Hans-Peter Weskott MD, Presenter: Luminary, General Electric Company Speaker, Bracco Group

Shanshan Yin MD, Abstract Co-Author: Nothing to Disclose

To evaluate the arterial hepatic architecture including diameter, course and branching by using a pulse inversion technique in patients with either diffuse and/or focal liver disease. 

For detection or characterization of focal liver lesions (FLL) in normal/or diffuse liver disease 137 patients underwent CEUS. With arrival of the first bubbles (contrast agent Sonovue, Bracco Company, Milan,Italy) a sweep of the right or left liver lobe was performed using a low MI harmonic imaging technique (pulse inversion, Logiq E9, C1-5, GE Healthcare, Milwaukee, USA). Cine capture was started to visualize the vascular continuity of intrahepatic arteries. Average accumulation time for a cine capture sequence was 6.5s ±1.8s. A successful examination was defined when at least three main branches of the right or left hepatic artery were imaged.  Loops were reviewed to compare course and size of intrahepatic arteries, including 44 patients with liver metastases,28 within liver cirrhosis and 65 patients without cirrhosis and malignant FLL among them 18 patients with benign FLL

The success rate was 88%.  In cirrhotic patients 78% had a tortuous course and dilated arteries including at least three main arterial branches. The mean diameter of the right or left main tortuous artery was 3.36±0.92mm. The smallest arterial branches measured 0.4mm. Compared to patients without collateral circulation (n=24), diameters were thinner in patients with collateral circulation (n=4) (3.39±0.96mm vs. 2.58±1.15mm , p=0.138). In non-cirrhotic patients, 54% showed corkscrew arteries involving no more than two main arterial branches, mostly seen in patients under chemotherapy. In comparison the mean diameter of the non-cirrhotic liver was thinner (2.32±0.89mm, p=0.000). Curly arteries were seen more often in the elderly (r=0.285). In metastatic disease, 45.4% patients had curly arteries. Tortuous feeding arteries were seen in all FNH and HCC. Arterial stenosis was seen in a patient with lung cancer without liver metastasis.

CEHA is capable to image changes of the intrahepatic arterial architecture and thus contributes to characterize the vascular status in patients with diffuse or focal liver diseases.

CEHA shows differences in in the arterial architecture of patients with diffuse liver disease, especially in patients under or after chemotharapy, it helps to image tumor supplying arteries in benign FLL and HCC. 

Weskott, H, Yin, S, Contrast-enhanced Hepatic Angiography: A Novel CEUS Technique to Image Intrahepatic Arteries.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14009109.html