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3530
P282
Ultrasound in Medicine and Biology
3525 SonoVue enhanced color Doppler ultrasound combined with resistance index improve the differential diagnosis of focal liver lesions Qi Q, Wang W, Wei R, Huang B, Ding H, Zhongshan Hospital, Fudan University, Shanghai, China Objectives: To investigate whether SonoVue enhanced color Doppler ultrasound (CDU) combined with resistance index (RI) can improve the characterization of focal liver lesions and help diagnosis. Methods: One hundred and twenty-four focal liver lesions (32 benign and 92 malignant) were studied with CDU before and after an injection of SonoVue. In the retrospective assessment, the arrival time, time to peak and total time of enhancement duration, and RI of intratumoral arterial flow were analyzed. Results: Before contrast, intratumoral arterial flow could be detected in 53.1% (17/32) benign lesions and 78.3% (72/92) malignant lesions. Mean RI were 0.51 ⫾ 0.08 and 0.77 ⫾ 0.14 (p ⬍ 0.001), respectively. After administration of SonoVue, arterial blood flow could be detected in 75% (24/32) benign lesions and 95.7% (88/92) malignant ones. Mean RI were 0.55 ⫾ 0.09 and 0.79 ⫾ 0.13 (p ⬍ 0.001), respectively. The arrival time, time to peak and total time of enhancement duration in malignant lesions were shorter than in benign ones. Taking presence of intratumoral arterial flow with RI ⱖ 0.60 as criterion of malignant lesion, the diagnostic accuracy increased from 75% (93/124) to 90.3% (112/124) after enhancement. Conclusions: Contrast-enhanced CDU combined with RI can help in revealing the blood supply of the hepatic lesions, consequently improve the diagnostic accuracy. 3527 Contrast-enhanced ultrasonography in the diagnosis of hepatocellular carcinoma and regenerative lesions in patients with cirrhosis Ping Z, The Third Xiangya Hospital, Central South University, Changsha, China Objectives: The aim of this study was to establish whether contrastenhanced ultrasonography (US) is able to distinguish between hepatocellular carcinoma (HCC) and regenerative nodules in cirrhosis. Methods: Sixty-eight cirrhotic patients with 58 HCC, 13 regenerative nodules were examined by using imaging technique of contrast pulse sequence (CPS). All the cases were confirmed by histopathology. The contrast agent used was SonoVue (Bracco, Italy). Results: After injection of SonoVue, 56 (96.6%) cases of HCC were enhanced in early artery phase and immediate or slowly wash out, one case was missed, one case was not enhanced in early artery phase. Ten (76.9%) cases of regenerative nodules were missed, two cases was enhanced in early artery phase and slowly wash out, one case was not enhanced in early artery phase and early portal phase. Conclusions: Contrast-enhanced US is a noninvasive, very sensitive technique in differentiating malignant and regenerative lesions in the liver. 3529 Contrast-agent enhancement patterns for diverse focal hepatic lesions in contrast-enhanced ultrasonography Lee HY, Lee JY, Choi BI, Han JK, Kim SH, Lee JM, Department of Radiology, Seoul National University College of Medicine, Korea Contrast-enhanced ultrasonography has been widely being used for the diagnosis of various focal hepatic lesions in our institute. We have investigated and reported diverse contrast-agent enhancement patterns
Volume 32, Number 5S, 2006 of diverse hepatic focal lesions. The purpose of this exhibit is to show and analyze contrast-agent enhancement patterns of focal hepatic lesions that we have experienced and to provide practical tips for differential diagnosis. It may be helpful to understand characteristic contrastagent enhancement patterns according to kinds of hepatic lesions. 3530 Value of contrast-enhanced ultrasonography with low MI in the diagnosis of small hepatic malignancy Ding H, Wang W-P, Huang B-J, Li C-L, Wei R-X, Zhongshan Hospital of Fudan University, China Objectives: To display the enhancement patterns of small hepatic malignant tumors on contrast-enhanced ultrasonography and to investigate the diagnostic value of contrast-enhanced ultrasonography. Methods: SonoVue-enhanced ultrasonography was performed on 249 cases with 267 hepatic malignant tumors (smaller than 3 cm in diameter, 177 with histopathology), including 218 primary liver carcinomas (PLCs) and 49 metastases. Enhancement patterns and phases of hepatic tumors on ultrasonography were analyzed retrospectively. Results: Most hepatic