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Focal hepatic lesions: contrast-enhancement patterns at pulse-inversion harmonic US using a microbubble contrast
Eun-A Kim1, Kwon-Ha Yoon, Young Hwan Lee
1Department of Radiology and Institute of Medical Science, Wonkwang University School of Medicine, Jeonbuk, Korea. yoonkh@wmc.wonkwang.ac.kr
Korean Journal of Radiology
|January 17, 2004
Summary
Pulse-inversion harmonic imaging (PIHI) effectively analyzes contrast-enhancement patterns in focal hepatic lesions. These patterns help differentiate hepatocellular carcinoma, metastases, and hemangiomas by revealing tumor vascularity and acoustic emission effects.
Area of Science:
- Medical Imaging
- Hepatology
- Oncology
Background:
- Focal hepatic lesions require accurate differentiation for effective treatment.
- Pulse-inversion harmonic imaging (PIHI) is an advanced ultrasound technique.
- Assessing tumor vascularity and acoustic emission effects aids in lesion characterization.
Purpose of the Study:
- To analyze contrast-enhancement patterns using PIHI in focal hepatic lesions.
- To determine tumor vascularity and acoustic emission effects.
- To establish PIHI's utility in differentiating hepatocellular carcinoma, metastases, and hemangiomas.
Main Methods:
- Reviewed PIHI images from 90 patients with focal hepatic lesions (HCC, metastases, hemangioma).
- Acquired vascular and delayed phase images post-contrast agent injection.
- Classified tumoral vascularity and acoustic emission effects into four patterns.
Main Results:
- Vascular phase: internal vessels in 93% of HCCs, marginal vessels in 83% of metastases, peripheral enhancement in 71% of hemangiomas.
- Delayed phase: inhomogeneous enhancement in 86% of HCCs, hypoechoic in 93% of metastases, reversed echogenicity in 65% of hemangiomas.
- High specificity (≥91%) and positive predictive values (≥71%) for differentiating lesions based on enhancement patterns.
Conclusions:
- PIHI contrast-enhancement patterns effectively depict tumoral vascularity.
- Acoustic emission effects observed in delayed phase images are valuable.
- PIHI aids in differentiating focal hepatic lesions, including HCC, metastases, and hemangiomas.