Contrast-enhanced ultrasound using SonoVue mixed with oral gastrointestinal contrast agent to evaluate esophageal hiatal hernia: Report of three cases and a literature review

Figure 4 A 46-year-old man with esophageal hiatal hernia. A: Compared to the gray-scale imaging (right panel), contrast-enhanced ultrasound imaging clearly showed the esophageal hiatus (arrows) and the supradiaphragmatic hernial sac (HS); B: Ultrasound image obtained with conventional oral contrast agent shows the HS; C: Gastroscopic front view showed the reflux esophagitis; D: In the reverse view, the cardia opening was shown to be loosened; E: High-resolution esophageal pressure measurement showed type II esophageal hiatal hernia. HS: Hernial sac; LL: Left liver lobe; ST: Stomach.