malignancies enhanced early in arterial phase with an initiation time of 17.1 ⫾ 4.1 s in PLCs and 17.3 ⫾ 3.5 sec in metastases, and enhancement diminished since 78.1 ⫾ 38.4 sec in PLCs and 47.4 ⫾ 18.6 sec in metastases after administration of SonoVue, respectively. There was no statistical difference of enhancement phases between PLCs and metastases. The most common enhancement pattern in PLCs was whole-lesion enhancement, while whole-lesion enhancement and rim-like enhancement were both frequent in metastases. The presence of rim-like enhancement in metastases was significantly higher than that in PLCs. Based on the enhancement phases and patterns of hepatic tumors, the sensitivity for differentiating hepatic malignancies from benign ones was 90.6% (242/267). Conclusions: Based on the microvascular images on contrast-enhanced ultrasonography, hepatic malignancies can be differentiated sensitively. 3532 Contrast-enhanced ultrasound features of liver abscess Xia Y, Jiang Y, Lv K, Peking Union Medical College Hospital, China Objectives: To investigate the features of liver abscess with the contrast-enhanced ultrasound (CEUS). Methods: A total of 193 patients suspicious of liver tumours were examined with CEUS. There were nine patients with liver abscess out of 193 cases. With the pulse inversion harmonic imaging mode, a bolus of 2.4 ml SonoVue was injected intravenously and the liver lesions were observed up to 5 minutes, video clips were stored for offline analysis. The CEUS diagnosis was made on the basis of enhancement patterns and clinical features. The final diagnosis of liver abscess was confirmed by tissue biopsy and follow-up. Results: All nine abscesses were diagnosed correctly on the basis of the enhancement pattern as well as clinical features. The features of liver abscess were variable but different from malignant liver disease on CEUS. Conclusions: Enhancement patterns of the abscess are variable and CEUS will be helpful in the diagnosis of liver abscess. 3533 Enhancement pattern of hepatic hemangioma Huang L, Liu S, Tang S, Xie L, Department Ultrasound, 2nd Hospital of Chinese Medical University, China Objectives: To evaluate the enhancement pattern of hepatic hemangioma with low mechanical index contrast-enhanced ultrasound.
Ultrasound in Medicine and Biology
3525 SonoVue enhanced color Doppler ultrasound combined with resistance index improve the differential diagnosis of focal liver lesions Qi Q, Wang W, Wei R, Huang B, Ding H, Zhongshan Hospital, Fudan University, Shanghai, China Objectives: To investigate whether SonoVue enhanced color Doppler ultrasound (CDU) combined with resistance index (RI) can improve the characterization of focal liver lesions and help diagnosis. Methods: One hundred and twenty-four focal liver lesions (32 benign and 92 malignant) were studied with CDU before and after an injection of SonoVue. In the retrospective assessment, the arrival time, time to peak and total time of enhancement duration, and RI of intratumoral arterial flow were analyzed. Results: Before contrast, intratumoral arterial flow could be detected in 53.1% (17/32) benign lesions and 78.3% (72/92) malignant lesions. Mean RI were 0.51 ⫾ 0.08 and 0.77 ⫾ 0.14 (p ⬍ 0.001), respectively. After administration of SonoVue, arterial blood flow could be detected in 75% (24/32) benign lesions and 95.7% (88/92) malignant ones. Mean RI were 0.55 ⫾ 0.09 and 0.79 ⫾ 0.13 (p ⬍ 0.001), respectively. The arrival time, time to peak and total time of enhancement duration in malignant lesions were shorter than in benign ones. Taking presence of intratumoral arterial flow with RI ⱖ 0.60 as criterion of malignant lesion, the diagnostic accuracy increased from 75% (93/124) to 90.3% (112/124) after enhancement. Conclusions: Contrast-enhanced CDU combined with RI can help in revealing the blood supply of the hepatic lesions, consequently improve the diagnostic accuracy. 