title: Detection of hepatic metastases with low MI real time contrast enhanced sonography and SonoVue.
abstract: OBJECTIVE
  SonoVue is the first ultrasound contrast agent which allows repeated continuous examination of the liver in real time. The aim of this study was to compare low mechanical index (MI) real time contrast enhanced ultrasound of the liver, using the contrast agent SonoVue, with conventional B-mode sonography for the detection of hepatic metastases.
  
  
  METHODS
  40 patients with known malignancy and at least one liver lesion on conventional B-mode sonography were included. Conventional B-mode sonography was performed followed by contrast enhanced ultrasound (CEUS) of the liver in the arterial (< 30 sec), portal-venous (40-120 sec) and delayed phase (> 120 sec) after injection of SonoVue. CEUS was performed using contrast specific imaging and low MI (< 0.3). Number, location and size of metastases on baseline and CEUS were compared with CT or MRI (blinded reader).
  
  
  RESULTS
  37 patients had 128 metastases on CT or MRI. Baseline US showed 74 metastases confirmed by reference examination (69%), while CEUS yielded 109 metastases (sensitivity 90%) (p < 0.001). On CEUS, 35 additional metastases not seen on baseline but confirmed by reference imaging were detected in 14 patients (36%). In 8 patients, CEUS showed 13 metastases not seen on reference imaging.
  
  
  CONCLUSIONS
  Detection of hepatic metastases is substantially improved by low MI real time contrast enhanced ultrasound with SonoVue compared to conventional B-mode sonography.
authors.affiliation: Klinik und Poliklinik für Radiologie und Nuklearmedizin, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin. anja.oldenburg@charite.de
authors.forename: A
authors.initials: A
authors.lastname: Oldenburg
authors.forename: J
authors.initials: J
authors.lastname: Hohmann
authors.forename: E
authors.initials: E
authors.lastname: Foert
authors.forename: J
authors.initials: J
authors.lastname: Skrok
authors.forename: C W
authors.initials: CW
authors.lastname: Hoffmann
authors.forename: B
authors.initials: B
authors.lastname: Frericks
authors.forename: K J
authors.initials: KJ
authors.lastname: Wolf
authors.forename: T
authors.initials: T
authors.lastname: Albrecht
mesh_terms: D000368:Aged; D003287:Contrast Media; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media