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Erschienen in: European Radiology 4/2005

01.04.2005 | Hepatobiliary-Pancreas

Liver haemangiomas undetermined at grey-scale ultrasound: contrast-enhancement patterns with SonoVue and pulse-inversion US

verfasst von: Tommaso Vincenzo Bartolotta, Massimo Midiri, Emilio Quaia, Michele Bertolotto, Massimo Galia, Filippo Cademartiri, Roberto Lagalla

Erschienen in: European Radiology | Ausgabe 4/2005

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Abstract

The objective of this study was to describe the spectrum of contrast-enhancement patterns of hepatic haemangiomas undetermined at grey-scale ultrasound (US) on SonoVue-enhanced pulse-inversion (PI) US. Twenty patients (11 women, nine men) with 35 haemangiomas (size range: 1–7 cm; mean: 3.1 cm) undetermined at baseline US underwent PI at low M.I. (0.05–0.08) after i.v. injection of SonoVue. All haemangiomas were confirmed by typical helical computed tomography (CT) and/or magnetic resonance imaging (MRI) findings. US examinations were videotaped and then reviewed by two experienced radiologists blinded to the final diagnosis. Readers evaluated by consensus the baseline echogenicity and the dynamic enhancement pattern of each lesion, in comparison with adjacent liver parenchyma. After administration of SonoVue, 31/35 (88%) haemangiomas showed peripheral hyperechoic nodules in the arterial phase, followed by progressive centripetal fill-in, which was complete in 25/35 cases and incomplete in 6/35 cases. Three out of 35 (9%) haemangiomas showed rapid and complete fill-in in the arterial phase, which persisted in the portal and delayed phases. Finally, 1/35 haemangiomas (3%) showed a rim of arterial contrast enhancement with progressive and complete centripetal fill-in in portal-venous and delayed phases. In conclusion, PI after the administration of SonoVue enabled the depiction of typical contrast-enhancement patterns in haemangiomas undetermined at baseline US.
Literatur
1.
Zurück zum Zitat Mergo PJ, Ros PR (1998) Benign lesions of the liver. Radiol Clin North Am 36:319–331PubMed Mergo PJ, Ros PR (1998) Benign lesions of the liver. Radiol Clin North Am 36:319–331PubMed
2.
Zurück zum Zitat Moody AR, Wilson SR (1993) Atypical hepatic hemangioma: a suggestive sonographic morphology. Radiology 188:413–417 Moody AR, Wilson SR (1993) Atypical hepatic hemangioma: a suggestive sonographic morphology. Radiology 188:413–417
3.
Zurück zum Zitat Harvey CJ, Albrecht T (2001) Ultrasound of focal liver lesions. Eur Radiol 11:1578–1593 Harvey CJ, Albrecht T (2001) Ultrasound of focal liver lesions. Eur Radiol 11:1578–1593
4.
Zurück zum Zitat Vilgrain V, Boulous L, Vullierme MP et al (2000) Imaging of atypical hemangiomas of the liver with pathological correlation. Radiographics 20:379–397PubMed Vilgrain V, Boulous L, Vullierme MP et al (2000) Imaging of atypical hemangiomas of the liver with pathological correlation. Radiographics 20:379–397PubMed
5.
Zurück zum Zitat Hosten N, Puls R, Bechstein WO, Felix R (1999) Focal liver lesions: Doppler ultrasound. Eur Radiol 9:428–435CrossRef Hosten N, Puls R, Bechstein WO, Felix R (1999) Focal liver lesions: Doppler ultrasound. Eur Radiol 9:428–435CrossRef
6.
Zurück zum Zitat Perkins AB, Imam K, Smith WJ, Cronan JJ (2000) Color and power Doppler sonography of liver hemangiomas: a dream unfulfilled? J Clin Ultrasound. 28:159–165CrossRef Perkins AB, Imam K, Smith WJ, Cronan JJ (2000) Color and power Doppler sonography of liver hemangiomas: a dream unfulfilled? J Clin Ultrasound. 28:159–165CrossRef
7.
Zurück zum Zitat Kim TK, Han JK, Kim AY et al (1999) Hepatic hemangiomas using a sonographic contrast agent (Levovist) and Power Doppler ultrasonography. J Ultrasound Med 18:737–743PubMed Kim TK, Han JK, Kim AY et al (1999) Hepatic hemangiomas using a sonographic contrast agent (Levovist) and Power Doppler ultrasonography. J Ultrasound Med 18:737–743PubMed
8.
