Hepatic tumors: US contrast enhancement with CO2 microbubbles.

Abstract

Enhancement of hepatic tumors on sonograms by injection of carbon dioxide microbubbles into the hepatic artery as a contrast material (enhanced ultrasonography) was performed in 43 patients with various histologically confirmed hepatic tumors. Enhanced sonograms were classified into five patterns according to the relative changes of the echo levels between the tumor and the nontumorous parenchyma of the liver as a result of enhancement: hyperechoic change, isoechoic change, hypoechoic change with hyperechoic rim (rim sign), marginal spotty hyperechoic change, and internal spotty hyperechoic change. Eighty-eight percent of hepatocellular carcinomas showed hyperechoic change, 70% of metastatic tumors exhibited hypoechoic change with the rim sign. The marginal spotty hyperechoic change and the internal spotty hyperechoic change were specific for cavernous hemangioma and fibrous granuloma, respectively. This method of enhancement is useful in assessing the nature of liver tumors and in the detection of small nodules in the liver.

Decreased phagocytic activity of Kupffer cells in a rat nonalcoholic steatohepatitis model

“…Until recently, ultrasonography enhanced by CO 2 microbubbles, delivered through an intra-arterial catheter (developed in the 1980s), was the only CEUS technique available [14,15] . The intravenous ultrasonographic contrast agent Levovist ® , available for clinical use in Japan since September 1999, facilitates the hepatic blood flow imaging with an inherently low level of invasiveness [16][17][18][19] .…”

Intraoperative Ultrasound in Patients with Hepatocellular Carcinoma: From Daily Practice to Future Trends

“…Historically, carbon dioxide gas was initially used as contrast medium [16,17]. Then, first-generation contrast media that enabled systemic circulation through pulmonary capillary vessels were developed, but with disparate results [18,19].…”

Contrast‐enhanced power Doppler sonography and helical computed tomography for assessment of vascularity of small hepatocellular carcinomas before and after percutaneous ablation

“…The vascularity pattern on Levovist-enhanced PDI was also assessed and classified according to the sonographic angiography categories described elsewhere. 22,23,31,32 Helical CT. Helical CT of the liver was performed using a Somatom Plus 4 scanner (Siemens, Erlangen, Germany). The non-ionic iodine contrast agent (120 ml of Omnitrast 300; Schering) was injected at a rate of 4 ml/second.…”