Contrast Enhanced Ultrasound for the evaluation of focal liver lesions in daily practice. A multicentre study.
OBJECTIVE
Development of contrast specific ultrasound techniques and introduction of the second-generation ultrasound contrast agents have improved the ability of this technique in detecting and characterizing focal liver lesions (FLLs). The purpose of this study was to present the experience of four Romanian centers in the evaluation of FLLs by contrast enhanced ultrasound (CEUS), in daily practice.


METHODS
We performed a multicentre retrospective study, including 1244 FLLs, evaluated by means of CEUS in four Romanian centers with extensive experience in ultrasound, during September 2009-December 2010.


RESULTS
This study included 1244 FLLs, both "de novo" (1056 cases) and pre-existing (such as hepatocellular carcinomas evaluated after percutaneous treatment to assess the treatment results). In 1046/1244 of cases (84.1%), CEUS showed a typical pattern of enhancement (according to the EFSUMB Guidelines 2008), thus being sufficient for a correct and final diagnosis, while in 198/1244 of cases (15.9%), other methods of diagnosis were required, such as contrast CT/MRI or biopsy. In our study, CEUS established the benign or malignant nature of lesions in 1139/1244 of cases (91.5%).


CONCLUSIONS
According to our results, CEUS could be the first imaging method of diagnosis for uncharacteristic FLLs detected by standard ultrasound, providing a correct classification in 84.1% of cases and a correct differentiation between benign/malignant lesions in 91.5% of cases. Thus, when faced with an uncharacteristic FLL on standard ultrasound, our local strategy is to perform CEUS as a first-line imaging investigation.
Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy Timişoara, Romania. isporea@umft.ro
Ioan
I
Sporea
Radu
R
Badea
Alina
A
Martie
Eugen
E
Dumitru
Simona
S
Ioaniţescu
Roxana
R
Şirli
Mihai
M
Socaciu
Alina
A
Popescu
Mirela
M
Dănilă
Mihai
M
Voiculescu
D003287:Contrast Media / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D012383:Romania / Q000453:epidemiology; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014463:Ultrasonography / Q000706:statistics & numerical data*; D014600:Utilization Review
D003287:Contrast Media