Contrast-enhanced ultrasound of embolic consolidations in patients with pulmonary embolism: A pilot study

To analyze and describe the contrast-enhanced ultrasound (CEUS) patterns of peripheral lung lesions in patients with pulmonary embolism (PE) confirmed on CT angiography or lung scintigraphy.

CEUS had been performed on 35 patients with peripheral lung lesions detected on gray-scale imaging and confirmed as PE. The following data were evaluated retrospectively: (1) accumulation of contrast medium (absent or present), (2) differentiation between pulmonary arterial (PA) and bronchial arterial blood supply, and (3) contrast-enhancement pattern (absent/nonhomogeneous or homogeneous). A CEUS pattern of absent or nonhomogeneous enhancement was suspicious (ie, typical) of embolic consolidations (EC), whereas a pattern of homogeneous PA enhancement was considered to be atypical of EC.

Peripheral lesions showed a CEUS pattern suspicious of EC in 80% of the patients, with no enhancement in 40% and nonhomogeneous enhancement in another 40%. A CEUS pattern of homogeneous PA enhancement, atypical of EC, was identified in the remaining 20% of the patients. Pulmonary lesions larger than 1 cm showed vascularization more often than smaller lesions did (p < 0.001).

Peripheral lung lesions in patients with confirmed PE show a CEUS pattern of absent or nonhomogeneous contrast enhancement for suspicious EC. Further prospective studies are required to verify the diagnostic accuracy of CEUS for EC.