Contrast advanced dynamic flow imaging and contrast pulse subtraction imaging: Preliminary results in hepatic tumors.
OBJECTIVE
To investigate the usefulness of contrast advanced dynamic flow imaging and contrast pulse subtraction imaging in the intranodular hemodynamics of hepatic tumors.


METHODS
Ten patients underwent contrast advanced dynamic flow imaging and contrast pulse subtraction imaging using Levovist(®), a microbubble contrast agent. Fourteen hepatic tumor nodules were studied: 9 were hepatocellular carcinoma, 1 metastasis, 1 hemangioma, 1 adenomatous hyperplasia, and 2 metastatic lymph nodes of hepatocellular carcinoma. Real-time scanning of contrast advanced dynamic flow imaging and intermittent interval-delay scanning of contrast pulse subtraction imaging were carried out in the early arterial phase, the late vascular phase, and the postvascular phase. The results obtained from contrast advanced dynamic flow imaging and contrast pulse subtraction imaging were compared with those obtained by precontrast power Doppler imaging and three-phase dynamic CT, respectively.


RESULTS
The rate of detection of intranodular vascularity by contrast advanced dynamic flow imaging (93%) or contrast pulse subtraction imaging (93%) was significantly higher than that of precontrast power Doppler imaging (29%) and was as high as that of dynamic CT. Characteristic intranodular hemodynamics were detected in hepatocellular carcinoma, metastasis, hemangioma, and adenomatous hyperplasia with typical appearance of an intranodular blood vessel image in the early arterial phase, a parenchymal stain image in the late vascular phase, and a perfusion defect image in the post-vascular phase.


CONCLUSIONS
Contrast advanced dynamic flow imaging and contrast pulse subtraction imaging clearly show the intranodular hemodynamics in hepatic tumors.
Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2, Ohno-Higashi, 589-8511, Osaka-Sayama, Japan.|Department of Ultrasound, Sun Yat-Sen University of Medical Science Memorial Hospital, 107 Yanjiangxi Rd, 510120, Guangzhou, China.
Yan Ling
YL
Wen
Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2, Ohno-Higashi, 589-8511, Osaka-Sayama, Japan.
Masatoshi
M
Kudo
Abdominal Ultrasound Unit, Kinki University School of Medicine, 377-2, Ohno-Higashi, 589-8511, Osaka-Sayama, Japan.
Kiyoshi
K
Maekawa
Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2, Ohno-Higashi, 589-8511, Osaka-Sayama, Japan.
Yasunori
Y
Minami
Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2, Ohno-Higashi, 589-8511, Osaka-Sayama, Japan.
Hobyung
H
Chung
Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2, Ohno-Higashi, 589-8511, Osaka-Sayama, Japan.
Yoichiro
Y
Suetomi
Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2, Ohno-Higashi, 589-8511, Osaka-Sayama, Japan.
Hirokazu
H
Onda
Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2, Ohno-Higashi, 589-8511, Osaka-Sayama, Japan.
Masayuki
M
Kitano
Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2, Ohno-Higashi, 589-8511, Osaka-Sayama, Japan.
Toshihiko
T
Kawasaki
contrast media; liver neoplasm; pulse inversion harmonic imaging; ultrasound; wide band harmonic imaging