Dennis B Rouw MD, Presenter: Nothing to Disclose

David Blom MD, Abstract Co-Author: Nothing to Disclose

Eric J Van der Jagt MD, Abstract Co-Author: Nothing to Disclose

Matthijs Oudkerk MD, Abstract Co-Author: Nothing to Disclose

To compare unenhanced ultrasound (US) versus dynamic contrast-enhanced US (CEUS) in the characterisation of focal liver lesions.

Fifty patients (24 men and 26 women, aged 25-79 years, mean 55 years) with 68 focal liver lesions (mean lesion size 3,1 cm were studied with ATL 5000 equipment. Fundamental B mode and color Doppler imaging of the liver were performed at baseline. To determine the dynamic contrast behaviour US investigations were performed continuously for 3 minutes at a low mechanical index (0.1-0.3) after a 2.4-4.8 ml Sonovue bolus injection using high quality curved transducers. Biopsy or combined CT/MR (with liverspecific contrast agent), biochemical markers, clinical follow up (>6 months) with additional imaging were used as standard of reference. CEUS diagnosis was established based on tumour vascularity and patterns of enhancement in the arterial and portal phases and degree of contrast uptake within the lesion relative to that of normal liver in the late phase. The exam was recorded digitally for off-site assessment by two observers. Diagnostic performance of CEUS indentifying the lesion (a) as benign or malignant (b) as its actual tumour type classification, were compared with baseline US.

The 68 lesions consisted of metastases (colon, GIST, carcinoid and mammacarcinoma) (n=28), HCC (n=9), adenoma (n=3), FNH (n=6) and hemangiomas (n=22). Of the 31 benign lesions, accurate diagnosis was made in 12 lesions (39%) on unenhanced US compared to 25 lesions (81%) on CEUS. Of the 37 malignant lesions, accurate diagnosis was made in 15 lesions (40%) with unenhanced US compared to 33 (89%)on CEUS.

CEUS improves the characterisation of focal liver lesions compared with unenhanced US and may obviate the need for further diagnostic tests.

Rouw , D, Blom , D, Van der Jagt , E, Oudkerk, M, Dynamic Contrast-enhanced Ultrasound in the Characterization of Focal Liver Lesions.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4410975.html