirteen patients with severe COVID-19 acute respiratory distress syndrome (ARDS) were investigated. 13 patients required intensive care treatment with mechanical ventilation. Five patients required extracorporeal membrane oxygenation (ECMO). Contrast-enhanced ultrasound (CEUS) was performed by an experienced investigator as a bolus injection of up to 2.4 ml sulfur hexafluoride microbubbles via a central venous catheter. In the parametric analysis of CEUS, the flare of microbubbles over time is visualized with colors. This is the first work using parametric analysis of CEUS to detect perfusion differences in the small bowel. Parametric analysis of CEUS in the intestinal phase was carried out, using DICOM loops for 20 seconds. In 5 patients, parametric analysis revealed intraindividual differences in contrast agent behavior in the small bowel region. Analogous to the computed tomography (CT) images parametric analysis showed regions of simultaneous hyper- and hypoperfusion of the small intestine in a subgroup of patients. In 5 patients, the parametric image of transmural global contrast enhancement was visualized. Our results using CEUS to investigate small bowel affection inCOVID-19 suggest that in severeCOVID-19ARDSsystemic inflammation and concomitant micro embolisms may lead to disruption of the epithelial barrier of the small intestine. This is the first study using parametric analysis of CEUS to evaluate the extent of small bowel involvement in severe COVID-19 disease and to detect microemboli. In summary, we show that in COVID-19 the small bowel may also be an important interaction site. This is in line with the fact that enterocytes have been shown to a plenitude of angiotensin converting enzyme (ACE)-2 receptors as entry sites of the virus.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | EFSUMB GUIDELINES; SARS CORONAVIRUS; INFECTION; ACE2; RECOMMENDATIONS; MECHANISMS; THROMBOSIS; PROGNOSIS; INJURY; Contrast enhanced ultrasound (CEUS); parametric imaging; COVID-19; small bowel |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin I Medicine > Abteilung für Nephrologie Medicine > Lehrstuhl für Röntgendiagnostik |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 09 Jan 2024 10:54 |
| Last Modified: | 29 Jan 2024 13:41 |
| URI: | https://pred.uni-regensburg.de/id/eprint/57129 |
Actions (login required)
 |
View Item |
