Contrast‐enhanced ultrasound with SonoVue: Differentiation between benign and malignant focal liver lesions in 317 patients

Herbay, A. von; Westendorff, Julia; Gregor, Michael

doi:10.1002/jcu.20626

Cited by 86 publications

(88 citation statements)

References 59 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Another advantage is that contrast injection can be repeated if necessary, due to its excellent tolerance [7] . CEUS has a sensitivity of 90%, a specificity of 99% and an accuracy of 89% in diagnosis of malignant liver lesions, as shown in Von Herbay's study [13] . The limits of enhanced-sonography for detection of liver lesions are the same as conventional ultrasonography.…”

Section: Contrast-enhanced Sonographymentioning

confidence: 79%

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

Molins¹

2010

WJR

View full text Add to dashboard Cite

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.

show abstract

Section: Contrast-enhanced Sonographymentioning

confidence: 79%

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

Molins¹

2010

WJR

View full text Add to dashboard Cite

show abstract

“…11a, b). In the detection of splenic metastases CEUS is 38 % more sensitive than Gray-scale US [1,24,25].…”

Section: Splenic Metastasismentioning

confidence: 99%

“…In the parenchymal phase, there is a marked hypo-enhancement after only 60 s in 100 % of cases due to rapid washout [24,30]. The main difference between benign and malignant splenic focal lesions is evidenced at CEUS by the different dynamics of uptake and washout of sulfur hexafluoride contrast agent in the arterial and parenchymal phase.…”

Section: Splenic Lymphomamentioning

confidence: 99%

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

“…3,10 Malignant splenic lesions characteristically demonstrate low level early diffuse or peripheral enhancement followed by washout of microbubbles in the late phases and become progressively hypo-enhancing. 3,11 CEUS can significantly improve the accuracy of diagnosis of focal splenic lesions.…”

Section: Differentiating Benign From Malignant Splenic Massesmentioning

confidence: 99%

“…However, it should be noted that the characteristic benign CEUS features may be less frequently seen in the more typical echogenic lesions than in lesions that are atypical on grey-scale imaging; CEUS is thus more reliable in the iso or hypoechogenic lesions. The nodular, peripheral arterial ehanancement pattern with gradual centripetal filling seen in many liver haemangiomas is uncommon in splenic haemangiomas, 15 and a subset of haemangiomas may be less well enhanced than splenic parenchyma in the late phase and cannot therefore be definitely distinguished from malignant lesions by their CEUS behaviour, 10 although the absence of large intra-lesional vessels makes a benign lesion more likely. 11 Hamartomas are uncommon benign splenic masses; they are sometimes grouped with haemangiomas as 'benign vascular tumours' and will also typically show persistent late-phase enhancement.…”

Section: Differentiating Benign From Malignant Splenic Massesmentioning

confidence: 99%

Contrast‐Enhanced Ultrasound of the Spleen

Encyclopedia of Diagnostic Imaging

View full text Add to dashboard Cite

Abnormalities in the spleen are less common than in most other abdominal organs. However, they will be regularly encountered by ultrasound practitioners, who carefully evaluate the spleen in their abdominal ultrasound studies. Conventional grey scale and Doppler ultrasound are frequently unable to characterise focal splenic abnormalities; even when clinical and laboratory information is added to the ultrasound findings, it is often not possible to make a definite diagnosis. Contrast-enhanced ultrasound (CEUS) is easy to perform, inexpensive, safe and will usually provide valuable additional information about splenic abnormalities, allowing a definitive or short differential diagnosis to be made. It also identifies those lesions that may require further imaging or biopsy, from those that can be safely dismissed or followed with interval ultrasound imaging. CEUS is also indicated in confirming the nature of suspected accessory splenic tissue and in selected patients with abdominal trauma. This article describes the CEUS examination technique, summarises the indications for CEUS and provides guidance on interpretation of the CEUS findings in splenic ultrasound. BMUS members can earn 1 CPD point by reading this approved CPD article and successfully completing the online test. Please go to the members' area of the BMUS website (www.bmus.org) and log into the BMUS CPD system.

show abstract

Contrast‐enhanced ultrasound with SonoVue: Differentiation between benign and malignant focal liver lesions in 317 patients

Abstract: CEUS is helpful in the differentiation between benign and malignant focal liver lesions.

Cited by 86 publications

References 59 publications

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

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

Focal splenic lesions: US findings

Contrast‐Enhanced Ultrasound of the Spleen

Contact Info

Product

Resources

About