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Contrast-enhanced ultrasound (CEUS) in hepatic lymphoma: retrospective evaluation in 38 cases
C Trenker1, S Kunsch2, P Michl2
1Interdisziplinäres Ultraschallzentrum, Universitätsklinikum Giessen und Marburg, Standort Marburg.
Insights
Contrast-enhanced ultrasound (CEUS) reveals varied arterial phase enhancement in hepatic lymphomas. In the late phase, these lymphomas consistently show hypoenhancement, aiding in lesion differentiation.
Area of Science:
- Radiology
- Hepatology
- Oncology
Background:
- Hepatic lymphoma diagnosis can be challenging.
- Distinguishing liver lesions requires advanced imaging techniques.
Purpose of the Study:
- To describe contrast-enhanced ultrasound (CEUS) patterns of hepatic lymphoma.
- To evaluate CEUS for differentiating hepatic lesions.
Main Methods:
- A study of 38 patients with hepatic lymphoma was conducted.
- Contrast-enhanced ultrasound (CEUS) was performed prior to B-mode imaging.
- Lesion enhancement patterns were analyzed during arterial, portal, and late phases.
Main Results:
- B-mode imaging showed hypoechoic lesions in 97.4% of cases.
- CEUS revealed diverse arterial phase enhancement (hyper-, iso-, hypoenhanced).
- All lesions demonstrated hypoenhancement in the late phase ('wash-out').
Conclusions:
- Hepatic lymphomas exhibit variable arterial CEUS patterns.
- Late-phase hypoenhancement is a characteristic finding.
- CEUS aids in evaluating malignancy but cannot definitively distinguish all liver lesions.
Purpose:
Description of contrast-enhanced ultrasound (CEUS) patterns of hepatic lymphoma.
Materials And Methods:
Over a period of 6 years and 1 month from January 2006 to January 2012, n = 38 patients with histological or clinically apparent hepatic lymphoma were studied by means of CEUS prior to B-mode imaging.
Results:
Using B-mode imaging, lesions were hypoechoic in n = 37 (97.4 %) cases, while a focal lymphoma lesion was echo-rich in 1 case (2.6 %). For comparison, with CEUS, a hyperenhanced signal during the arterial phase was observed in n = 9 (23.7 %), an isoenhanced signal in n = 17 (44.7 %) and a hypoenhanced signal in n = 12 (31.6 %) cases. During the portal phase n = 2 (5.3 %) lesions were isoenhanced and n = 36 (94.7 %) were hypoenhanced followed by a hypoenhancement in n = 38 (100 %) cases in the late phase.
Conclusion:
Lymphomas of the liver can cause different contrast accumulation in the arterial phase of CEUS. Furthermore, a clear differentiation from other malignant liver lesions such as metastases is crucial as different contrast accumulation in the arterial phase of CEUS is observed. In the late phase, hepatic lymphomas lead to a hypoenhancement in CEUS, also known as a "wash-out" phenomenon. In conclusion, CEUS is helpful to differentiate hepatic lesions by means of evaluating the malignancy or benignancy. In this regard, the application of CEUS can help to find the right diagnosis. A final discrimination between malignant liver lesions, such as liver lymphomas, metastasis or HCC, remains impossible.
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