title: Pyogenic hepatic abscesses: distinctive features from hypovascular hepatic malignancies on contrast-enhanced ultrasound with SH U 508A; early experience.
abstract: The aim of this study was to investigate the feasibility of contrast-enhanced US (conE US) in differentiating pyogenic hepatic abscesses (PyHAs) from hypovascular hepatic malignancies. conE US images of 16 PyHAs in 12 patients were evaluated retrospectively and were compared with those of 22 hypovascular hepatic malignancies in 12 patients. The conE US images were obtained at 30, 90, 150 and 270 s after a bolus injection of 4 g of SH U 508A (Levovist, Schering; 300 mg/mL). The images were specifically analyzed for the shape (round or ovoid, lobulating or coalescent according to the complexity), the margin (sharp or ill-defined), and the pattern of contrast agent enhancement of the lesion (internal and rim enhancement). In our experience, as to the shape of the lesion, PyHAs were usually coalescent (94%), and hepatic malignancies were more frequently round or ovoid (36%) or lobulating (50%) (p < 0.0001). The margin of the lesion was usually sharp in PyHAs (81%), whereas it was more commonly ill-defined (59%) in hepatic malignancies (p = 0.02). Whereas PYHAs usually produced no internal enhancement (94%), diffuse (73%) or peripheral (27%) hypoechoic intratumoral enhancement was seen in hepatic malignancies (p < 0.0001). This study shows that conE US is potentially useful in differentiation of PyHAs from hypovascular hepatic malignancies. PyHAs usually produce characteristic features, such as coalescent appearance, sharp boundary of necrotic cavity, and lack of internal enhancement on conE US.
authors.affiliation: Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Kyoung Won
authors.initials: KW
authors.lastname: Kim
authors.forename: Byung Ihn
authors.initials: BI
authors.lastname: Choi
authors.forename: Seong Ho
authors.initials: SH
authors.lastname: Park
authors.forename: Ah Young
authors.initials: AY
authors.lastname: Kim
authors.forename: Young Hwan
authors.initials: YH
authors.lastname: Koh
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Lee
authors.forename: Joon Koo
authors.initials: JK
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D003937:Diagnosis, Differential; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008100:Liver Abscess / Q000000981:diagnostic imaging* / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides; D012189:Retrospective Studies; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508