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

Abstract EN

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.