Publications by authors named "Zoltan Harkanyi"

Article Synopsis
  • Gray-scale and color/power Doppler ultrasound are primary imaging tools for assessing the spleen, gallbladder, and pancreas in children, while contrast-enhanced ultrasound (CEUS) is emerging as a safe and reliable method for evaluating liver lesions.
  • The manuscript discusses the potential of CEUS for studying normal variations and diseases of the spleen, gallbladder, and pancreas in children, showcasing various case examples.
  • It further examines specific examination techniques, key imaging findings in different lesions, and the limitations of CEUS in these pediatric organs.
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Contrast-enhanced ultrasound (CEUS) is increasingly being used in children. One of the most common referrals for CEUS performance is characterization of indeterminate focal liver lesions and follow-up of known liver lesions. In this setting, CEUS is performed with intravenous administration of ultrasound contrast agents (UCAs).

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Pediatric applications of contrast-enhanced ultrasound (CEUS) are growing. Evaluation of the kidneys and adrenal glands in children using intravenous administration of US contrast agents, however, is still an off-label indication. Pediatric CEUS applications for kidneys are similar to those in adults, including ischemic disorders, pseudo- versus real tumors, indeterminate lesions, complex cystic lesions, complicated pyelonephritis, and abscesses.

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Trauma is the leading cause of morbidity and mortality in children, and rapid identification of organ injury is essential for successful treatment. Contrast-enhanced ultrasound (CEUS) is an appealing alternative to contrast-enhanced CT in the evaluation of children with blunt abdominal trauma, mainly with respect to the potential reduction of population-level exposure to ionizing radiation. This is particularly important in children, who are more vulnerable to the hazards of ionizing radiation than adults.

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The European Federation of Ultrasound in Medicine and Biology (EFSUMB) created the "EFSUMB Pediatric Registry" (EFSUMB EPR) with the purpose of collecting data regarding the intravenous application of pediatric contrast-enhanced ultrasound (CEUS). The primary aim was to document the current clinical practice and usefulness of the technique and secondarily to assess CEUS safety in children. We issue the preliminary results of this database and examine the overall practice of CEUS in children in Europe.

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Aim: A case of heterogeneous late-phase hepatic enhancement (HLHE) using contrast-enhanced ultrasound (CEUS) with SonoVue is presented, where HLHE lasted after 50 min of injection.

Methods: This study aims to review prior literature on this topic, to characterize the features of HLHE in the liver, and to find possible and reliable explanations for this phenomenon.

Results: From literature, thus far five publications discuss this phenomenon with a total of 21 patients.

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The use of contrast-enhanced ultrasound (CEUS) in adults is well established in many different areas, with a number of current applications deemed "off-label", but the use supported by clinical experience and evidence. Paediatric CEUS is also an "off-label" application until recently with approval specifically for assessment of focal liver lesions. Nevertheless there is mounting evidence of the usefulness of CEUS in children in many areas, primarily as an imaging technique that reduces exposure to radiation, iodinated contrast medium and the "patient-friendly" circumstances of ultrasonography.

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Purpose: To examine retrospectively the diagnostic and differential diagnostic value of color Doppler imaging (CDI) in cases of suspected intraocular and orbital tumors.

Patients And Methods: Color Doppler examination (using Acuson 128, Philips-ATL UM-9, HDI 3000, 5000, Siemens Elegra, GE Logiq9) was performed in a total of 194 patients (177 intraocular, 17 orbital tumors). The results were compared to the clinical findings (routine examination, conventional ultrasound examination) and the results of angiography (FLAG, ICG).

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The basic imaging method worldwide for the evaluation of the liver tumors before surgery and interventional treatments is spiral CT. CT is rapid, sensitive and accurate modality compared to US and it has become available in the past years in Hungary. Multislice CT represents further technical development which significantly shortened the examination time and CT-angiography can be performed at the same time with the evaluation of the liver parenchyma.

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Modern ultrasound contrast media are gas-containing stabilized microbubbles that remain intact in the circulating blood for several minutes after intravenous injection and increase the intensity of the backscattered ultrasound. When the microbubbles disappear from the blood, they can be detected in the parenchyma of the liver and the spleen for about 30 more minutes (late liver- and spleen-specific phase). The insonated microbubbles produce second harmonic ultrasound frequencies, whose detection requires nonconventional ultrasound modalities such as pulsed inversion imaging.

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Article Synopsis
  • The study aimed to explore how short dynamic exercise affects heart rate, blood pressure, intraocular pressure, and blood flow velocities in the eyes, focusing on the ophthalmic artery and central retinal artery.
  • Twelve healthy young adults participated in two separate studies to measure blood flow velocities using color Doppler imaging before and after exercise.
  • Findings showed that while the central retinal artery maintained stable blood flow parameters after exercise, the ophthalmic artery experienced a decrease in blood flow velocities, indicating a compensatory autoregulation mechanism in the retinal circulation that might overreact in certain conditions.
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Purpose: The study investigated the reproducibility of orbital blood flow measurements with color Doppler imaging (CDI) at different stages of observer experience.

Methods: The subjects were 31 healthy volunteers and 2 sequential groups of 25 glaucoma patients each. Repeated blood flow measurements (usually 3 sets) in orbital vessels (ophthalmic artery, short posterior ciliary arteries, central retinal artery, and central retinal vein) were performed by the same observer in a single session in each subject.

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