Focal Hepatic Lesions: Contrast-Enhancement Patterns at Pulse-Inversion Harmonic US using a Microbubble Contrast Agent.
- Author:
Eun A KIM
1
;
Kwon Ha YOON
;
Young Hwan LEE
;
Hye Won KIM
;
Seon Kwan JUHNG
;
Jong Jin WON
Author Information
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords: Liver, US; Liver, neoplasms; Liver neoplasms, US microbubbles; Ultrasound (US), contrast media; Ultrasound (US), harmonic study
- MeSH: Adult; Aged; Carcinoma, Hepatocellular/blood supply/*ultrasonography; Colon/pathology; Contrast Media/*administration & dosage; Diagnosis, Differential; Female; Hemangioma/blood supply/*ultrasonography; Human; Image Enhancement/*methods; Liver/pathology/ultrasonography; Liver Neoplasms/blood supply/secondary/*ultrasonography; Lung/pathology; Male; *Microbubbles; Middle Aged; Pancreas/pathology; Polysaccharides/administration & dosage/diagnostic use; Reproducibility of Results; Retrospective Studies; Sensitivity and Specificity; Stomach/pathology; Support, Non-U.S. Gov't
- From:Korean Journal of Radiology 2003;4(4):224-233
- CountryRepublic of Korea
- Language:English
- Abstract: 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.
