title: Evaluation of Liver Metastases Using Contrast-Enhanced Ultrasound: Enhancement Patterns and Influencing Factors.
abstract: OBJECTIVE
  To evaluate the enhancement patterns of liver metastases and their influencing factors using dynamic contrast-enhanced ultrasound (CEUS).
  
  
  METHODS
  A total of 240 patients (139 male and 101 female; 58.5 ± 11.2 years of age) diagnosed with liver metastases in our hospital were enrolled in this study to evaluate tumor characteristics using CEUS. A comparison of enhancement patterns with tumor size and primary tumor type was performed using the chi-square test. The differences between quantitative variables were evaluated with the independent-sample t-test and one-way analysis of variance.
  
  
  RESULTS
  The enhancement patterns of liver metastases on CEUS were categorized as diffuse homogeneous hyperenhancement (133/240, 55.4%), rim-like hyperenhancement (80/240, 33.3%), heterogeneous hyperenhancement (10/240, 4.2%), and isoenhancement (17/240, 7.1%). There were significant differences in the enhancement patterns during the arterial phase based on the nodule size (p=0.001). A total of 231 of the nodules showed complete washout during the portal phase, and 237 nodules were hypoenhanced during the delayed phase. The washout time was correlated with tumor vascularity, with a longer washout time observed in hypervascular metastases compared to hypovascular metastases (p=0.033).
  
  
  CONCLUSIONS
  Diffuse homogeneous hyperenhancement followed by rapid washout was the most common enhancement pattern of liver metastases on CEUS and was affected by the nodule size and tumor vascularity. Small metastases were prone to show diffuse homogeneous hyperenhancement. Hypervascular metastases showed a significantly longer washout time compared to hypovascular metastases.
authors.affiliation: Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Wen-Tao
authors.initials: WT
authors.lastname: Kong
authors.affiliation: Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Zheng-Biao
authors.initials: ZB
authors.lastname: Ji
authors.affiliation: Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Wen-Ping
authors.initials: WP
authors.lastname: Wang
authors.affiliation: Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Cai
authors.affiliation: Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Bei-Jian
authors.initials: BJ
authors.lastname: Huang
authors.affiliation: Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Ding
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: Contrast enhanced ultrasound; Enhancement pattern; Liver metastases