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Real‐time Imaging With the Sonographic Contrast Agent SonoVue
Author(s) -
von Herbay Alexandra,
Vogt Christoph,
Willers Reinhard,
Häussinger Dieter
Publication year - 2004
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/jum.2004.23.12.1557
Subject(s) - medicine , focal nodular hyperplasia , mechanical index , hepatocellular carcinoma , hemangioma , receiver operating characteristic , ultrasound , radiology , contrast enhanced ultrasound , prospective cohort study , area under the curve , differential diagnosis , pathology , microbubbles
Objective. We investigated the ability of contrast‐enhanced sonography with SonoVue (Altana Pharma, Konstanz, Germany), a sulfur hexafluoride microbubble contrast agent, to reveal differences between benign and malignant focal hepatic lesions. Methods. One hundred twenty‐six lesions in 124 patients with focal hepatic lesions detected by B‐mode sonography (hepatocellular carcinoma, n = 36; metastasis, n = 25; cholangiocellular carcinoma, n = 1; lymphoma, n = 2; focal nodular hyperplasia, n = 9; adenoma, n = 4; regenerative cirrhotic nodule, n = 13; hemangioma, n = 29; and focal hyposteatosis, n = 7) were examined in a prospective study. After intravenous injection of 2.4 mL of SonoVue, the liver was examined continuously for 3 minutes by low–mechanical index pulse inversion sonography. Results. For the discrimination of malignant versus benign liver lesions, SonoVue‐enhanced sonography improved sensitivity from 78% to 100% and specificity from 23% to 92% compared with baseline sonography. Receiver operating characteristic analysis revealed a significant improvement in this discrimination (area under the receiver operating characteristic curve, 0.510 ± 0.054 [SD] at baseline sonography, 0.998 ± 0.003 with SonoVue‐enhanced sonography; P < .001). The following flow patterns in the early phase were diagnosis specific: early central starlike pattern for focal nodular hyperplasia, peripheral globular‐nodular pattern for hemangioma, and diffuse arterial enhancement for malignant lesions. Homogeneous enhancement in the late phase was predictive for benign lesions ( P < .001). Conversely, 93% of patients without contrast enhancement in the late phase had malignant lesions ( P < .001). Conclusions. SonoVue‐enhanced sonography has greater specificity and sensitivity than baseline sonography for the differentiation of benign and malignant liver lesions.