Differential diagnosis of hepatic nodules using delayed parenchymal phase imaging of levovist contrast ultrasound: comparative study with SPIO-MRI

Liver specific phase of perflubutane microbubbles contrast-enhanced ultrasound for potential use in the diagnosis of focal liver lesions

“…Kupffer cells in vitro showed a certain ability to phagocytose different kinds of contrast agent microbubbles, with phagocytic rate of 99% for Sonazoid, 47% for Levovist and 7.3% for SonoVue, respectively [8]. On Levovist CEUS, enhancement of liver parenchyma maintained up to 30 min, and the reason was supposed to be phagocytosis of microbubbles by Kupffer cells [12][13][14][15]. Further study preliminarily proved the hypothesis by elimination of Kupffer cells in vivo and resulted in a decreased intensity of the delayed parenchymal images on Sonazoid CEUS [8].…”

Decrease in accumulation of ultrasound contrast microbubbles in non‐alcoholic steatohepatitis

“…These agents, except for those described with code names, are or were commercially available. Only Levovist and Sonazoid among these agents can indicate the delayed parenchymal enhancement of reticulo‐endothelial organs such as the liver and spleen after microbubbles disappear from the circulating blood 26–31 . Levovist is the only commercially available agent which can show liver‐ or spleen‐specific contrast imaging at the present time.…”

How to characterize non‐hypervascular hepatic nodules on contrast‐enhanced computed tomography in chronic liver disease: Feasibility of contrast‐enhanced ultrasound with a microbubble contrast agent

“…Furthermore, there were no lesions with the pathological result of DN, considered to be a premalignant lesion. Although some studies have been carried out, sufficient results have not been achieved in the differential diagnosis of DN from well‐differentiated HCC by imaging methods 26–28 . CEUS studies for the characterization of hepatic nodules without hypervascular appearance should be continued.…”

“…There have been many studies with sufficient results concerning the characterization of hepatic nodules and the evaluation of therapeutic effects 18–26 . However, the characterization of hepatic nodules without hypervascular appearance using CEUS has not been fully discussed 27–29 . The characterization of small hepatic nodules by ultrasound (US) examination is important because they are appropriate candidates for percutaneous US‐guided treatment.…”