Advertisement

Real-time contrast-enhanced ultrasound imaging of focal liver lesions in fatty liver

  • Guang-Jian Liu
    Affiliations
    Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
    Search for articles by this author
  • Wei Wang
    Affiliations
    Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
    Search for articles by this author
  • Xiao-Yan Xie
    Affiliations
    Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
    Search for articles by this author
  • Hui-Xiong Xu
    Affiliations
    Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
    Search for articles by this author
  • Zuo-Feng Xu
    Affiliations
    Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
    Search for articles by this author
  • Yan-Ling Zheng
    Affiliations
    Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
    Search for articles by this author
  • Jin-Yu Liang
    Affiliations
    Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
    Search for articles by this author
  • Fuminori Moriyasu
    Affiliations
    Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
    Search for articles by this author
  • Ming-De Lu
    Correspondence
    Corresponding author. Department of Hepatobiliary Surgery, The First Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou 510080, People's Republic of China. Tel.: +86 20 87765183; fax: +86 20 87765183.
    Affiliations
    Department of Hepatobiliary Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
    Search for articles by this author
Published:September 25, 2009DOI:https://doi.org/10.1016/j.clinimag.2009.07.003

      Abstract

      Purpose

      The objective of this study was to investigate the contrast-enhanced ultrasound (CEUS) imaging features of focal liver lesions (FLLs) in fatty liver.

      Method

      One hundred FLLs in 98 patients with fatty liver were evaluated with real-time CEUS.

      Results

      All malignant FLLs showed hyperenhancement in arterial phase and contrast washout in portal and late phases. Among the FLLs, 3.3% of hemangiomas, 12.5% of focal nodular hyperplasias (FNHs), and 2.5% of focal fatty sparing lesions showed contrast washout in the late phase. The sensitivity and specificity for the characterization of hepatocellular carcinoma, metastasis, hemangioma, FNH, and focal fatty sparing lesions were 100% and 95.6%, 60% and 100%, 93.3% and 98.6%, 87.5% and 97.8%, and 92.6% and 100%, respectively.

      Conclusions

      Correct characterization of FLLs in fatty liver by CEUS is possible based on their typical enhancement patterns.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Clinical Imaging
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Claudon M
        • Cosgrove D
        • Albrecht T
        • et al.
        Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS)—update 2008.
        Ultraschall Med. 2008; 29: 28-44
        • Quaia E
        • Caliada F
        • Bertolotto M
        • et al.
        Characterization of focal liver lesions with contrast-specific US modes and a sulfur hexafluoride-filled microbubble contrast agent: diagnostic performance and confidence.
        Radiology. 2004; 232: 420-430
        • von Herbay A
        • Vogt C
        • Willers R
        • Häussinger D
        Real-time imaging with the sonographic contrast agent SonoVue: differentiation between benign and malignant hepatic lesions.
        J Ultrasound Med. 2004; 23: 1557-1568
        • Ding H
        • Wang WP
        • Huang BJ
        • et al.
        Imaging of focal liver lesions: low-mechanical-index real-time ultrasonography with SonoVue.
        J Ultrasound Med. 2005; 24: 285-297
        • Xu HX
        • Liu GJ
        • Lu MD
        • et al.
        Characterization of small focal liver lesions using real-time contrast-enhanced sonography: diagnostic performance analysis in 200 patients.
        J Ultrasound Med. 2006; 25: 349-361
        • Konno K
        • Ishida H
        • Sato M
        • et al.
        Liver tumors in fatty liver: difficulty in ultrasonographic interpretation.
        Abdom Imaging. 2001; 26: 487-491
        • Jeffrey RB
        • Ralls PW
        The liver.
        in: Jeffrey RB Ralls PW Sonography of the abdomen. Raven Press, New York1995: 71-170
        • Fracanzani AL
        • Burdick L
        • Borzio M
        • et al.
        Contrast-enhanced Doppler ultrasonography in the diagnosis of hepatocellular carcinoma and premalignant lesions in patients with cirrhosis.
        Hepatology. 2001; 34: 1109-1112
        • Kim SH
        • Lee JM
        • Lee JY
        • et al.
        Value of contrast-enhanced sonography for the characterization of focal hepatic lesions in patients with diffuse liver disease: receiver operating characteristic analysis.
        AJR Am J Roentgenol. 2005; 184: 1077-1084
        • Bartolotta TV
        • Taibbi A
        • Galia M
        • et al.
        Characterization of hypoechoic focal hepatic lesions in patients with fatty liver: diagnostic performance and confidence of contrast-enhanced ultrasound.
        Eur Radiol. 2007; 17: 650-661
        • Bartolotta TV
        • Midiri M
        • Galia M
        • et al.
        Characterization of benign hepatic tumors arising in fatty liver with SonoVue and pulse inversion US.
        Abdom Imaging. 2007; 32: 84-91
        • Scatarige JC
        • Scott WW
        • Donovan PJ
        • Siegelman SS
        • Sanders RC
        Fatty infiltration of the liver: ultrasonographic and computed tomographic correlation.
        J Ultrasound Med. 1984; 3: 9-14
        • Jacobs JE
        • Birnbaum BA
        • Shapiro MA
        • et al.
        Diagnostic criteria for fatty infiltration of the liver on contrast-enhanced helical CT.
        AJR Am J Roentgenol. 1998; 171: 659-664
        • Burns PN
        Instrumentation for contrast echocardiography.
        Echocardiography. 2002; 19: 241-258
        • Wilson SR
        • Kim TK
        • Jang HJ
        • Burns PN
        Enhancement patterns of focal liver masses: discordance between contrast-enhanced sonography and contrast-enhanced CT and MRI.
        AJR Am J Roentgenol. 2007; 189: W7-W12
        • Lin LW
        • Yang JJ
        • Lin XY
        • et al.
        Effect of fatty liver background on contrast-enhanced ultrasonographic appearance of focal nodular hyperplasia.
        Hepatobiliary Pancreat Dis Int. 2007; 6: 610-615
        • Bartolotta TV
        • Midiri M
        • Scialpi M
        • et al.
        Focal nodular hyperplasia in normal and fatty liver: a qualitative and quantitative evaluation with contrast-enhanced ultrasound.
        Eur Radiol. 2004; 14: 583-591
        • Liu GJ
        • Lu MD
        • Xu HX
        • et al.
        Real-time contrast-enhanced ultrasound imaging of infected focal liver lesions.
        J Ultrasound Med. 2008; 27: 657-666
        • Catalano O
        • Sandomenico F
        • Raso MM
        • Siani A
        Low mechanical index contrast-enhanced sonographic findings of pyogenic hepatic abscess.
        AJR Am J Roentgenol. 2004; 182: 447-450
        • Xu HX
        • Lu MD
        • Liu GJ
        • et al.
        Imaging of peripheral cholangiocarcinoma with low-mechanical index contrast-enhanced sonography and SonoVue: initial experience.
        J Ultrasound Med. 2006; 25: 23-33
        • Sherlock S
        • Dooley J
        Nutritional and metabolic liver diseases.
        in: Sherlock S Dooley J Diseases of the liver and biliary system. Blackwell Sciences, London1997: 427-454
        • Veenhuizen JJ
        • Drackley JK
        • Richard MJ
        • et al.
        Metabolic changes in blood and liver during development and early treatment of experimental fatty liver and ketosis in cows.
        J Dairy Sci. 1991; 74: 4238-4253