title: Evaluation of the diagnostic accuracy of CEUS in children with benign and malignant liver lesions and portal vein anomalies.
abstract: OBJECTIVE
  Comparison of the diagnostic findings of MRI, CT and CEUS in children with benign and malignant and portal venous anomalies of the liver.
  
  
  METHODS
  Retrospective analysis of the diagnostic findings of CEUS, MRI and CT scans in 56 children (age 0-17 years) with a total of 60 benign and malignant liver lesions and anomalies of the portal vein/perfusion. All patients underwent CEUS using sulphur hexafluoride microbubbles and a multi-frequency probe (1-5 MHz, 6-9 MHz). Cine-loops were stored up to 3 minutes. MRI was performed in 38 lesions. CT was performed in 8 lesions.
  
  
  RESULTS
  Out of the 56 patients 49 liver lesions (48 benign, 1 malignant), 9 anomalies of the portal vein/perfusion and 2 of the biliary system were detected. 16/49 lesions were analyzed histopathologically. Using CEUS, the characterization of the lesions was possible in 45 out of 49 cases. In 32 cases, CEUS provided the exact diagnosis. Only two benign lesions were falsely categorized as malignant.Findings of MRI and CEUS were concordant in 84% of cases (n = 32/38). CEUS considered 1 benign lesion to be malignant. 2 lesions were not detectable and in 3 lesions no definite diagnosis was established using MRI.Findings of CT and CEUS were concordant in 5 of 8 cases. In 21 lesions CEUS as the only imaging modality was found to be sufficient for diagnostics.
  
  
  CONCLUSIONS
  Despite the restricted indications for using CEUS in children, it offers a high diagnostic detection rate (93%) for characterization of liver lesions and portal vein anomalies.
authors.affiliation: Department of Radiology, University Hospital Regensburg, Franz-Josef-Strauss-Allee, Regensburg, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Pschierer
authors.affiliation: Department of Paediatrics and Juvenile Medicine (KUNO), University Hospital Regensburg, Franz-Josef-Strauss-Allee, Regensburg, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Grothues
authors.affiliation: Department of Radiology, University Hospital Regensburg, Franz-Josef-Strauss-Allee, Regensburg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Rennert
authors.affiliation: Department of Radiology, University Hospital Regensburg, Franz-Josef-Strauss-Allee, Regensburg, Germany.
authors.forename: N Platz Batista
authors.initials: NP
authors.lastname: da Silva
authors.affiliation: Department of Radiology, University Hospital Regensburg, Franz-Josef-Strauss-Allee, Regensburg, Germany.
authors.forename: A G
authors.initials: AG
authors.lastname: Schreyer
authors.affiliation: Department of Paediatrics and Juvenile Medicine (KUNO), University Hospital Regensburg, Franz-Josef-Strauss-Allee, Regensburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Melter
authors.affiliation: Department of Radiology, University Hospital Regensburg, Franz-Josef-Strauss-Allee, Regensburg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Stroszczysnski
authors.affiliation: Department of Radiology, University Hospital Regensburg, Franz-Josef-Strauss-Allee, Regensburg, Germany.
authors.forename: E M
authors.initials: EM
authors.lastname: Jung
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging*; D008107:Liver Diseases / Q000000981:diagnostic imaging*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D008297:Male; D045423:Microbubbles; D011169:Portal Vein / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D013459:Sulfur Hexafluoride; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D013459:Sulfur Hexafluoride
keywords: Contrast enhanced ultrasound (CEUS); children; diagnostic value; liver; safety