Charakterisierung fokaler leberläsionen mit kontrastmittelgestütztem "low MI real time" ultraschall und SonoVue

Translated title of the contribution: Characterization of focal liver lesions with contrast-enhanced low MI real time ultrasound and SonoVue

Joachim Hohmann, J. Skrok, R. Puls, T. Albrecht

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: SonoVue is a new microbubble ultrasound contrast agent that for the first time allows continuous real time examination during the different phases of contrast enhancement using low transmission power, expressed as mechanical index (MI). This study investigates whether low MI real time phase inversion imaging with SonoVue can improve the characterization of focal liver lesions in comparison to unenhanced sonography and power Doppler sonography. Materials and Methods: Sixty-three patients with 35 malignant and 28 benign liver lesions were studied with unenhanced ultrasound (US) including B-mode and power Doppler, followed by contrast-enhanced al MI (0.1 - 0.3) real time phase inversion US during arterial, portal-venous and delayed liver phase (> 2 min after injection). Findings of the scans obtained before and after administration of contrast agent were compared with each other and with reference examinations (biopsy, MRI, CT or intraoperative US). Results: The number of correctly diagnosed lesions increased from 41 (65%) without contrast agent to 58 (92%) with contrast agent (p < 0.001). The differentiation of malignant from benign lesions improved from 43 (68%) to 60 (95%, p < 0.001). After administration of the contrast agent, all 35 malignant lesions were correctly recognized and 3 of the 28 benign lesions were misclassified. All 27 metastases showed little or no enhancement on portalvenous and delayed phase imaging, independent of their arterial features. All 6 hepatocellular carcinomas (HCC) enhanced markedly during arterial phase and 5 showed less contrast uptake than normal liver in the late phase. Ten of 11 hemangioma displayed arterial peripheral nodular enhancement followed by progressive centripetal fill-in. Nine of 11 focal nodular hyperplasias (FNHs) showed profuse arterial enhancement (5 with a transient "spokewheel") and contrast uptake similar to normal liver thereafter. One FNH showed a subtle central scar. Conclusion: Low MI real time US with SonoVue markedly improves the characterization of focal hepatic lesions in comparison with unenhanced sonography.

Translated title of the contributionCharacterization of focal liver lesions with contrast-enhanced low MI real time ultrasound and SonoVue
Original languageGerman
Pages (from-to)835-843
Number of pages9
JournalRoFo Fortschritte auf dem Gebiet der Rontgenstrahlen und der Bildgebenden Verfahren
Volume175
Issue number6
DOIs
StatePublished - Jun 1 2003

Keywords

  • Contrast media
  • Liver neoplasms
  • Low MI
  • Microbubbles
  • Ultrasound

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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