title: Contrast-enhanced US with Levovist for the diagnosis of hepatic hemangioma: time-related changes of enhancement appearance and the hemodynamic background.
abstract: OBJECTIVE
  To elucidate the diagnostic confidence of contrast-enhanced ultrasound (CEUS) with Levovist for hepatic hemangioma.
  
  
  METHODS
  The subjects were 34 patients with 38 hemangiomas and 12 patients with 15 hypervascular hepatocellular carcinomas. The early-phase (15-60 second) and liver-specific phase (after 5 min) were observed by the first injection. The 2nd injection was done for solo-phase method to observe liver-specific phase images without taking early-phase sonograms. The 3rd injection was done for changing posture method to observe liver-specific sonograms under left lateral ducubitus position.
  
  
  RESULTS
  In the early-phase of hemangioma, nodular enhancement (NE) was found transiently in 13 lesions (34%) and continuously in 25 lesions (66%), while hepatocellular carcinoma (HCC, n = 15) did not show this pattern. Intratumoral arterioportal shunt was closely related to the short duration of NE. Two enhancement patterns were observed in the liver-specific phase of hemangioma, diffuse in 12 lesions (31%) and partial in 26 lesions (69%), which were dependent on the early-phase enhancement. Liver-specific findings were also affected by taking early-phase sonograms or changing the posture of the patient. This method provided sensitivity of 79% and specificity of 100% for the diagnosis of hemangioma.
  
  
  CONCLUSIONS
  CEUS with Levovist may be promising method for the diagnosis of hepatic hemangioma.
authors.affiliation: Department of Medicine and Clinical Oncology, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Maruyama
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Okugawa
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Yoshizumi
authors.forename: Shoichi
authors.initials: S
authors.lastname: Matsutani
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ebara
authors.forename: Osamu
authors.initials: O
authors.lastname: Yokosuka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006392:Hemangioma, Cavernous / Q000098:blood supply / Q000000981:diagnostic imaging*; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides; D011859:Radiography; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508