Zurück zum Zitat Burns PN, Wilson SR, Simpson DH (2000) Pulse inversion imaging of liver blood flow: improved method for characterizing focal masses with microbubble contrast. Invest Radiol 35:58–71 Burns PN, Wilson SR, Simpson DH (2000) Pulse inversion imaging of liver blood flow: improved method for characterizing focal masses with microbubble contrast. Invest Radiol 35:58–71
9.
Zurück zum Zitat Bertolotto M, Dalla Palma L, Quaia E et al (2000) Characterization of unifocal liver lesions with pulse inversion harmonic imaging after Levovist injection: preliminary results. Eur Radiol 10:1369–1376CrossRefPubMed Bertolotto M, Dalla Palma L, Quaia E et al (2000) Characterization of unifocal liver lesions with pulse inversion harmonic imaging after Levovist injection: preliminary results. Eur Radiol 10:1369–1376CrossRefPubMed
10.
Zurück zum Zitat Quaia E, Bertolotto M, Dalla Palma L (2002) Characterization of liver hemangiomas with pulse inversion harmonic imaging. Eur Radiol 12:537–544PubMed Quaia E, Bertolotto M, Dalla Palma L (2002) Characterization of liver hemangiomas with pulse inversion harmonic imaging. Eur Radiol 12:537–544PubMed
11.
Zurück zum Zitat Bartolotta TV, Midiri M, Galia M et al (2003) Atypical liver hemangiomas: contrast-enhancement patterns with SH U 508A and pulse-inversion US. Radiol Med 106:320–328 Bartolotta TV, Midiri M, Galia M et al (2003) Atypical liver hemangiomas: contrast-enhancement patterns with SH U 508A and pulse-inversion US. Radiol Med 106:320–328
12.
Zurück zum Zitat Schneider M, Arditi M, Barrau M et al (1995) BRI: a new ultrasonographic contrast agent based on sulphur hexafluoride-filled microbubbes. Invest Radiol 30:451–457 Schneider M, Arditi M, Barrau M et al (1995) BRI: a new ultrasonographic contrast agent based on sulphur hexafluoride-filled microbubbes. Invest Radiol 30:451–457
13.
Zurück zum Zitat Quaia E, Degobbis F, Tona G et al (2004) Differential patterns of contrast enhancement in different focal liver lesions after injection of the microbubble US contrast agent SonoVue. Radiol Med 107:155–165 Quaia E, Degobbis F, Tona G et al (2004) Differential patterns of contrast enhancement in different focal liver lesions after injection of the microbubble US contrast agent SonoVue. Radiol Med 107:155–165
14.
Zurück zum Zitat Nicolau C, Catala V, Vilana R, Gilabert et al (2004) Evaluation of hepatocellular carcinoma using SonoVue, a second generation ultrasound contrast agent: correlation with cellular differentiation. Eur Radiol 14:1092–1099CrossRefPubMed Nicolau C, Catala V, Vilana R, Gilabert et al (2004) Evaluation of hepatocellular carcinoma using SonoVue, a second generation ultrasound contrast agent: correlation with cellular differentiation. Eur Radiol 14:1092–1099CrossRefPubMed
15.
Zurück zum Zitat Hanafusa K, Ohashi I, Himeno Y et al (1995) Hepatic hemangioma: findings with two phase CT. Radiology 196:465–469PubMed Hanafusa K, Ohashi I, Himeno Y et al (1995) Hepatic hemangioma: findings with two phase CT. Radiology 196:465–469PubMed
16.
Zurück zum Zitat Semelka RC, Brown ED, Ascher SM et al (1994) Hepatic hemangiomas: a multi-institutional study of appearance on T2-weighted and serial gadolinium-enhanced gradient-echo MR images. Radiology 192:401–406PubMed Semelka RC, Brown ED, Ascher SM et al (1994) Hepatic hemangiomas: a multi-institutional study of appearance on T2-weighted and serial gadolinium-enhanced gradient-echo MR images. Radiology 192:401–406PubMed
17.
Zurück zum Zitat Nino-Murcia M, Olcott EW, Jeffrey RB et al (2000) Focal liver lesions: pattern-based classification scheme for enhancement at arterial phase. Radiology 215:746–751PubMed Nino-Murcia M, Olcott EW, Jeffrey RB et al (2000) Focal liver lesions: pattern-based classification scheme for enhancement at arterial phase. Radiology 215:746–751PubMed
18.
Zurück zum Zitat Leen E, Angerson WJ, Yarmenitis S et al (2002) Multi-centre clinical study evaluating the efficacy of SonoVue (BR1), a new contrast agent in Doppler investigation of focal hepatic lesions. Eur J Radiol 41:200–206CrossRef Leen E, Angerson WJ, Yarmenitis S et al (2002) Multi-centre clinical study evaluating the efficacy of SonoVue (BR1), a new contrast agent in Doppler investigation of focal hepatic lesions. Eur J Radiol 41:200–206CrossRef
19.
