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Prospective Multicenter Trial Evaluating a Novel Method of Characterizing Focal Liver Lesions Using Contrast-Enhanced Sonography

Edward Leen1, Piercarlo Ceccotti1, Christina Kalogeropoulou1, Wilson J. Angerson2, Susan J. Moug2 and Paul G. Horgan2

1 Department of Radiology, Glasgow Royal Infirmary, Alexandra Parade, Glasgow, Scotland G31 2ER.
2 Department of Surgery, Glasgow Royal Infirmary, Glasgow, Scotland.


Figure 1
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  		Fig. 1A —53-year-old man with liver metastasis. Baseline fundamental B-mode scan shows poorly defined and almost isoechoic metastasis (arrows).

 

Figure 2
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  		Fig. 1B —53-year-old man with liver metastasis. Contrast-enhanced scan with pulse inversion harmonic imaging shows rim enhancement of metastasis (arrows), which is of reduced intensity compared with adjacent normal liver parenchyma.

 

Figure 3
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  		Fig. 2A —61-year-old man with hepatocellular carcinoma. Baseline fundamental B-mode scan shows small focal hypoechoic hepatocellular carcinoma (arrows).

 

Figure 4
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  		Fig. 2B —61-year-old man with hepatocellular carcinoma. Contrast-enhanced scan with pulse inversion harmonic imaging shows homogeneous enhancement (arrows) of lesion during arterial phase.

 

Figure 5
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  		Fig. 2C —61-year-old man with hepatocellular carcinoma. Portal venous phase—lesion is of reduced intensity (arrows) compared with adjacent normal liver.

 

Figure 6
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  		Fig. 3A —29-year-old woman with focal nodular hyperplasia. Baseline fundamental B-mode scan shows ill-defined hypoechoic lesion.

 

Figure 7
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  		Fig. 3B —29-year-old woman with focal nodular hyperplasia. Baseline color Doppler sonography shows presence of large vessels in lesion.

 

Figure 8
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  		Fig. 3C —29-year-old woman with focal nodular hyperplasia. Contrast-enhanced scan with pulse inversion harmonic imaging shows well-defined enhancement of whole lesion during arterial phase with central artery (straight arrow) and adjacent tiny scar (curved arrow) with no enhancement.

 

Figure 9
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  		Fig. 3D —29-year-old woman with focal nodular hyperplasia. Lesion disappears because it is isointense to adjacent normal liver parenchymal in late phase.

 

Figure 10
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  		Fig. 4A —33-year-old woman with hemangioma. Baseline fundamental B-mode scan shows well-defined hypoechoic lesion with apparent hyperechoic capsule.

 

Figure 11
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  		Fig. 4B —33-year-old woman with hemangioma. Peripheral nodular enhancement is observed in arterial phase.

 

Figure 12
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  		Fig. 4C —33-year-old woman with hemangioma. Late phase shows almost complete enhancement of lesion, which is more intense than that of healthy liver.

 

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