title: [Detection of liver metastases--comparison of contrast--enhanced ultrasound using first versus second generation contrast agents].
abstract: OBJECTIVE
  To compare detection rates for liver metastases for conventional ultrasound, US using tissue harmonic imaging (THI), echo-enhanced pulse inversion harmonic imaging using Optison and Levovist.
  
  
  METHODS
  In 73 patients with histologically proven gastrointestinal tumors spiral CT (S-CT), conventional US, US in the THI-mode, echo-enhanced ultrasound in the portal venous phase (ECI Optison ) and in the liver specific late phase (ECI Levovist) were performed and reviewed by blinded readers.
  
  
  RESULTS
  73 patients (25 female, 48 male, age 63 +/- 11) were included. S-CT detected 158 liver metastases. Conventional US detected 117, THI 119, ECI Optison 169 and ECI Levovist 166 liver metastases. Especially for small (< 2 cm) liver metastases and metastases near the diaphragm echo-enhanced ultrasound exceeded conventional US (p < 0.001). Between both echo enhancers there was no significant difference.
  
  
  CONCLUSIONS
  Using echo enhancers increases the ultrasound detection rate significantly. Examination in the portalvenous phase using a second generation enhancer (Optison) is equal to a late-phase examination using Levovist.
authors.affiliation: Medizinische Klinik I mit Poliklinik, FAU Erlangen-Nuremberg, Erlangen. thomas.bernatik@med1.imed.uni-erlangen.de
authors.forename: T
authors.initials: T
authors.lastname: Bernatik
authors.forename: D
authors.initials: D
authors.lastname: Becker
authors.forename: D
authors.initials: D
authors.lastname: Neureiter
authors.forename: J
authors.initials: J
authors.lastname: Hänsler
authors.forename: M
authors.initials: M
authors.lastname: Frieser
authors.forename: S
authors.initials: S
authors.lastname: Schaber
authors.forename: E G
authors.initials: EG
authors.lastname: Hahn
authors.forename: D
authors.initials: D
authors.lastname: Strobel
mesh_terms: D003287:Contrast Media; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography
chemical_list: D003287:Contrast Media