An Algorithm for the Diagnosis of Focal Liver Masses Using Microbubble Contrast-Enhanced Pulse-Inversion Sonography

Wilson, Stephanie R.; Burns, Peter N.

doi:10.2214/ajr.04.1920

Cited by 163 publications

(134 citation statements)

References 26 publications

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“…Pulse inversion imaging suppresses echoes from tissues in favor of those from bubbles. When used at a low mechanical index, pulseinversion imaging does not cause disruption of the microbubbles, thus allowing a continuous assessment of the vessels as the contrast agent traverses the imaging field [6] . Contrast agents are safe and produce very few adverse effects.…”

Section: Contrast-enhanced Sonographymentioning

confidence: 99%

Contrast-enhanced ultrasound in diagnosis and characterization of focal hepatic lesions

Molins¹

2010

WJR

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The extensive use of imaging techniques in differential diagnosis of abdominal conditions and screening of hepatocellular carcinoma in patients with chronic hepatic diseases, has led to an important increase in identification of focal liver lesions. The development of contrastenhanced ultrasound (CEUS) opens a new window in the diagnosis and follow-up of these lesions. This technique offers obvious advantages over the computed tomography and magnetic resonance, without a decrease in its sensitivity and specificity. The new second generation contrast agents, due to their intravascular distribution, allow a continuous evaluation of the enhancement pattern, which is crucial in characterization of liver lesions. The dual blood supply in the liver shows three different phases, namely arterial, portal and late phases. The enhancement during portal and late phases can give important information about the lesion's behavior.Each liver lesion has a different enhancement pattern that makes possible an accurate approach to their diagnosis. The role of emerging techniques as a contrastenhanced three-dimensional US is also discussed. In this article, the advantages, indications and technique employed during CEUS and the different enhancement patterns of most benign and malignant focal liver lesions are discussed.

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Section: Contrast-enhanced Sonographymentioning

confidence: 99%

Contrast-enhanced ultrasound in diagnosis and characterization of focal hepatic lesions

Molins¹

2010

WJR

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“…arterial (10-20 to 25-35 s after injection), portal (30-45 to 120 s) and late parenchymal (> 120 s) phases [13] . Simply put, the late phase is useful to determine the benign or malignant nature of a lesion while the arterial phase helps in predicting its histology [14][15][16][17][18][19] . Between 86% to 93% of benign lesions retain the contrast in the late phase, while 78% to 98% of the malignant ones demonstrate wash out of the contrast [14,16,18] .…”

Section: Contrast-enhanced Us Patterns Of Focal Liver Lesionsmentioning

confidence: 99%

“…Simply put, the late phase is useful to determine the benign or malignant nature of a lesion while the arterial phase helps in predicting its histology [14][15][16][17][18][19] . Between 86% to 93% of benign lesions retain the contrast in the late phase, while 78% to 98% of the malignant ones demonstrate wash out of the contrast [14,16,18] . The persistence of the second generation contrast agent in a healthy liver is thought to be the result of a very slow flow through the sinusoid [20] .…”

Section: Contrast-enhanced Us Patterns Of Focal Liver Lesionsmentioning

confidence: 99%

“…The characteristic early arterial nodular enhancement with delayed centripetal fill-in described on CT or MRI [23][24][25] is the most common appearance of haemangiomas during the arterial phase of contrast-enhanced US, seen in 52% to 88% of cases ( Figure 1) [15,16,18,19] . Sustained enhancement has been reported in 83% to 100% during the late phase [16][17][18][19] .…”

Section: Haemangiomasmentioning

confidence: 99%

“…Sustained enhancement has been reported in 83% to 100% during the late phase [16][17][18][19] . The real time nature of contrast-enhanced US is particularly useful in diagnosing small, rapidly perfusing (flash-filling) haemangiomas, where the typical enhancement pattern can be appreciated [6] .…”

Section: Haemangiomasmentioning

confidence: 99%

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Use of second generation contrast-enhanced ultrasound in the assessment of focal liver lesions

Morin¹,

Lim²,

Cobbold³

et al. 2007

WJG

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Ultrasound (US) is often the first imaging modality employed in patients with suspected focal liver lesions. The role of US in the characterisation of focal liver lesions has been transformed with the introduction of specific contrast media and the development of specialized imaging techniques. Ultrasound now can fully characterise the enhancement pattern of hepatic lesions, similar to that achieved with contrast enhanced multiphasic computed tomography (CT) and magnetic resonance imaging (MRI). US contrast agents are safe, well-tolerated and have very few contraindications. Furthermore, real-time evaluation of the vascularity of focal liver lesions has become possible with the use of the newer microbubble contrast agents. This article reviews the enhancement pattern of the most frequent liver lesions seen, using the second generation US contrast media. The common pitfalls for each type of lesion are discussed. The recent developments in US contrast media and specific imaging techniques have been a major advance and this technique, in view of the intrinsic advantages of US, will undoubtedly gain popularity in the years to come.

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Noninvasive and Invasive Imaging of the Liver and Biliary Tract

Das

Morgan

Ginsberg

2017

Schiff's Diseases of the Liver

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An Algorithm for the Diagnosis of Focal Liver Masses Using Microbubble Contrast-Enhanced Pulse-Inversion Sonography

Abstract: A simple diagnostic algorithm for interpretation of microbubble-enhanced sonography provides sensitive and accurate diagnosis of commonly encountered liver masses.

Cited by 163 publications

References 26 publications

Contrast-enhanced ultrasound in diagnosis and characterization of focal hepatic lesions

Contrast-enhanced ultrasound in diagnosis and characterization of focal hepatic lesions

Use of second generation contrast-enhanced ultrasound in the assessment of focal liver lesions

Noninvasive and Invasive Imaging of the Liver and Biliary Tract

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