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

Morin, S.H.X.; Lim, Adrian; Cobbold, Jeremy; Taylor-Robinson, Simon D

doi:10.3748/wjg.v13.45.5963

Cited by 38 publications

(24 citation statements)

References 47 publications

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“…A hypoechoic mass with irregular thick wall, with internal septa, sometimes containing gas (bright punctate echoes with dirty shadowing), are the most frequent ultrasound features of these lesions, but not specific. CEUS brings several typical elements that lead to a positive diagnosis, such as: marginal rim enhancement in the arterial phase, with enhancement of the septa (honeycomb appearance), with no enhancement in the liquid areas, and venous hypoenhancement [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Does Contrast Enhanced Ultrasound improve the management of liver abscesses? A single centre experience

Spârchez

Radu²,

Kacsó

et al. 2015

Med Ultrason

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Liver abscess is a potentially lethal condition that requires prompt recognition and adequate treatment for a good outcome. The aim of this study was to assess the value of contrast enhanced ultrasound (CEUS) in the management of liver abscesses in the clinical practice of a single centre. Material and methods: A retrospective analysis was performed including all patients diagnosed with liver abscesses during 5 years (2010-2014) in a tertiary Department of Gastroenterology and Hepatology. The demographic data, the presence of risk factors, the cause of liver abscess, the B-mode conventional US aspect, the CEUS appearance and the patient's outcome were documented and analyzed. Results: The study group included 41 patients diagnosed with liver abscesses (17 women and 24 men, mean age 63.3±13.2 years), 16/41 (39%) of them with diabetes mellitus. A single lesion was found in 28 (68.3%) patients, and 13 (31.7%) patients had multiple abscesses. The CEUS study was conclusive for the diagnosis of liver abscess in clinical context in 38/41 cases (92.7%). All conclusive cases presented rim enhancement in the arterial phase and no enhancement in the liquid areas. The honeycomb appearance with septa enhancement was present in 17/41 (41.5%) patients. Washout of the marginal rim was found in 22/41 (53.6%) lesions. Conclusion: In our group the most frequent CEUS features found were the rim enhancement in the arterial phase and the presence of no enhancement areas, followed by the honeycomb appearance. CEUS was able to be conclusive for the diagnosis of liver abscess in almost 93% of cases.

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Section: Introductionmentioning

confidence: 99%

Does Contrast Enhanced Ultrasound improve the management of liver abscesses? A single centre experience

Spârchez

Radu²,

Kacsó

et al. 2015

Med Ultrason

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“…CEUS involves the use of microbubble contrast agents and specialized imaging techniques such as harmonic and pulse inversion imaging to show sensitive blood flow and tissue perfusion information. The introduction of new generation microbubble contrast agents allows real-time imaging, which further improves the characterization and detection of FLLs [7] . CEUS significantly improved the diagnostic performance in small FLLs compared to BUS [8] .…”

Section: Introductionmentioning

confidence: 99%

Detection of focal liver lesions in cirrhotic liver using contrast-enhanced ultrasound

Wong

Xu²,

Xie³

2009

WJR

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Patients with liver cirrhosis are at increased risk of hepatocellular carcinoma (HCC). Conventional or baseline ultrasound (BUS) is often used as the first-line tool for HCC surveillance or detection, but the accuracy of BUS in HCC detection or differentiation from other focal liver lesions (FLLs) is limited. Contrast-enhanced ultrasound (CEUS) represents a recent revolution in the field of ultrasonography and it has become increasingly important in the detection and evaluation of FLLs. In CEUS, HCC typically exhibits arterial hyper-enhancement and portal-venous washout represented by hypoenhanced lesions in the portal venous and late phases. The detection rate of HCC was significantly higher with CEUS compared with BUS. Even regenerative or some dysplastic nodules may exhibit arterial hyperenhancement as they are differentiated from HCC by its iso-enhancing pattern in portal and late phases. The contrast-enhancement patterns of other different types of benign and malignant FLLs, as well as their detection rates with CEUS, were also discussed.

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“…37 Early diagnosis and treatment are critical for increasing survival. 29 CEUS detects HCC with a very high sensitivity of 100%, specificity of 95.6%, PPV of 66.7% and NPV of 100% in comparison to the gold standards of histopathology and CT/MRI. 38 In a multicentric study 14 comparing CEUS with CT and/or dynamic MRI for nodule characterization, CEUS proved to be 30.2% more sensitive in diagnosing malignancy and 16.1% more specific in excluding malignancy with an overall accuracy of 22.9%.…”

Section: A Ceus Patterns Of Benign Fllmentioning

confidence: 96%

“…25 The characteristic pattern seen in 52-88% of cases is peripheral nodular enhancement during AP and gradual central filling during PV and DP. Sustained enhancement during DP is seen in about 83-100% cases 17,24,25,29 ( Figure 1). Small hemangiomas (<15 mm) may show atypical patterns of rapid homogeneous enhancement on CT/MRI, raising suspicion during diagnosis.…”

Section: A Ceus Patterns Of Benign Fllmentioning

confidence: 97%

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Role of contrast enhanced ultrasound in hepatic imaging

Dhamija¹

2014

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Grey scale ultrasound (US) is the first line imaging modality used for the evaluation of liver by the radiologists and clinicians worldwide. It is a simple, inexpensive, safe and an easily available technique. US has the ability to delineate the hepatic parenchyma and differentiate the cystic from solid hepatic lesions. However, it has limited accuracy in the detection and characterization of focal liver lesions (FLL). CEUS is a major breakthrough in ultrasound imaging which evolved with the aim of overcoming these limitations of US. With the use of ultrasound contrast agents(UCAs), CEUS has the ability to detect the intranodular hemodynamics and thereby provide information of the enhancement pattern of the lesion resulting in reliable characterization of the FLL. This capability brings it at par with the cross sectional contrast enhanced imaging techniques of computed tomography and magnetic resonance imaging. UCAs are safe, non-nephrotoxic and thus can be used to evaluate patients with renal failure as well. The technique of CEUS is simple, requires few minutes to perform, portable, lacks ionising radiation and above all is a cost-effective modality. These advantages have made CEUS an established modality for hepatic imaging. Besides detection and characterization of FLL, it also plays a vital role in the management and repeated follow up of treated patients of FLL. Newer clinical applications of CEUS with promising results are also being unravelled .This review highlights the multifaceted role of CEUS in hepatic imaging and its upcoming clinical applications.

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

Cited by 38 publications

References 47 publications

Does Contrast Enhanced Ultrasound improve the management of liver abscesses? A single centre experience

Does Contrast Enhanced Ultrasound improve the management of liver abscesses? A single centre experience

Detection of focal liver lesions in cirrhotic liver using contrast-enhanced ultrasound

Role of contrast enhanced ultrasound in hepatic imaging

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