Differential Diagnosis of Arterial Phase Enhanced Hepatic Inflammatory Lesions and Hepatocellular Carcinomas with Contrast-enhanced Ultrasound.

Abstract

We aimed to investigate the enhancement patterns of contrast-enhanced ultrasound (CEUS) with SonoVue and determine the utility of this method for differential diagnosis between hepatic inflammatory lesions with arterial phase enhancement and hepatocellular carcinomas (HCC). Twenty-three patients with arterial-enhanced inflammatory liver lesions and 46 HCC patients were included. These lesions had been subjected to CEUS examination and confirmed by pathologic results or imaging follow-up for at least 1 y. In the arterial phase of CEUS, 65.2% of the inflammatory lesions showed patchy (slight enhancement with poorly defined margins) or centripetal enhancement, whereas 89.1% of the HCC lesions showed homogeneous or heterogeneous enhancement (p < 0.001). Moreover, 82.6% of the inflammatory lesions had poorly defined margins, and 78.3% were irregular in shape at the peak, whereas 87.0% of the HCC lesions had well-defined margins and 76.1% were regular (both p < 0.001). Feeding vessels were more frequently visualized in HCCs (71.7%) than in inflammatory lesions (26.1%, p < 0.001). Additionally, 88.2% of the internal non-perfused areas in inflammatory lesions were regular in shape, while 68.0% of these areas in HCCs had an irregular shape (p < 0.001). CEUS pattern analysis provides important information for differentiating inflammatory liver lesions and HCCs and is helpful for improving diagnostic accuracy.

• Authors: Wei Yang, Kun Yan, Song Wang, Ying Dai, Wei Wu, Shan-Shan Yin, Min-Hua Chen
• Journal: Ultrasound in medicine & biology (Ultrasound Med Biol) Vol. 42 Issue 1 Pg. 82-91 (Jan 2016) ISSN: 1879-291X [Electronic] England
• PMID: 26456578 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2016. Published by Elsevier Inc.

Chemical References

• Contrast Media
• Phospholipids
• contrast agent BR1
• Sulfur Hexafluoride

Topics

• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Hepatocellular (diagnostic imaging)
• Contrast Media
• Diagnosis, Differential
• Female
• Humans
• Image Enhancement
• Liver (diagnostic imaging)
• Liver Neoplasms (diagnostic imaging)
• Male
• Middle Aged
• Phospholipids
• Reproducibility of Results
• Sulfur Hexafluoride
• Ultrasonography