Contrast enhanced ultrasound for the characterization of focal liver lesions
Ioan Sporea1, Radu Badea, Alina Martie
1Department of Gastroenterology and Hepatology, Victor Babeş University of Medicine and Pharmacy, 13, Snagov str, 300482 Timişoara, Romania. isporea@umft.ro
Aim:
to present the practice of two experienced centres concerning the use of contrast enhanced ultrasound (CEUS) in the characterization of focal liver lesions (FLL).
Material And Method:
A prospective, bicentric study, between 09.2009-09.2010 was undertaken and 729 FLL (506-Center A, 223-Center B) were evaluated. A CEUS examination was considered conclusive, if the FLL had a typical enhancement pattern according to EFSUMB Guidelines.
Results:
From the 729 cases with FLL, 389 (53.4%) were patients without known and 340 (46.6%) with known chronic liver disease. CEUS was conclusive for the diagnosis in 597/729 cases (82%) and allowed the positive diagnosis of benign vs. malignant lesion in 662/729 (90.8%) FLL. For each center independently (Center A vs. Center B) the situation was as follows: conclusive for the diagnosis 390/506 (77.1%) vs 207/223 (92.8%) (p<0.0001), conclusive for the differentiation benign/malignant 449/506 (88.7%) vs. 213/223 (95.5%) (p=0.0032).
Conclusion:
In our bicentric study, CEUS was conclusive for diagnosis in 82% of FLL and the benign or malignant character of a lesion was demonstrated in 90.8% of cases. Thus, when faced with an uncharacteristic FLL on standard ultrasound, our local strategy in both centers was to perform CEUS as a first-line investigation thus avoiding other expensive examinations.
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