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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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