title: Improvement in the routine diagnostic assessment of the liver by high-resolution sonography: an analysis of 999 cases.
abstract: OBJECTIVE
  High-frequency ultrasound transducers have been helpful in certain settings of transabdominal ultrasound examination, and their role in the evaluation of the liver surface in patients with cirrhosis is well documented. However, their value in the routine assessment of the liver has not yet been analysed systematically. The aim of this pilot study was to clarify whether the additional use of high-frequency ultrasound as compared to the standard 3.5 MHz-transducer is of any benefit.
  
  
  METHODS
  A total of 999 patients from a tertiary care medical centre were examined with a wideband 3.5 MHz- and a high-frequency transducer (band width 4.5 to 10 MHz) with tissue harmonic imaging using one of two high-end ultrasound machines (Siemens Sonoline Elegra or Hitachi EUB-8500). Findings on hepatic pathologies were collected on a standardized documentation sheet and were evaluated using descriptive statistics.
  
  
  RESULTS
  In all, 948 patients showed a plain liver surface when the 3.5 MHz transducer was used, whereas this was only true for 862 patients examined with the high-frequency probe. Using the 7.5 MHz probe, the structure of the liver parenchyma appeared to be homogeneous (n=800; 80.1%) less often than when the 3.5 MHz probe (n=822; 82.3%) was used. More cases of liver cirrhosis were suspected with the high-frequency probe (n=66; 6.6% as compared with n=49; 4.9%). In 85 patients (8.5%) new hepatic pathologies were described which had not been detected with the 3.5 MHz probe. The examiners judged the high-frequency examination to be helpful in 284 cases. The time needed for the additional examination ranged between 0.5 and 10 min (mean: 2.2 min).
  
  
  CONCLUSIONS
  This study demonstrates that the additional use of a high-frequency transducer during routine abdominal examinations reveals new hepatic pathologies in a significant proportion of examined patients, without substantial prolongation of the overall examination period.
authors.affiliation: Department of Internal Medicine I, University of Regensburg, Regensburg, Germany. doris.schacherer@klinik.uni-regensburg.de
authors.forename: Doris
authors.initials: D
authors.lastname: Schacherer
authors.forename: Carola
authors.initials: C
authors.lastname: Schuh
authors.forename: Ulrike
authors.initials: U
authors.lastname: Strauch
authors.forename: Boris
authors.initials: B
authors.lastname: Ehrenstein
authors.forename: Reiner
authors.initials: R
authors.lastname: Wiest
authors.forename: Juergen
authors.initials: J
authors.lastname: Schölmerich
authors.forename: Klaus
authors.initials: K
authors.lastname: Schlottmann
authors.forename: Frank
authors.initials: F
authors.lastname: Klebl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D005260:Female; D005858:Germany; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D014159:Transducers; D018084:Ultrasonography, Interventional / Q000295:instrumentation