Vito Cantisani MD, Presenter: Nothing to Disclose

Paolo Ricci MD, Abstract Co-Author: Nothing to Disclose

Federico Arduini MD, Abstract Co-Author: Nothing to Disclose

Elisa Pagliara MD, Abstract Co-Author: Nothing to Disclose

Sara Pacella MD, Abstract Co-Author: Nothing to Disclose

Roberto Passariello MD, Abstract Co-Author: Nothing to Disclose

To evaluate the accuracy of pattern-based classification of Sonovue contrast-enhanced US in the differential diagnosis of hepatic focal lesions.

One-hundred-twentyfive lesions (38 HCC, 35 hemangiomas, 25 FNHs, 23 metastases, and 4 adenomas) in 106 patients, identified at baseline US, were evaluated with real-time low mechanical index (0.04-0.20) US during arterial, portal, and late phases after injection of Sonovue (Bracco, Milan, Italy). Subsequently, all the patients underwent multislice Spiral CT and dynamic MRI (N=95). The US enhancement patterns were classified, and sensitivity. specificity, and accuracy in the characterization of the liver lesions were calculated

Five US-enhancement patterns were found to be useful in the differentiation of hepatic lesions: heterogeneous or homogeneous enhancement during the arterial phase (18-30 sec), followed by rapid washout with pseudocapsule enhancement during portal phase, and hypoechogenicity during the late phase for HCCs; rim-enhancement during the portal phase and hypoechogenicity during the late phase, for metastases; globular peripheral enhancement during the arterial phase, with subsequent progressive filling-in during the portal and late phase, for hemangiomas; homogeneous and fast enhancement (12-18 sec) during arterial phase, with hyperechogenicity during the portal and late phase, for FNH; strong and fast enhancement during the arterial phase, with rapid washout during the portal phase, for adenoma. The sensitivity, specificity, and accuracy were: 94.%, 97.7%, 96.8% for HCC; 97.1%, 98.8%, e 98.4%, for hemangiomas; 95.6%,99%, e 98.4% for metastases; 100% , 100%, 100%, for FNH; 75%, 99.1%, 98.4% for adenoma.

Sonovue-enhanced real-time low mechanical index (MI) US provides specific contrast-enhancement patterns of different focal liver lesions, allowing accurate characterization.

Cantisani, V, Ricci, P, Arduini, F, Pagliara, E, Pacella, S, Passariello, R, Evaluation of Sonovue-enhanced US Patterns in the Differentiation of Hepatic Neoplasms.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4416637.html