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Related Experiment Videos

Pulse-inversion harmonic imaging improves lesion conspicuity during US-guided biopsy.

Jean-Yves Meuwly1, Pierre Schnyder, François Gudinchet

  • 1Department of Diagnostic and Interventional Radiology, University Hospital, Rue du Bugnon 46, Lausanne, Switzerland. Meuwly@chuv.hospvd.ch

Journal of Vascular and Interventional Radiology : JVIR
|March 13, 2003
PubMed
Summary

Pulse-inversion harmonic imaging (PIHI) enhances the visibility of challenging liver lesions for biopsy. This ultrasound technique improves targeting accuracy and safety for focal liver lesions lacking conspicuity on conventional ultrasound.

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Area of Science:

  • Medical Imaging
  • Interventional Radiology
  • Hepatology

Background:

  • Percutaneous biopsy of focal liver lesions is crucial for diagnosis.
  • Lesions with low conspicuity on conventional ultrasound pose a challenge for accurate targeting.
  • Advanced imaging techniques are needed to improve biopsy guidance for subtle lesions.

Purpose of the Study:

  • To evaluate the feasibility of using pulse-inversion harmonic imaging (PIHI) for percutaneous biopsy of low-conspicuity focal liver lesions.
  • To assess PIHI guidance in the late phase after microbubble contrast agent injection.
  • To determine if PIHI improves lesion targeting compared to conventional ultrasound.

Main Methods:

  • A prospective study involving 12 patients with low-conspicuity liver lesions underwent biopsy with PIHI guidance after Levovist injection.

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  • Lesion conspicuity, procedure time, number of passes, and complication rates were recorded.
  • Results were compared to a control group of 19 patients who had conventional ultrasound-guided biopsies.

    • Main Results:

    • PIHI guidance significantly enhanced lesion conspicuity in all cases after contrast injection.
    • The PIHI group experienced longer procedure times (66 min vs. 33 min) and required more passes (1.9 vs. 1.4).
    • No significant differences were found in biopsy success or complication rates between the PIHI and conventional ultrasound groups.

    Conclusions:

    • Late-phase PIHI with Levovist provides clear delineation of focal liver lesions, enabling accurate and safe sampling.
    • This technique expands the utility of ultrasound-guided biopsy to lesions previously difficult to target.
    • PIHI offers a valuable tool for improving percutaneous biopsy of challenging liver lesions.