title: Liver haemangiomas undetermined at grey-scale ultrasound: contrast-enhancement patterns with SonoVue and pulse-inversion US.
abstract: The objective of this study was to describe the spectrum of contrast-enhancement patterns of hepatic haemangiomas undetermined at grey-scale ultrasound (US) on SonoVue-enhanced pulse-inversion (PI) US. Twenty patients (11 women, nine men) with 35 haemangiomas (size range: 1-7 cm; mean: 3.1 cm) undetermined at baseline US underwent PI at low M.I. (0.05-0.08) after i.v. injection of SonoVue. All haemangiomas were confirmed by typical helical computed tomography (CT) and/or magnetic resonance imaging (MRI) findings. US examinations were videotaped and then reviewed by two experienced radiologists blinded to the final diagnosis. Readers evaluated by consensus the baseline echogenicity and the dynamic enhancement pattern of each lesion, in comparison with adjacent liver parenchyma. After administration of SonoVue, 31/35 (88%) haemangiomas showed peripheral hyperechoic nodules in the arterial phase, followed by progressive centripetal fill-in, which was complete in 25/35 cases and incomplete in 6/35 cases. Three out of 35 (9%) haemangiomas showed rapid and complete fill-in in the arterial phase, which persisted in the portal and delayed phases. Finally, 1/35 haemangiomas (3%) showed a rim of arterial contrast enhancement with progressive and complete centripetal fill-in in portal-venous and delayed phases. In conclusion, PI after the administration of SonoVue enabled the depiction of typical contrast-enhancement patterns in haemangiomas undetermined at baseline US.
authors.affiliation: Department of Radiology, University of Palermo, Via Del Vespro 127, 90127 Palermo, Italy. tv_bartolotta@yahoo.com
authors.forename: Tommaso Vincenzo
authors.initials: TV
authors.lastname: Bartolotta
authors.forename: Massimo
authors.initials: M
authors.lastname: Midiri
authors.forename: Emilio
authors.initials: E
authors.lastname: Quaia
authors.forename: Michele
authors.initials: M
authors.lastname: Bertolotto
authors.forename: Massimo
authors.initials: M
authors.lastname: Galia
authors.forename: Filippo
authors.initials: F
authors.lastname: Cademartiri
authors.forename: Roberto
authors.initials: R
authors.lastname: Lagalla
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D005260:Female; D006391:Hemangioma / Q000000981:diagnostic imaging*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010743:Phospholipids; D011446:Prospective Studies; D013459:Sulfur Hexafluoride; D014463:Ultrasonography / Q000379:methods
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride