Incidentally Detected Splenic Lesions in Ultrasound: Does Contrast-Enhanced Ultrasonography Improve the Differentiation of Benign Hemangioma/Hamartoma from Malignant Lesions?

Stang, Axel; Keles, Handan; Hentschke, Suna; Cu, von Seydewitz; Dahlke, Joachim; Habermann, CR; Weßling, Johannes

doi:10.1055/s-0031-1282034

Cited by 35 publications

(51 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the arterial phase, benign lesions show iso-hyper-enhancement followed in the parenchymal phase by slow, modest and incomplete washout in only 31 % of cases. The great intensity of enhancement in the arterial phase in benign splenic pathologies may reflect hypervascularity caused by an increased arterial blood flow, while modest washout might be due to the presence of spleen-like sinusoidal epithelium [31]. In the arterial phase, malignant focal splenic lesions present inhomogeneous enhancement which may be poor and in some cases peripheral or absent with areas of hypo-enhancement associated with a rapid and complete washout, indicating a low uptake of contrast medium.…”

Section: Splenic Lymphomamentioning

confidence: 99%

“…A lesion which is constantly non-enhanced or isoenhanced in the parenchymal phase is to be considered benign in 100 % of cases, whereas a lesion showing progressive hypo-enhancement is predictive of malignancy in 87 % of cases [31].…”

Section: Splenic Lymphomamentioning

confidence: 99%

“…Focal hyperechoic irregularities discovered incidentally at Gray-scale US imaging have a low-risk of being malignant, although CEUS yields false positive outcome in 15-22 % of cases, whereas iso-hypo-echoic neoformations incidentally identified at Gray-scale US with no history of malignancy have a risk of being malignant in 34.3 % of cases; in these lesions CEUS has a diagnostic accuracy of 91-94 % with a negative predictive value (NPV) of 100 %. [31].…”

Section: Splenic Lymphomamentioning

confidence: 99%

See 2 more Smart Citations

Focal splenic lesions: US findings

et al. 2013

View full text Add to dashboard Cite

Ultrasound (US) imaging of the spleen was considered of little use in the past and was performed only to distinguish between cystic and solid lesions. However, in the last decade due to experience acquired and the introduction of second-generation contrast agents, this technique has been re-evaluated as contrast-enhanced US (CEUS) allows detection and characterization of most focal lesions of the spleen with a high sensitivity and a good specificity. Gray-scale US presents a low specificity in splenic infarctions with a high rate of false negative cases, whereas specificity reaches 100 %, if the examination is performed using US contrast agents. Gray-scale US can provide a correct diagnosis in simple cysts, whereas CEUS is useful when cystic lymphangioma is suspected. In the study of splenic lesions, the most important problem is to differentiate between angioma, hamartoma, lymphoma, and metastasis. CEUS reaches a good specificity in the differentiation of benign from malignant splenic lesions, as hypo-enhancement in the parenchymal phase is predictive of malignancy in 87 % of cases. In conclusion, Gray-scale US and particularly CEUS are at present widely indicated in the study of focal splenic lesions.Keywords Focal splenic lesion Á Splenic angioma/ hamartoma Á Splenic cysts Riassunto L'ecografia splenica è stata considerata nel passato poco utile ed indicata solo nella diagnosi differenziale tra lesioni cistiche e solide. Nell'ultimo decennio grazie alla maggior esperienza ed all'utilizzo dei mezzi di contrasto ecografici di II generazione (CEUS), questa metodica è stata rivalutata, in quanto consente di evidenziare e caratterizzare con elevata sensibilità e buona specificità la maggior parte delle lesioni focali della milza. Negli infarti splenici l'ecografia B-Mode ha una bassa specificità con elevata percentuale di falsi negativi, mentre questa risulta il 100 %, quanto l'esame è eseguito con i mezzi di contrasto ecografici. Nelle cisti semplici l'esame ecografico è sufficiente per porre una corretta diagnosi, mentre la CEUS può risultare utile nel sospetto di linfoangioma cistico. Il problema più importante a livello splenico è quello di definire con la maggior accuratezza possibile la diagnosi differenziale tra Angioma/Amartoma e Linfoma/Metastasi. La CEUS presenta nella lesioni spleniche una buona specificità nel differenziare una lesione benigna da una maligna, in quanto la presenza di ipoehnancement in fase parenchimale è predittiva nell'87 % dei casi di malignità. In conclusione l'ecografia B-Mode ed ancor più la CEUS trova al momento attuale ampie indicazioni nelle lesioni focali spleniche.

