Characterization of focal liver lesions with SonoVue- enhanced sonography： International multicenter-study in comparison to CT and MRI

• Published in: World journal of gastroenterology : WJG Vol. 15; no. 30; pp. 3748 - 3756
• Main Authors: Trillaud, Hervé, Bruel, Jean-Michel, Valette, Pierre-Jean, Vilgrain, Valérie, Schmutz, Gérard, Oyen, Raymond, Jakubowski, Wieslaw, Danes, Jan, Valek, Vlastimil, Greis, Christian
• Format: Journal Article
• Language: English
• Published: United States Department of radiology,University of Victor Segalen Bordeaux 2,CHU Bordeaux Hospital Saint André,1 rue Jean Burguet,33075 Bordeaux,France%Department of radiology,CHU of Montpellier Hospital,Saint Eloi,34295 Montpellier,Cedex 5,France%Department of radiology,CHU Lyon University,69437 Lyon Cedex 03,France%Hospital Beaujon,92110 Clichy,France%Department of radiology,Hospital Caen,Caen,14033 Caen Cedex,France%Department of radiology,University Hospitals Leuven,Gasthuisberg,Herestrat 49,3000 Leuven,Belgium%Department of radiology,Zaklad Diagnostyki Obrazowej,Wojewodzki Zespol Publicznych Zakladow,Opieki Zdrowotnej,ul Kendrtatowicza 8,03-242 Warszawa,Poland%Department of Radiology,General University Hospital,U Nemocnice 2,12000 Praha 2,Czech Republic%Department of Radiology,University Hospital Brno Bohunice,Jihlavka 20,63900 Brno,Czech Republic%Ultrasound Medical Department,Bracco Imaging Deutschland GmbH,Max-Stromeyer-Strasse 116,78467 Konstanz,Germany 14.08.2009; The WJG Press and Baishideng
• Subjects: Adult; Aged; Aged, 80 and over; Contrast Media - metabolism; Female; Focal Nodular Hyperplasia - diagnosis; Focal Nodular Hyperplasia - diagnostic imaging; Focal Nodular Hyperplasia - pathology; Hemangioma - diagnosis; Hemangioma - diagnostic imaging; Hemangioma - pathology; Humans; Liver - diagnostic imaging; Liver - pathology; Liver Neoplasms - diagnosis; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - pathology; Magnetic Resonance Imaging; Male; Middle Aged; MRI; Original; Sensitivity and Specificity; Tomography, X-Ray Computed; Ultrasonography - instrumentation; Ultrasonography - methods; 多中心; Sonography; Liver; Liver disease; Contrast-enhanced sonography; Liver lesion; Oncologic imaging; Contrast media; Dynamic sonography
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.15.3748

AIM： To evaluate in a multicenter study whether the sonographic characterization of focal liver lesions can be improved using SonoVue-enhancement; and to compare this method with computed tomography （CT） and magnetic resonance imaging （MRI）. METHODS： One hundred and thirty four patients withone focal liver lesion detected in baseline ultrasound （US） were examined with conventional US, contrastenhanced US （n = 134）, contrast-enhanced CT （n = 115） and/or dynamic contrast-enhanced MRI （n = 70）. The lesions were classified as malignant, benign or indeterminate and the type of lesion was determined. The final diagnosis based on the combined information of all imaging examinations, clinical information and histology （n = 32） was used. Comparisons were made to see whether the addition of contrast-enhanced US led to the improvement of the characterization of doubtful focal liver lesions. RESULTS： In comparison with unenhanced US, SonoVue markedly improves sensitivity and specificity for the characterization （malignant/benign） of focal liver lesions. In comparison with CT and/or dynamic MRI, SonoVue -enhanced sonography applied for characterization of focal liver lesions was 30.2% more sensitive in the recognition of malignancy and 16.1% more specific in the exclusion of malignancy and overall 22.9% more accurate. In the subgroup with confirmative histology available （n = 30）, sensitivity was 95.5% （CEUS）, 72.2% （CT） and 81.8% （MRI）, and specificity was 75.0% （CEUS）, 37.5% （CT） and 42.9% （MRI）. The sensitivity and specificity of CEUS for the identification of focal nodular hyperplasia （FNH） and hemangiomas was 100% and 87%, resulting in an accuracy of 94.5%. CONCLUSION： SonoVue-enhanced sonography emerges as the most sensitive, ost specific and thus most accurate imaging modality for the characterization of focal liver lesions.