title: Clinical evaluation of contrast-enhanced color Doppler sonography in the differential diagnosis of liver tumors.
abstract: OBJECTIVE
  We investigated the value of contrast-enhanced color Doppler sonography in the differential diagnosis of liver tumors.
  
  
  METHODS
  We prospectively examined 105 focal liver lesions in 100 patients by real-time gray-scale sonography, color Doppler sonography, and contrast-enhanced color Doppler sonography with galactose-based microbubbles (SH U 508A; Levovist). The final diagnoses of the liver lesions as confirmed by pathology or additional imaging techniques were 31 metastases, 25 hemangiomas, 19 hepatocellular carcinomas, 19 focal nodular hyperplasias, 2 cholangiocellular carcinomas, and 9 other lesions.
  
  
  RESULTS
  Vascularity could be detected in 43 (41%) of the 105 lesions by conventional color Doppler sonography compared to 67 (64%) by contrast-enhanced color Doppler sonography. Contrast-enhanced color Doppler sonography identified moderate or extensive vascularity in all 19 focal nodular hyperplasias, moderate or extensive vascularity in 16 hepatocellular carcinomas and both cholangiocellular carcinomas, and no or minor vascularity in all but 3 hemangioma. The combination of gray-scale, conventional color Doppler, and contrast-enhanced color Doppler sonography led to the correct diagnosis in 81% of cases (85 of 105), compared to 57% (60/105) for gray-scale and conventional color Doppler sonography and 31% (33/105) for gray-scale sonography alone.
  
  
  CONCLUSIONS
  Contrast-enhanced color Doppler sonography improves the detection of tumor vascularity and is useful in the differential diagnosis of liver lesions.
authors.affiliation: Department of Medicine I, Division of Ultrasound Diagnostics, Friedrich-Alexander University of Erlangen-Nuremberg, Krankenhausstrasse 12, 91054 Erlangen, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Strobel
authors.forename: U
authors.initials: U
authors.lastname: Krodel
authors.forename: P
authors.initials: P
authors.lastname: Martus
authors.forename: E G
authors.initials: EG
authors.lastname: Hahn
authors.forename: D
authors.initials: D
authors.lastname: Becker
mesh_terms: D016001:Confidence Intervals; D003287:Contrast Media / Q000008:administration & dosage*; D003937:Diagnosis, Differential; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color / Q000379:methods*
chemical_list: D003287:Contrast Media