show abstract

Section: Splenic Lymphomamentioning

confidence: 99%

Section: Splenic Lymphomamentioning

confidence: 99%

Section: Splenic Lymphomamentioning

confidence: 99%

See 1 more Smart Citation

Focal splenic lesions: US findings

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Hyperechoic FSLs incidentally detected on US are in most cases benign. CEUS improves the differentiation between benign and malignant FSLs especially for isoechoic or hypoechoic incidental lesions, unclear on conventional US [72]. Benign FSLs typically appear as nonenhancing in all phases (cystic lesions, infarcted areas) or show rapid enhancement followed by persistent late-phase enhancement (solid lesions).…”

Section: Spleenmentioning

confidence: 99%

“…Benign FSLs typically appear as nonenhancing in all phases (cystic lesions, infarcted areas) or show rapid enhancement followed by persistent late-phase enhancement (solid lesions). Malignant FSLs usually show early diffuse or peripheral enhancement, followed by "wash-out" in the late phase, with progressive hypo-enhancement [70,72,73]. In some cases the behaviour of malignant and benign lesions overlap, and benign lesions as haemangiomas, hamartomas, or other uncommon splenic abnormalities show some degree of "wash-out", mimicking a malignant pattern [70,74].…”

Section: Spleenmentioning

confidence: 99%

Romanian National Guidelines on Contrast Enhanced Ultrasound in clinical practice

et al. 2017

View full text Add to dashboard Cite

Contrast-enhanced ultrasound (CEUS) allows a real-time assessment of the vascular pattern of different types of lesions, as it has no renal or liver toxicity, it lacks radiation exposure and it is also cheaper than other imaging methods, having a diagnostic capability that matches contrast-enhanced CT or MRI. In Romania CEUS is used more and more, especially by clinicians, and since some centres have extensive experience in this domain, we felt the need to disseminate our expertise in order to implement this method in as many centres as possible. These Guidelines present the clinical applications of CEUS in the liver, spleen, pancreas, kidney, testis, bowel, intra-cavitary and endoscopic ultrasound, as well as other applications.

show abstract

Conventional Ultrasound and Contrast‐Enhanced Ultrasound in the Diagnosis of Splenic Diseases

Song

Sun

et al. 2020

J of Ultrasound Medicine

View full text Add to dashboard Cite

Accurate diagnosis of splenic diseases is important for timely and accurate treatment. The objective of this study was to compare the accuracy of contrast‐enhanced ultrasound (CEUS) and conventional ultrasound (US) in detecting splenic lesions. A systematic literature search was undertaken, and 8 studies met the inclusion criteria. The sensitivity and specificity of the consolidated results of CEUS were 0.95 (95% confidence interval [CI], 0.92–0.97) and 0.97 (95% CI, 0.90–0.99), respectively (I2 = 27.4%; area under the curve [AUC] from a summary receiver operating characteristic curve = 0.97). The sensitivity and specificity of the consolidated results of conventional US were 0.70 (95% CI, 0.56–0.80) and 0.96 (95% CI, 0.76–0.99; I2 = 83.4%; AUC = 0.84). In this systematic review and meta‐analysis, the sensitivity and specificity of CEUS were higher than those of conventional US in diagnosing splenic lesions. Contrast‐enhanced US is a promising method for accurately diagnosing splenic lesions.

show abstract

Incidentally Detected Splenic Lesions in Ultrasound: Does Contrast-Enhanced Ultrasonography Improve the Differentiation of Benign Hemangioma/Hamartoma from Malignant Lesions?

Abstract: Sulfur hexafluoride-enhanced CEUS improves differentiation between benign vascular and malignant splenic tumors and may be especially useful in clinical scenarios in which the incidental hypoechoic splenic lesion is unclear on conventional US.

Cited by 35 publications

References 13 publications

Focal splenic lesions: US findings

Focal splenic lesions: US findings

Romanian National Guidelines on Contrast Enhanced Ultrasound in clinical practice

Conventional Ultrasound and Contrast‐Enhanced Ultrasound in the Diagnosis of Splenic Diseases

Contact Info

Product

Resources

About