HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Nicolau, C. Articles by Brú, C. Search for Related Content PubMed PubMed Citation Articles by Nicolau, C. Articles by Brú, C. Social Bookmarking                      What's this?

Importance of Evaluating All Vascular Phases on Contrast-Enhanced Sonography in the Differentiation of Benign from Malignant Focal Liver Lesions

¹ All authors: Diagnosis Imaging Center, Hospital Clinic, Villarroel 170, Barcelona 08036, Spain.

OBJECTIVE. Our objective was to evaluate the accuracy of a blood-pool sonographic contrast agent in the late phase compared with the three vascular phases for differentiation between benign and malignant focal liver lesions.

SUBJECTS AND METHODS. In 152 patients (105 with chronic liver disease), 152 solid focal liver lesions characterized either by fine-needle biopsy or by dynamic CT or MRI were studied. The final diagnoses were metastasis for 24, hepatocellular carcinoma for 75, focal nodular hyperplasia for 13, regenerating or dysplastic nodule for 14, hemangioma for 22, cholangiocarcinoma for two, and another focal liver lesion for two. Real-time sonography was performed after a bolus injection of 2.4 mL of SonoVue, using a low mechanical index (< 0.2). All lesions were evaluated in the arterial, portal, and late phases; classified as benign or malignant; and correlated with final diagnoses.

RESULTS. For discrimination between malignant and benign focal liver lesions, evaluation of all vascular phases improved the sensitivity from 78.4% to 98% and the accuracy from 80.9% to 92.7%, compared with evaluation of the late phase alone. The increase in accuracy was higher in patients with chronic liver disease (16.3%) than in those without (2.1%).

CONCLUSION. Evaluation of SonoVue enhancement in all three vascular phases is superior to evaluation of SonoVue enhancement in the late phase alone, especially in patients with chronic liver disease.

Keywords: abdominal imaging • contrast media • dynamic sonography • liver disease • sonography

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				L. Chami, N. Lassau, D. Malka, M. Ducreux, S. Bidault, A. Roche, and D. Elias Benefits of Contrast-Enhanced Sonography for the Detection of Liver Lesions: Comparison with Histologic Findings Am. J. Roentgenol., March 1, 2008; 190(3): 683 - 690. [Abstract] [Full Text] [PDF]

				T. K. Kim, H.-J. Jang, P. N. Burns, J. Murphy-Lavallee, and S. R. Wilson Focal Nodular Hyperplasia and Hepatic Adenoma: Differentiation with Low-Mechanical-Index Contrast-Enhanced Sonography Am. J. Roentgenol., January 1, 2008; 190(1): 58 - 66. [Abstract] [Full Text] [PDF]

				B. Lanka, H.-J. Jang, T. K. Kim, P. N. Burns, and S. R. Wilson Impact of Contrast-Enhanced Ultrasonography in a Tertiary Clinical Practice J. Ultrasound Med., December 1, 2007; 26(12): 1703 - 1714. [Abstract] [Full Text] [PDF]

				E. Quaia, M. D'Onofrio, P. Cabassa, F. Vecchiato, S. Caffarri, F. Pittiani, K. M. Wittkowski, and M. A. Cova Diagnostic Value of Hepatocellular Nodule Vascularity After Microbubble Injection for Characterizing Malignancy in Patients with Cirrhosis Am. J. Roentgenol., December 1, 2007; 189(6): 1474 - 1483. [Abstract] [Full Text] [PDF]

				J. Murphy-Lavallee, H.-J. Jang, T. K. Kim, P. N. Burns, and S. R. Wilson Are Metastases Really Hypovascular in the Arterial Phase?: The Perspective Based on Contrast-Enhanced Ultrasonography J. Ultrasound Med., November 1, 2007; 26(11): 1545 - 1556. [Abstract] [Full Text] [PDF]

				H.-J. Jang, T. K. Kim, P. N. Burns, and S. R. Wilson Enhancement Patterns of Hepatocellular Carcinoma at Contrast-enhanced US: Comparison with Histologic Differentiation Radiology, September 1, 2007; 244(3): 898 - 906. [Abstract] [Full Text] [PDF]

				O. Catalano, V. Migaleddu, E. Quaia, and G. Caruso Terminology for Contrast-Enhanced Sonography: A Practical Glossary J. Ultrasound Med., June 1, 2007; 26(6): 717 - 730. [Abstract] [Full Text] [PDF]

				S. R. Wilson, H.-J. Jang, T. K. Kim, and P. N. Burns Diagnosis of Focal Liver Masses on Ultrasonography: Comparison of Unenhanced and Contrast-Enhanced Scans J. Ultrasound Med., June 1, 2007; 26(6): 775 - 787. [Abstract] [Full Text] [PDF]

				O. Catalano, F. Sandomenico, A. Nunziata, M. M. Raso, P. Vallone, and A. Siani Transient Hepatic Echogenicity Difference on Contrast-Enhanced Ultrasonography: Sonographic Sign and Pitfall J. Ultrasound Med., March 1, 2007; 26(3): 337 - 345. [Abstract] [Full Text] [PDF]