Zurück zum Zitat Bartolotta TV, Midiri M, Scialpi M, Sciarrino E, Galia M, Lagalla R (2004) Focal nodular hyperplasia in normal and fatty liver: a qualitative and quantitative evaluation with contrast-enhanced ultrasound. Eur Radiol 14:583–591CrossRefPubMed Bartolotta TV, Midiri M, Scialpi M, Sciarrino E, Galia M, Lagalla R (2004) Focal nodular hyperplasia in normal and fatty liver: a qualitative and quantitative evaluation with contrast-enhanced ultrasound. Eur Radiol 14:583–591CrossRefPubMed
20.
Zurück zum Zitat Foley D, Jochem RJ (1991) Computed tomography. Focal and diffuse liver disease. Radiol Clin North Am 29:1213–1222 Foley D, Jochem RJ (1991) Computed tomography. Focal and diffuse liver disease. Radiol Clin North Am 29:1213–1222
21.
Zurück zum Zitat Ros PR (2000) Benign liver lesions. Eur Radiol 10 (Suppl 2):S175–S184CrossRef Ros PR (2000) Benign liver lesions. Eur Radiol 10 (Suppl 2):S175–S184CrossRef
22.
Zurück zum Zitat Farrell MA, Charboneau JW, Reading CC (2000) Sonographic–pathologic correlation of the hyperechoic border of an atypical hepatic hemangioma. J Ultrasound Med 20:169–170 Farrell MA, Charboneau JW, Reading CC (2000) Sonographic–pathologic correlation of the hyperechoic border of an atypical hepatic hemangioma. J Ultrasound Med 20:169–170
23.
Zurück zum Zitat Brancatelli G, Federle MP, Blachar A et al (2001) Hemangioma in the cirrhotic liver: diagnosis and natural history. Radiology 219:69–74 Brancatelli G, Federle MP, Blachar A et al (2001) Hemangioma in the cirrhotic liver: diagnosis and natural history. Radiology 219:69–74
24.
Zurück zum Zitat Caturelli E, Pompili M, Bartolucci F et al (2001) Hemangioma-like lesions in chronic liver disease: diagnostic evaluation in patients. Radiology 220:337–342 Caturelli E, Pompili M, Bartolucci F et al (2001) Hemangioma-like lesions in chronic liver disease: diagnostic evaluation in patients. Radiology 220:337–342
25.
Zurück zum Zitat Bollinger A, Putti P, Barras JP et al (1974) Red blood cell velocity in nailfold capillaries of men, measured by a television microscopy technique. Microvasc Res 7:61–72CrossRef Bollinger A, Putti P, Barras JP et al (1974) Red blood cell velocity in nailfold capillaries of men, measured by a television microscopy technique. Microvasc Res 7:61–72CrossRef
26.
Zurück zum Zitat Young LK, Yang WT, Chan KW et al (1998) Hepatic hemangiomas: quantitative color power US angiography—facts and fallacies. Radiology 207:51–57 Young LK, Yang WT, Chan KW et al (1998) Hepatic hemangiomas: quantitative color power US angiography—facts and fallacies. Radiology 207:51–57
27.
Zurück zum Zitat Strobel D, Krodel U, Martus P et al (2000) Clinical evaluation of contrast-enhanced color Doppler sonography in the differential diagnosis of liver tumors. J Clin Ultrasound 28:1–13CrossRefPubMed Strobel D, Krodel U, Martus P et al (2000) Clinical evaluation of contrast-enhanced color Doppler sonography in the differential diagnosis of liver tumors. J Clin Ultrasound 28:1–13CrossRefPubMed
28.
Zurück zum Zitat Dill-Macky MJ, Burns PN, Khalili K et al (2002) Focal hepatic masses: enhancement patterns with SH U 508 A and pulse-inversion US. Radiology 222:95–102PubMed Dill-Macky MJ, Burns PN, Khalili K et al (2002) Focal hepatic masses: enhancement patterns with SH U 508 A and pulse-inversion US. Radiology 222:95–102PubMed
29.
Zurück zum Zitat Wilson SR, Burns PN, Muradali D et al (2000) Harmonic hepatic US with microbubble contrast agent: initial experience showing improved characterization of hemangioma, hepatocellular carcinoma, and metastasis. Radiology 215:153–161 Wilson SR, Burns PN, Muradali D et al (2000) Harmonic hepatic US with microbubble contrast agent: initial experience showing improved characterization of hemangioma, hepatocellular carcinoma, and metastasis. Radiology 215:153–161
30.
