Characterization of Focal Liver Lesions with Contrast-Enhanced Ultrasound

Intraoperative Ultrasound in Patients with Hepatocellular Carcinoma: From Daily Practice to Future Trends

“…Nowadays, second-generation contrast media, which are more sensitive and resistant to ultrasound, have been introduced [20,21]. The most used second-generation contrast medium is SonoVue (gaseous sulphur hexafluoride; Bracco, Milano Italy), which nowadays has a recognized diagnostic role for liver disease [22]. Recently, in Japan a new second-generation contrast medium has been used, Sonazoid (gaseous perflubutane; GE Healthcare, Norway), that has the advantage of Kupffer imaging in addition to vascular imaging, thus theoretically providing greater diagnostic accuracy [23].…”

Analysis of only 0-1 min clip or 1-4 min Clip for focal liver lesions during contrast-enhanced ultrasonography

“…Generally, regenerative nodules are nearly isoenhancing in all phases but the not negligible rate of HCCs showing this same vascular pattern (the so-called "hypovascular HCC" approximately 10-20 %) [14]. The differential diagnosis among regenerative nodule, hepatocellular adenoma and HCC is not always easy to be reached, which imposes a strict recall strategy for any newly detected lesion in cirrhosis [15]. Contrast features of metastases at CEUS are hyperenhancement during the arterial phase (or rimlike enhancement with non-enhancing central areas in hypo-vascular metastases) followed by marked hypo-enhancement during the late phase [16].…”

The future of pediatric US

“…However, there is no doubt that US contrast agents can increase the sensitivity and specificity of US diagnoses. The temporal resolution of contrast kinetics with US has been shown to be superior to that of both CT and MR and has proved to provide markedly improved accuracy in the characterization of liver masses in adults [47,48]. Contrast-enhanced US can improve the detection and evaluation of renal abnormalities, venous thromboses and organ perfusion and can aid in the assessment of neoplasms and their response to treatment [48].…”