Characterization of Focal Liver Lesions Indistinctive on B Mode Ultrasound: Benefits of Contrast-Enhanced Ultrasound

Abstract

Aim. The aim of this prospective study was to evaluate the additional value of contrast-enhanced ultrasound (CEUS) in identifying and characterizing of focal liver lesions (FLLs) that are indistinctive on B mode ultrasound (BMUS). Methods. The study focused on 70 consecutive patients (male 46, female 24; mean age, 53.1 years ± 10). All lesions were detected by MRI but could not be clearly visualized by BMUS. CEUS was performed by injected SonoVue® (Bracco Imaging Spa, Milan, Italy) as a quick bolus into the antecubital vein. All lesions were proved by pathologic and MRI findings as primary or metastatic hepatic malignancies. Results. On CEUS, 45 (64.2%) FLLs displayed arterial hyperenhancement and 55 (78.5%) lesions showed hypoenhancement in portal venous and late phase (PVLP). Homogeneous and complete hyperenhancement pattern during the arterial phase is highly suspicious for HCC in liver cirrhosis (96.8%). Arterial isoenhancement and early washout during PVLP are characteristic for metastasis (73.3%). For recurrence lesions, arterial hyperenhancement and isoenhancement during PVLP are more common (60%). Conclusion. CEUS may provide added diagnostic values in FLLs appearing indistinctive on BMUS. Presence of early arterial enhancement and washout during PVLP may be helpful for detection of those lesions.

The imaging features of ectopic spleen: which modality is more consistent? A cases series report and literature reviews

“…CEUS applications have gained increasing experience in the differential diagnosis of space-occupying lesions in recent years. Numerous national and international groups have advocated the use of the CEUS test for the diagnosis of focal liver lesions ( 28 ). Referring to the CEUS performance of ES, it is rarely reported in the literature.…”

Ultrasound Image–Based Radiomics

“…Hyperechoic tumors are easier to detect and are usually present in association with tumors that originate in the alimentary tract system or vasculature, mainly due to multiple echogenicities caused by abnormally increased vascular interfaces. In addition, cystic echoes that are caused by excess mucus or necrosis produced by all tumor types are not commonly observed 3,23,24,49 . Although certain metastatic liver tumors have typical features, multiple metastatic lesions from the same primary tumor may have diversified US manifestations attributed to the blood supply type, the degree of cell differentiation, and necrosis.…”