title: Contrast enhancement patterns of hepatic tumours during the vascular phase using coded harmonic imaging and Levovist to differentiate hepatocellular carcinoma from other focal lesions.
abstract: The purpose of the study was to assess contrast enhancement patterns of hepatic tumours during the vascular phase using contrast-enhanced ultrasound and Levovist to differentiate hepatocellular carcinoma from other hepatic tumours. 89 hepatic tumours in 82 consecutive patients were evaluated using coded harmonic ultrasound imaging. The procedure used a phase inversion harmonic technique and coded technology. We observed images for 2 min from the beginning of the administration as the vascular phase using continuous transmission and intermittent transmissions of 1 s or 2 s. The contrast agent Levovist was administered intravenously as a bolus infusion of 2.5 g. Tumour vessels with flow spreading into the tumour and/or homogeneously stained hyperechoic images were observed in 34 of the 41 hepatocellular carcinomas (sensitivity, 82.9%; specificity, 93.8%). Peripheral enhancements were characteristic of intrahepatic cholangiocarcinoma and metastatic hepatic tumours (sensitivity, 60.0% and 83.3%; specificity, 65.5% and 76.4%, respectively). Pooling at the periphery or throughout the tumour was apparent only in haemangioma (sensitivity, 76.5%; specificity, 100%). A tortuous feeding artery and spoke-like vascularization were evident only in the two focal nodular hyperplasias. Contrast-enhanced ultrasound using coded harmonic ultrasound imaging and Levovist provided detailed information about tumour vascularity and contrast enhancement patterns in hepatic tumours.
authors.affiliation: Division of Hepatobiliary Pancreatic Medical Oncology, National Cancer Centre Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Furuse
authors.forename: M
authors.initials: M
authors.lastname: Nagase
authors.forename: H
authors.initials: H
authors.lastname: Ishii
authors.forename: M
authors.initials: M
authors.lastname: Yoshino
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging*; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging; D003287:Contrast Media; D005260:Female; D006391:Hemangioma / Q000000981:diagnostic imaging; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008099:Liver / Q000098:blood supply; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508