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

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World Journal of Gastroenterology 2009年第30期15卷 3748-3756页

作者： Hervé Trillaud Jean-Michel Bruel Pierre-Jean Valette Valérie Vilgrain Gérard Schmutz Raymond Oyen Wieslaw Jakubowski Jan Danes Vlastimil Valek christian greis Department of radiology University of Victor Segalen Bordeaux 2CHU Bordeaux Hospital Saint André1 rue Jean Burguet33075 BordeauxFrance Department of radiology CHU of Montpellier HospitalSaint Eloi34295 MontpellierCedex 5France Department of radiology CHU Lyon University69437 Lyon Cedex 03France Department of radiology Hospital Beaujon92110 ClichyFrance Department of radiology Hospital CaenCaen14033 Caen CedexFrance Department of radiology University Hospitals LeuvenGasthuisbergHerestrat 493000 LeuvenBelgium Department of radiology Zaklad Diagnostyki ObrazowejWojewodzki Zespol Publicznych ZakladowOpieki Zdrowotnejul Kendrtatowicza 803-242 WarszawaPoland Department of Radiology General University HospitalU Nemocnice 212000 Praha 2Czech Republic Department of Radiology University Hospital Brno BohuniceJihlavka 2063900 BrnoCzech Republic Ultrasound Medical Department Bracco Imaging Deutschland GmbHMax-Stromeyer-Strasse 11678467 KonstanzGermany

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.

关键词： Contrast-enhanced sonography Contrastmedia Dynamic sonography Liver lesion Liverdisease Liver Oncologic imaging Sonography

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Assessment of metastatic liver disease in patients with primary extrahepatic tumors by contrast-enhanced sonography versus CT and MRI

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World Journal of Gastroenterology 2006年第11期12卷 1699-1705页

作者： Christoph F Dietrich Wolfgang Kratzer Deike Strobel Etienne Danse Robert Fessl Alfred Bunk Udo Vossas Karlheinz Hauenstein Wilhelm Koch Wolfgang Blank Matthijs Oudkerk Dietbert Hahn christian greis Department of Internal Medicine Ⅱ Johann Wolfgang Goethe University Hospital 60590 FrankfurtGermany Department of Internal Medicine Ⅰ University Hospital Ulm 89070Germany Medical Clinic Ⅰ University Hospital Erlangen 91054Germany Department of Radiology University Hospital St.Luc Brussels 1200Belgium Department of Radiology Central Hospital Augsburg 86156Germany Department for Visceral Thoracic and Vascular Surgery University HospitalDresden 01307Germany Department of Radiology Marien Hospital DUsseldorf 40479Germany Department of Radiology University Hospital Rostock 18055Germany Medical Clinic Ⅱ Leopoldina Hospital Schweinfurt 97422Germany Department of Internal Medicine Hospital am Steinenberg Reutlingen 72764Germany Department of Radiology University Hospital Groningen 9700Netherlands Department of Radiology University Hospital Würzburg 97080Germany Clinical Research Bracco Altana Pharma Konstanz 78467Germany

AIM： To evaluate contrast-enhanced ultrasonography （CEUS） using SonoVue in the detection of liver metastases in patients with known extrahepatic primary tumors versus the combined gold standard comprising CT, MRI and clinical/histological data. METHODS： It is an international multicenter study, and there were 12 centres and 125 patients （64 males, 61 females, aged 59 ± 11 years） involved, with 102 patients per protocol. Primary tumors were colorectal in 35%, breast in 27%, pancreatic in 17% and others in 21%. CEUS using SonoVue was employed with a Iow-mechanical-index technique and contrast-specific software using Siemens Elegra, Philips HDI 5000 and Acuson Sequoia; continuous scanning for at least five minutes. RESULTS： CEUS with SonoVue increased significantly the number of focal liver lesions detected versus unenhanced sonography. In 31.4% of the patients, more lesions were found after contrast enhancement. The total numbers of lesions detected were comparable with CEUS （55）, triple-phase spiral CT （61） and HRI with a liverspecific contrast agent （53）. Accuracy of detection of metastatic disease （i.e. at least one metastatic lesion） was significantly higher for CEUS （91.2%） than for unenhanced sonography （81.4%） and was similar to that of triple-phase spiral CT （89.2 %）. In 53 patients whose CEUS examination was negative, a follow-up examination 3-6 months later confirmed the absence of metastatic lesions in 50 patients （94.4%）. CONCLUSION： CEUS is proved to be reliable in the detection of liver metastases in patients with known extrahepatic primary tumors and suspected liver lesions.

关键词： CT MRI Metastasis Detection SonoVue

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