Incidental focal solid liver lesions: diagnostic performance of contrast-enhanced ultrasound and MR imaging.
OBJECTIVE
To prospectively assess the diagnostic performance of contrast-enhanced ultrasound (CEUS) and MR imaging in incidental solid focal liver lesions not characterised on ultrasound.


METHODS
Forty-seven patients with 50 lesions underwent MR imaging and CEUS: 24 focal nodular hyperplasias (FNH), 11 adenomas, 10 haemangiomas, 1 focal fatty change and 4 malignant lesions were identified. Two experienced radiologists randomly reviewed contrast-enhanced MR imaging and CEUS data, and provided the most likely diagnosis. Sensitivity (Se), specificity (Sp), likelihood ratios (LR) and kappa value were calculated.


RESULTS
A histotype diagnosis was obtained in 66-52% with MR imaging and 52-53% with CEUS, respectively, for both readers. Se, Sp and LR for haemangioma were 100-100, 100-100 and 78-78 with MR imaging and 89-89, 100-100 and 68-70 with CEUS; for FNH with MR imaging they were 88-63, 96-100 and 23-34 and 74-67, 88-96 and 6-17 with CEUS. If the diagnosis of haemangioma was uncertain with CEUS, MR imaging always confirmed the diagnosis. If the diagnosis of FNH was uncertain with either CEUS or MR imaging, the other imaging technique confirmed the diagnosis in approximately half the cases.


CONCLUSIONS
Both CEUS and MR imaging have a high diagnostic performance in incidental focal liver lesions and are complementary when diagnosis is uncertain.
Soussan
Michael
M
Department of Radiology, Assistance Publique des Hôpitaux de Paris, APHP, Hôpital Beaujon, Clichy, France.
Aubé
Christophe
C
Bahrami
Stéphane
S
Boursier
Jérôme
J
Valla
Dominique Charles
DC
Vilgrain
Valérie
V
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003287:Contrast Media; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011859:Radiography; D014465:Ultrasonics; D014463:Ultrasonography
D003287:Contrast Media