Carlos Nicolau MD, Presenter: Nothing to Disclose

Ramon Vilana, Abstract Co-Author: Nothing to Disclose

Violeta Catala, Abstract Co-Author: Nothing to Disclose

Luis Bianchi, Abstract Co-Author: Nothing to Disclose

Xavier Bargalló, Abstract Co-Author: Nothing to Disclose

Concepció Brú, Abstract Co-Author: Nothing to Disclose

To assess the accuracy of contrast- enhanced ultrasound (CEUS) using a new echocontrast agent, SonoVue® in the diagnosis of hepatocellular carcinoma (HCC) in patients with chronic liver disease (CLD).

One hundred and forty three focal liver lesions (FLLs), (mean size 2.3 +/- 1.1 cm), with 68 of them < 2cm, in 129 CLD patients were studied. Final diagnoses obtained by fine needle biopsy (n = 124), or MRI with a follow-up of at least 9 months (n =19) were: 100 HCCs, 24 regenerating/dysplastic nodules, 15 haemangiomas, 2 FNH, 1 focal regenerating hyperplasia, 1 cholangiocarcinoma. After baseline US, CEUS studies in real time were performed with Contrast Coherent Imaging (CCI) or Cadence (tm) contrast pulse sequencing technology (CPS), (both contrast specific softwares from ACUSON Sequoia ™, Siemens Ultrasound), and a low mechanical index (<0.2) after a bolus injection of 2.4 mL of SonoVue® (Bracco, Italy). The enhancement behaviour of FLLs during the vascular phases of contrast was analysed, lesions were classified following previously accepted criteria, and results were compared to findings of pathology or MRI.

One hundred and thirty / 143 (90.9 %) FLLs were correctly diagnosed, with 96% sensitivity and 79 % specificity for the diagnosis of HCC. Only 4 /100 (4%) HCCs were not diagnosed due to the absence of arterial enhancement. One malignant FLL (cholangiocarcinoma) that enhanced in arterial phase and 8 benign FLLs were misdiagnosed as HCCs. Six benign FLL due to the presence of an homogeneous arterial enhancement (2 haemangiomas 2 cm.

CEUS using SonoVue in the vascular phase is a useful tool in the diagnosis of HCC in CLD patients due to its high accuracy, even in FLL < 2 cm.

Nicolau, C, Vilana, R, Catala, V, Bianchi, L, Bargalló, X, Brú, C, Accuracy of Contrast-enhanced Ultrasound in the Diagnosis of Hepatocellular Carcinoma in Patients with Chronic Liver Disease.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4406563.html