[Detection of liver lesions by contrast-enhanced ultrasound -- comparison to intraoperative findings]

Evaluation of b-mode and colour-duplex imaging, contrast-enhanced ultrasound (CEUS) and CT for the detection of liver lesions in comparison to intraoperative and histological findings.

Before laparotomy, 100 patients with suspected liver lesions were prospectively examined with b-mode and colour-duplex imaging followed by contrast-enhanced ultrasound (SonoVue) and CT-scan. Patients with nonresectable tumours (n=44) were excluded from the analysis. The diagnostic findings of 56 patients who displayed liver lesions were compared to the intraoperative and histological findings.

CEUS enhanced the sensitivity for the number of detected lesions from 53 % (b-mode) to 86 % (CEUS) (p = 0.001), while CT-scan reached 76 %. The specificity of the three methods differed only slightly (87 % to 89 %). Contrast agents lead to an improvement in the results of ultrasound, particularly in cases of nodular metastases smaller than one centimeter (n = 7), after adjuvant chemotherapy (n = 4), near the surface (n = 6) and in lesions situated around the Lig. teres (n = 6).

CEUS leads to a significant improvement in the detection of liver lesions. For patients after adjuvant chemotherapy as well as for cases of small nodular metastases a CEUS should be carried out as a routine.