title: The contribution of contrast enhanced ultrasound for the characterization of benign liver lesions in clinical practice - a monocentric experience.
abstract: BACKGROUND
  Contrast-enhanced ultrasound (CEUS) uses second generation microbubble contrast agents and is considered to be a useful imaging method for focal liver lesions (FLLs) characterization.
  
  
  OBJECTIVE
  To observe if CEUS increases the diagnostic performance of benign FLLs as compared with standard ultrasonography examination (US).
  
  
  METHODS
  This is a single centre study developed during September 2009- December 2011 in the Department of Gastroenterology and Hepatology,  in Timisoara. We evaluated 386 benign FLLs diagnosed by means of CEUS. Before performing CEUS, all FLLs were examined by US and Power Doppler techniques. At CEUS, the benign nature of a lesion was established by the absence of washout in the portal and late phase. The typical features observed using contrast, allowed their classification in a particular type of pathology, according to the 2008 EFSUMB Guidelines.
  
  
  RESULTS
  From 386 benign FLLs, 81 (20.9%) of them were diagnosed in patients with chronic liver disease, while 305 (79.1%) were in patients without chronic hepatopathy. In 355 (92%) cases CEUS established a particular type of pathology. The most frequent lesions were: hemangiomas (37.5%), focal fatty alterations (24.8%), complex cysts (10.7%) and regenerative nodules (11.8%). Based on US we correctly estimated the positive diagnosis in 55.7% cases and using CEUS, the diagnostic performance increased up to 92%.
  
  
  CONCLUSIONS
  In our study, by means of US the estimate positive diagnosis was made in 55.7% of cases. CEUS properly characterized 92% of benign FLLs and increased the diagnostic performance of these lesions, as compared with US.
authors.affiliation: Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy, Timisoara, Romania. florentina2206@yahoo.com
authors.forename: Alina
authors.initials: A
authors.lastname: Martie
authors.forename: Simona
authors.initials: S
authors.lastname: Bota
authors.forename: Ioan
authors.initials: I
authors.lastname: Sporea
authors.forename: Roxana
authors.initials: R
authors.lastname: Sirli
authors.forename: Alina
authors.initials: A
authors.lastname: Popescu
authors.forename: Mirela
authors.initials: M
authors.lastname: Danila
mesh_terms: D003287:Contrast Media; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010743:Phospholipids; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D012383:Romania / Q000453:epidemiology; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride; D014463:Ultrasonography / Q000706:statistics & numerical data*
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride