Contrast-enhanced ultrasound in diagnosing liver malignancy

Area of Science:

• Radiology
• Medical Imaging
• Hepatology

Background:

• Contrast enhancers significantly expand sonographic imaging capabilities.
• Characteristic enhancement patterns aid in diagnosing focal liver lesions.
• Contrast-enhanced ultrasound (CEUS) is crucial for liver lesion characterization.

Purpose of the Study:

• To evaluate contrast ultrasound signs for diagnosing malignant liver lesions.
• To assess the diagnostic performance of CEUS in differentiating malignant from benign liver lesions.
• To identify specific CEUS patterns indicative of malignancy.

Main Methods:

• 86 patients with 100 solid liver lesions underwent CEUS.
• Low mechanical index CEUS was performed over 300 seconds.
• Histology or CT/NMR confirmed diagnoses; quantitative contrast harmonic imaging (CHI) analyzed perfusion.

Main Results:

• 55 malignant and 45 benign lesions were identified.
• Malignant lesions showed diverse arterial phase patterns (hypervascular, rim enhancement, non-specific vascularization).
• Diminishing contrast agent in the late phase (compared to arterial) was observed in 51/55 malignant lesions, with 93-98% accuracy.

Conclusions:

• Diminishing contrast agent in the late phase is a valuable CEUS sign for malignancy.
• This finding aids in differentiating malignant from benign liver lesions with high accuracy.
• CEUS provides reliable diagnostic information for focal liver lesions.