E-ISSN 1305-3612
Abdominal Imaging - Original Article
The potential role of modern US in the follow-up of patients with retroperitoneal fibrosis
1 Departments of Diagnostic and Interventional Radiology nd Urology (A.S.B., S.R.), HELIOS Medical Center Wuppertal, University Hospital Witten/Herdecke, Wuppertal, Germany;  
2 Departments of Diagnostic and Interventional Radiology nd Urology HELIOS Medical Center Wuppertal, University Hospital Witten/Herdecke, Wuppertal, Germany;  
3 Department of Radiology, Charité University Medicine, Berlin, Germany  
4 Departments of Diagnostic and Interventional Radiology and Urology , HELIOS Medical Center Wuppertal, University Hospital Witten/Herdecke, Wuppertal, Germany  
Diagn Interv Radiol 2014; 20: 3-8
DOI: 10.5152/dir.2013.13132
Abstract

PURPOSE: 
We aimed to evaluate a standardized ultrasonography (US) algorithm for the visualization of pathologic para-aortic tissue in retroperitoneal fibrosis (RPF). 

 

MATERIALS AND METHODS: 
Thirty-five patients with lumbar RPF of typical extent, as determined by abdominal magnetic resonance imaging, were included. Examinations were conducted using standardized abdominal US with axial sections obtained at the levels of the renal arteries, aortic bifurcation, and both common iliac arteries. Imaging of each section was acquired with fundamental B-mode (US) and tissue harmonic imaging, respectively. In addition, we examined RPF visualized using extended field-of-view US. 

 

RESULTS: 
Tissue harmonic imaging adequately visualized RPF of typical extent in 33 patients (94.2%). Excellent and good visualization with mild artifacts were achieved in 25 (71.4%) and six (17.1%) patients, respectively. When RPF spread along the iliac arteries, excellent visualization was achieved in 38.7% for the left side and 34.5% for the right side. There were significantly fewer diagnostic examinations for the right iliac (27.6%) than for the left one (9.7%) (P = 0.016). Overall, harmonic imaging achieved significantly better visualization than fundamental B-Mode (P < 0.001). 

 

CONCLUSION: 
We described the first systematic evaluation of RPF visualization by modern US techniques. The best imaging quality was found in the typical RPF location, at the level of the aortic bifurcation. These results advocate for the presented US algorithm as an efficient follow-up alternative to cross-sectional imaging in RPF patients.

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