3527 Contrast-enhanced ultrasonography in the diagnosis of hepatocellular carcinoma and regenerative lesions in patients with cirrhosis Ping Z, The Third Xiangya Hospital, Central South University, Changsha, China Objectives: The aim of this study was to establish whether contrastenhanced ultrasonography (US) is able to distinguish between hepatocellular carcinoma (HCC) and regenerative nodules in cirrhosis. Methods: Sixty-eight cirrhotic patients with 58 HCC, 13 regenerative nodules were examined by using imaging technique of contrast pulse sequence (CPS). All the cases were confirmed by histopathology. The contrast agent used was SonoVue (Bracco, Italy). Results: After injection of SonoVue, 56 (96.6%) cases of HCC were enhanced in early artery phase and immediate or slowly wash out, one case was missed, one case was not enhanced in early artery phase. Ten (76.9%) cases of regenerative nodules were missed, two cases was enhanced in early artery phase and slowly wash out, one case was not enhanced in early artery phase and early portal phase. Conclusions: Contrast-enhanced US is a noninvasive, very sensitive technique in differentiating malignant and regenerative lesions in the liver. 3529 Contrast-agent enhancement patterns for diverse focal hepatic lesions in contrast-enhanced ultrasonography Lee HY, Lee JY, Choi BI, Han JK, Kim SH, Lee JM, Department of Radiology, Seoul National University College of Medicine, Korea Contrast-enhanced ultrasonography has been widely being used for the diagnosis of various focal hepatic lesions in our institute. We have investigated and reported diverse contrast-agent enhancement patterns
Volume 32, Number 5S, 2006 of diverse hepatic focal lesions. The purpose of this exhibit is to show and analyze contrast-agent enhancement patterns of focal hepatic lesions that we have experienced and to provide practical tips for differential diagnosis. It may be helpful to understand characteristic contrastagent enhancement patterns according to kinds of hepatic lesions. 3530 Value of contrast-enhanced ultrasonography with low MI in the diagnosis of small hepatic malignancy Ding H, Wang W-P, Huang B-J, Li C-L, Wei R-X, Zhongshan Hospital of Fudan University, China Objectives: To display the enhancement patterns of small hepatic malignant tumors on contrast-enhanced ultrasonography and to investigate the diagnostic value of contrast-enhanced ultrasonography. Methods: SonoVue-enhanced ultrasonography was performed on 249 cases with 267 hepatic malignant tumors (smaller than 3 cm in diameter, 177 with histopathology), including 218 primary liver carcinomas (PLCs) and 49 metastases. Enhancement patterns and phases of hepatic tumors on ultrasonography were analyzed retrospectively. Results: Most hepatic malignancies enhanced early in arterial phase with an initiation time of 17.1 ⫾ 4.1 s in PLCs and 17.3 ⫾ 3.5 sec in metastases, and enhancement diminished since 78.1 ⫾ 38.4 sec in PLCs and 47.4 ⫾ 18.6 sec in metastases after administration of SonoVue, respectively. There was no statistical difference of enhancement phases between PLCs and metastases. The most common enhancement pattern in PLCs was whole-lesion enhancement, while whole-lesion enhancement and rim-like enhancement were both frequent in metastases. The presence of rim-like enhancement in metastases was significantly higher than that in PLCs. Based on the enhancement phases and patterns of hepatic tumors, the sensitivity for differentiating hepatic malignancies from benign ones was 90.6% (242/267). Conclusions: Based on the microvascular images on contrast-enhanced ultrasonography, hepatic malignancies can be differentiated sensitively. 3532 Contrast-enhanced ultrasound features of liver abscess Xia Y, Jiang Y, Lv K, Peking Union Medical College Hospital, China Objectives: To investigate the features of liver abscess with the contrast-enhanced ultrasound (CEUS). Methods: A total of 193 patients suspicious of liver tumours were examined with CEUS. There were nine patients with liver abscess out of 193 cases. With the pulse inversion harmonic imaging mode, a bolus of 2.4 ml SonoVue was injected intravenously and the liver lesions were observed up to 5 minutes, video clips were stored for offline analysis. The CEUS diagnosis was made on the basis of enhancement patterns and clinical features. The final diagnosis of liver abscess was confirmed by tissue biopsy and follow-up. Results: All nine abscesses were diagnosed correctly on the basis of the enhancement pattern as well as clinical features. The features of liver abscess were variable but different from malignant liver disease on CEUS. Conclusions: Enhancement patterns of the abscess are variable and CEUS will be helpful in the diagnosis of liver abscess. 3533 Enhancement pattern of hepatic hemangioma Huang L, Liu S, Tang S, Xie L, Department Ultrasound, 2nd Hospital of Chinese Medical University, China Objectives: To evaluate the enhancement pattern of hepatic hemangioma with low mechanical index contrast-enhanced ultrasound.