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Imaging of Focal Liver Lesions
Author(s) -
Ding Hong,
Wang Wen-Ping,
Huang Bei-Jian,
Wei Rui-Xue,
He Nian-An,
Qi Qing,
Li Chao-Lun
Publication year - 2005
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.2005.24.3.285
Subject(s) - medicine , focal nodular hyperplasia , mechanical index , lesion , hemangioma , pathology , radiology , ultrasonography , ultrasound , contrast enhanced ultrasound , liver hemangioma , hepatocellular carcinoma , microbubbles
Objective The purpose of this study was to evaluate the usefulness of a contrast‐enhanced contrast‐specific ultrasonographic technique with a low mechanical index for characterization of focal liver lesions. Methods Contrast‐specific ultrasonography was used to assess 144 patients with 147 focal liver lesions: 87 primary liver carcinomas, 27 hemangiomas, 16 focal nodular hyperplasias, 5 hepatic abscesses, 3 inflammatory pseudotumors of the liver, and 9 metastases. A sulfur hexafluoride gas–based contrast agent was used with a mechanical index of 0.08 to 0.11. Results On contrast‐enhanced ultrasonography, the typical hemodynamic pattern of primary liver carcinoma was the whole‐lesion enhancement or mosaic enhancement in the arterial phase with an enhancement defect in the late phase (sensitivity, 92.0%; specificity, 86.7%). The most common enhancement pattern of hemangioma was that enhancement appeared in the periphery first and progressively filled into the lesion center (sensitivity, 96.3%; specificity, 97.5%). The enhancement pattern of focal nodular hyperplasia was that the whole lesion enhanced early and rapidly in the arterial phase with a centrifugal radiating configuration and appeared isoechoic or hyperechoic until the late phase (sensitivity, 87.6%; specificity, 94.5%). The central scar was detected in 31.3% of cases in the late phase. The specific enhancement of a hepatic abscess was the honeycomblike enhancement in all phases (sensitivity, 80.0%; specificity, 100%). No enhancement of a lesion in all phases was specific for an inflammatory pseudotumor of the liver. Conclusions Contrast‐enhanced real‐time ultrasonography is a promising approach in the noninvasive characterization of focal liver lesions and can be useful as a first‐line imaging technique clinically when a focal liver lesion is detectable on ultrasonography.