[Focal liver lesions: clinical usefulness of contrast-enhanced ultrasound in the selection of surgical patients].
The aim of the study was to evaluate the role of contrast-enhanced ultrasound (CEUS) in the characterisation of focal liver lesions and for the selection of surgical patients. One hundred and thirty-five consecutive patients (71 women, 64 men) with 165 focal liver lesions (mean size: 3.1 cm)--89 benign (10 simple cysts, 26 haemangiomas, 29 focal nodular hyperplasia, 2 hepatocellular adenomas, 11 focal fatty sparing, 3 focal fatty areas, 5 regenerative nodules, 2 hydatid cysts, 1 abscess) and 76 malignant (47 metastases, 26 hepatocellular carcinomas and 3 peripheral cholangiocarcinomas)--underwent CEUS after the administration of SonoVue. Two radiologists reviewed baseline US and CEUS scans obtained 25-30 sec (arterial phase), 55-80 sec (portal-venous phase), and 235-260 sec (late phase) after initiating SonoVue injection, respectively. The radiologists classified each lesion as malignant or benign on the basis of clearly defined diagnostic criteria. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were calculated. CEUS correctly characterised 156/165 focal liver lesions (94.5%), 85 benign and 71 malignant. Five focal liver lesions (3%; 3 haemangiomas and 2 hepatocellular carcinomas) remained undetermined after CEUS and 4 focal liver lesions (2.4%; 3 hepatocellular carcinomas and 1 abscess) were misdiagnosed. CEUS presented sensitivity, specificity, and diagnostic accuracy values of 93.4%, 95.5% and 94.7% respectively. Positive and negative predictive values were 94.7% and 94.4%, respectively. CEUS is a useful tool in the characterisation of focal liver lesions and for selecting surgical patients.
Bartolotta
Tommaso Vincenzo
TV
Unità Interdipartimentale per lo Screening, la Diagnosi ed il Trattamento delle Neoplasie Epatiche, Università degli Studi di Palermo, Dipartimento di Biotecnologie Mediche e Medicina Legale, Divisione di Scienze Radiologiche.
Sandonato
Luigi
L
Taibbi
Adele
A
Latteri
Stefania
S
Soresi
Maurizio
M
Lombardo
Giuseppina
G
Genova
Claudio
C
Latteri
Mario Adelfio
MA
D018248:Adenoma, Liver Cell / Q000000981:diagnostic imaging / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000601:surgery; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging / Q000601:surgery; D003287:Contrast Media; D003560:Cysts / Q000000981:diagnostic imaging / Q000601:surgery; D003937:Diagnosis, Differential; D004444:Echinococcosis, Hepatic / Q000000981:diagnostic imaging / Q000601:surgery; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D020518:Focal Nodular Hyperplasia / Q000000981:diagnostic imaging / Q000601:surgery; D006391:Hemangioma / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D018084:Ultrasonography, Interventional / Q000379:methods
D003287:Contrast Media