title: Contrast enhanced ultrasound for the diagnosis of liver hemangiomas - results of a Romanian multicentre study.
abstract: Contrast enhanced ultrasound (CEUS) has been proven to be a reliable method for the characterization of focal liver lesions (FLL). The aim of this paper was to evaluate the performance of CEUS for the diagnosis of liver hemangiomas in a large cohort of patients.
  
  
  
  We performed a multicentre prospective study which included successive CEUS examinations from fourteen centers from Romania. CEUS examinations were performed in de novo FLL, using low mechanical index ultrasound, following an intravenous bolus of 2.4 ml SonoVue. CEUS was considered conclusive for hemangioma if a typical pattern was present following contrast (centripetal fill in during the arterial phase, hyperenhanced lesion during venous and late phases). In all cases a reference method was available (contrast CT or MRI or biopsy). The trial was registered in clinicaltrials.gov (Identifier NCT01329458).
  
  
  
  During February 2011 - May 2015, 1153 CEUS examinations were performed for the evaluation of de novo FLL. Out of the 1153 de novo FLL, 238 cases were diagnosed as hemangiomas by CEUS (typical enhancing pattern). Contrast CT/MRI and biopsy diagnosed additional 24 hemangiomas. From the 238 cases diagnosed as hemangiomas by CEUS, in 11 the final diagnosis was different. Considering contrast CT/MRI and biopsy as reference methods, CEUS had 90.4% sensitivity, 98.8% specificity, 95.4% positive predictive value, 97.4% negative predictive value, resulting in 96.9% diagnostic accuracy for the diagnosis of hemangiomas.
  
  
  
  CEUS is a sensitive and very specific method for the diagnosis of hemangiomas.
authors.affiliation: Department of Gastroenterology and Hepatology, "Victor Babeş" University of Medicine and Pharmacy Timişoara, Romania. roxanasirli@gmail.com.
authors.forename: Roxana
authors.initials: R
authors.lastname: Sirli
authors.affiliation: Department of Gastroenterology and Hepatology, "Victor Babeş" University of Medicine and Pharmacy Timişoara, Romania.
authors.forename: Ioan
authors.initials: I
authors.lastname: Sporea
authors.affiliation: Centre for Research in Gastroenterology and Hepatology, University of Medicine and Pharmacy Craiova, Romania.
authors.forename: Daniela Larisa
authors.initials: DL
authors.lastname: Săndulescu
authors.affiliation: Department of Gastroenterology and Hepatology, "Victor Babeş" University of Medicine and Pharmacy Timişoara, Romania.
authors.forename: Alina
authors.initials: A
authors.lastname: Popescu
authors.affiliation: Department of Gastroenterology and Hepatology, "Victor Babeş" University of Medicine and Pharmacy Timişoara, Romania.
authors.forename: Mirela
authors.initials: M
authors.lastname: Dănilă
authors.affiliation: Centre for Research in Gastroenterology and Hepatology, University of Medicine and Pharmacy Craiova, Romania.
authors.forename: Adrian
authors.initials: A
authors.lastname: Săftoiu
authors.affiliation: Regional Institute of Gastroenterology and Hepatology "Prof. Dr. Octavian Fodor", "Iuliu Hatieganu" University of Medicine and Pharmacy Cluj Napoca, Romania.
authors.forename: Zeno
authors.initials: Z
authors.lastname: Spârchez
authors.affiliation: Regional Institute of Gastroenterology and Hepatology "Prof. Dr. Octavian Fodor", "Iuliu Hatieganu" University of Medicine and Pharmacy Cluj Napoca, Romania.
authors.forename: Radu
authors.initials: R
authors.lastname: Badea
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D006391:Hemangioma / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010743:Phospholipids; D015203:Reproducibility of Results; D012383:Romania; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride