title: Contrast-enhanced ultrasound (CEUS) in hepatic lymphoma: retrospective evaluation in 38 cases.
abstract: OBJECTIVE
  Description of contrast-enhanced ultrasound (CEUS) patterns of hepatic lymphoma.
  
  
  METHODS
  Over a period of 6 years and 1 month from January 2006 to January 2012, n = 38 patients with histological or clinically apparent hepatic lymphoma were studied by means of CEUS prior to B-mode imaging.
  
  
  RESULTS
  Using B-mode imaging, lesions were hypoechoic in n = 37 (97.4 %) cases, while a focal lymphoma lesion was echo-rich in 1 case (2.6 %). For comparison, with CEUS, a hyperenhanced signal during the arterial phase was observed in n = 9 (23.7 %), an isoenhanced signal in n = 17 (44.7 %) and a hypoenhanced signal in n = 12 (31.6 %) cases. During the portal phase n = 2 (5.3 %) lesions were isoenhanced and n = 36 (94.7 %) were hypoenhanced followed by a hypoenhancement in n = 38 (100 %) cases in the late phase.
  
  
  CONCLUSIONS
  Lymphomas of the liver can cause different contrast accumulation in the arterial phase of CEUS. Furthermore, a clear differentiation from other malignant liver lesions such as metastases is crucial as different contrast accumulation in the arterial phase of CEUS is observed. In the late phase, hepatic lymphomas lead to a hypoenhancement in CEUS, also known as a "wash-out" phenomenon. In conclusion, CEUS is helpful to differentiate hepatic lesions by means of evaluating the malignancy or benignancy. In this regard, the application of CEUS can help to find the right diagnosis. A final discrimination between malignant liver lesions, such as liver lymphomas, metastasis or HCC, remains impossible.
authors.affiliation: Interdisziplinäres Ultraschallzentrum, Universitätsklinikum Giessen und Marburg, Standort Marburg.
authors.forename: C
authors.initials: C
authors.lastname: Trenker
authors.affiliation: Klinik für Innere Medizin, Schwerpunkt Gastroenterologie, Endokrinologie und Stoffwechsel, Universitätsklinikum Gießen und Marburg, Standort Marburg.
authors.forename: S
authors.initials: S
authors.lastname: Kunsch
authors.affiliation: Klinik für Innere Medizin, Schwerpunkt Gastroenterologie, Endokrinologie und Stoffwechsel, Universitätsklinikum Gießen und Marburg, Standort Marburg.
authors.forename: P
authors.initials: P
authors.lastname: Michl
authors.affiliation: Klinik für Innere Medizin, Schwerpunkt Gastroenterologie, Endokrinologie und Stoffwechsel, Universitätsklinikum Gießen und Marburg, Standort Marburg.
authors.forename: T T
authors.initials: TT
authors.lastname: Wissniowski
authors.affiliation: Klinik für Innere Medizin, Schwerpunkt Hämatologie, Onkologie und Immunologie, Universitätsklinikum Giessen und Marburg, Standort Marburg.
authors.forename: K
authors.initials: K
authors.lastname: Goerg
authors.affiliation: Klinik für Innere Medizin, Schwerpunkt Hämatologie, Onkologie und Immunologie, Universitätsklinikum Giessen und Marburg, Standort Marburg.
authors.forename: C
authors.initials: C
authors.lastname: Goerg
mesh_terms: D000328:Adult; D003287:Contrast Media; D005260:Female; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006689:Hodgkin Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000188:drug therapy; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008224:Lymphoma, Follicular / Q000000981:diagnostic imaging* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010743:Phospholipids; D012039:Regional Blood Flow / Q000187:drug effects / Q000502:physiology; D012189:Retrospective Studies; D013459:Sulfur Hexafluoride; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride