1.Focal Hepatic Lesions: Contrast-Enhancement Patterns at Pulse-Inversion Harmonic US using a Microbubble Contrast Agent.
Eun A KIM ; Kwon Ha YOON ; Young Hwan LEE ; Hye Won KIM ; Seon Kwan JUHNG ; Jong Jin WON
Korean Journal of Radiology 2003;4(4):224-233
OBJECTIVE: To analyze the contrast-enhancement patterns obtained at pulseinversion harmonic imaging (PIHI) of focal hepatic lesions, and to thus determine tumor vascularity and the acoustic emission effect. MATERIALS AND METHODS: We reviewed pulse-inversion images in 90 consecutive patients with focal hepatic lesions, namely hepatocellular carcinoma (HCC) (n=43), metastases (n=30), and hemangioma (n=17). Vascular and delayed phase images were obtained immediately and five minutes following the injection of a microbubble contrast agent. Tumoral vascularity at vascular phase imaging and the acoustic emission effect at delayed phase imaging were each classified as one of four patterns. RESULTS: Vascular phase images depicted internal vessels in 93% of HCCs, marginal vessels in 83% of metastases, and peripheral nodular enhancement in 71% of hemangiomas. Delayed phase images showed inhomogeneous enhancement in 86% of HCCs; hypoechoic, decreased enhancement in 93% of metastases; and hypoechoic and reversed echogenicity in 65% of hemangiomas. Vascular and delayed phase enhancement patterns were associated with a specificity of 91% or greater, and 92% or greater, respectively, and with positive predictive values of 71% or greater, and 85% or greater, respectively. CONCLUSION: Contrast-enhancement patterns depicting tumoral vascularity and the acoustic emission effect at PIHI can help differentiate focal hepatic lesions.
Adult
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Aged
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Carcinoma, Hepatocellular/blood supply/*ultrasonography
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Colon/pathology
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Contrast Media/*administration & dosage
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Diagnosis, Differential
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Female
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Hemangioma/blood supply/*ultrasonography
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Human
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Image Enhancement/*methods
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Liver/pathology/ultrasonography
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Liver Neoplasms/blood supply/secondary/*ultrasonography
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Lung/pathology
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Male
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*Microbubbles
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Middle Aged
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Pancreas/pathology
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Polysaccharides/administration & dosage/diagnostic use
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Reproducibility of Results
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Retrospective Studies
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Sensitivity and Specificity
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Stomach/pathology
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Support, Non-U.S. Gov't