Contrast-enhanced ultrasound in differential diagnosis of focal liver lesions
Abstract
AIM: To continue studying the features of visualization of focal liver lesions by using of contrast-enhanced ultrasound (CEUS).
MATERIAL AND METHODS: A retrospective analysis included 106 patients with morphologically confirmed benign liver tumors and metastases (MTS). Patients were divided into groups regarding morphological criteria: focal-nodular hyperplasia (FNH) - 22 patients, hemangiomas - 26, hepatocellular adenoma (HCA) - 15 and 43 patients with liver MTS. All patients underwent multiparametric ultrasound examination with CEUS.
RESULTS: Characteristic signs of FNH are early contrasting in the arterial phase (AF) and significantly different 'contrasting onset in focus' in comparison with hemangiomas (p<0.001), HCA and MTS (p<0.05). Specific signs: 'spokes of the wheel' symptom and advanced contrast accumulation (96%), 'center-to-edge' filling (86%). There was no contrasting in AF in 42% of patients with hemangiomas. Specific signs are 'peripheral nodular exacerbation' (92%) and 'edge-to-center' filling (76%). WASH-OUT sign is not typical. HCA is characterized by complete (100%) and intensive (80%) centripetal filling. WASH-OUT sing was detected in 6 (40%) patients (p<0.001 for 'wash-out onset' and p<0.005 for 'maximum wash-out time' in comparison with MTS). We did not find specific types of vascular pattern. The most important differential sign of MTS was WASH-OUT sign (100%). Me of 'wash-out onset' sign was 40 (35-56) seconds. Specific signs: 'black hole' symptom -…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 106 participants or records.
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