Zurück zum Zitat Kim TK, Choi BI, Han JK et al (2000) Hepatic tumors: contrast agent-enhancement patterns with pulse-inversion harmonic US. Radiology 216:411–417PubMed Kim TK, Choi BI, Han JK et al (2000) Hepatic tumors: contrast agent-enhancement patterns with pulse-inversion harmonic US. Radiology 216:411–417PubMed
31.
Zurück zum Zitat Tanaka S, Ioka T, Oshikawa O et al (2001) Dynamic sonography of hepatic tumors. Am J Roentgenol 177:799–805 Tanaka S, Ioka T, Oshikawa O et al (2001) Dynamic sonography of hepatic tumors. Am J Roentgenol 177:799–805
32.
Zurück zum Zitat Von Herbay A, Vogt C, Haussinger D (2002) Pulse Inversion sonography in the early phase of the sonographic contrast agent Levovist: differentiation between benign and malignant focal liver lesions. J Ultrasound Med 21:1191–2000PubMed Von Herbay A, Vogt C, Haussinger D (2002) Pulse Inversion sonography in the early phase of the sonographic contrast agent Levovist: differentiation between benign and malignant focal liver lesions. J Ultrasound Med 21:1191–2000PubMed
33.
Zurück zum Zitat Sidhu PS, Shaw AS, Ellis SM et al (2004) Microbubble ultrasound contrast in the assessment of hepatic artery patency following liver transplantation: role in reducing frequency of hepatic artery arteriography. Eur Radiol 14:21–30CrossRefPubMed Sidhu PS, Shaw AS, Ellis SM et al (2004) Microbubble ultrasound contrast in the assessment of hepatic artery patency following liver transplantation: role in reducing frequency of hepatic artery arteriography. Eur Radiol 14:21–30CrossRefPubMed
34.
Zurück zum Zitat Klein D, Jenett M, Gassel HJ et al (2004) Quantitative dynamic contrast-enhanced sonography of hepatic tumors. Eur Radiol 14:1082–1091CrossRefPubMed Klein D, Jenett M, Gassel HJ et al (2004) Quantitative dynamic contrast-enhanced sonography of hepatic tumors. Eur Radiol 14:1082–1091CrossRefPubMed
35.
Zurück zum Zitat Horton KM, Bluemke DA, Hruban RH et al (1999) CT and MR imaging of benign hepatic and biliary tumors. Radiographics 19:431–451PubMed Horton KM, Bluemke DA, Hruban RH et al (1999) CT and MR imaging of benign hepatic and biliary tumors. Radiographics 19:431–451PubMed
36.
Zurück zum Zitat Correas JM, Bridal L, Lesavre A et al (2001) Ultrasound contrast agent: properties, principles of action, tolerance, and artifacts Eur Radiol 11:1316–1328CrossRefPubMed Correas JM, Bridal L, Lesavre A et al (2001) Ultrasound contrast agent: properties, principles of action, tolerance, and artifacts Eur Radiol 11:1316–1328CrossRefPubMed
37.
Zurück zum Zitat Dalla Palma L, Bertolotto M (1999) Introduction to ultrasound contrast agents: physics overview. Eur Radiol 9(Suppl 3):S338–S342CrossRef Dalla Palma L, Bertolotto M (1999) Introduction to ultrasound contrast agents: physics overview. Eur Radiol 9(Suppl 3):S338–S342CrossRef
38.
Zurück zum Zitat Madjar H, Prömpeler HJ, Del Favero C et al (2000) A new Doppler signal enhancing agent for flow assessment in breast lesions. Eur J Ultrasound 12:123–130 Madjar H, Prömpeler HJ, Del Favero C et al (2000) A new Doppler signal enhancing agent for flow assessment in breast lesions. Eur J Ultrasound 12:123–130
39.
Zurück zum Zitat M Schneider (1999) SonoVue, a new ultrasound contrast agent. Eur Radiol 9 (Suppl 3):S347–S348CrossRef M Schneider (1999) SonoVue, a new ultrasound contrast agent. Eur Radiol 9 (Suppl 3):S347–S348CrossRef
40.
Zurück zum Zitat Lencioni R, Cioni D, Bartolozzi C (2002) Tissue harmonic and contrast agent and contrast-specific imaging: back to gray scale in ultrasound. Eur Radiol 12:151–165PubMed Lencioni R, Cioni D, Bartolozzi C (2002) Tissue harmonic and contrast agent and contrast-specific imaging: back to gray scale in ultrasound. Eur Radiol 12:151–165PubMed
41.
Zurück zum Zitat Leen E (2001) The role of contrast-enhanced ultrasound in the characterisation of focal liver lesions. Eur Radiol 11:27–34 Leen E (2001) The role of contrast-enhanced ultrasound in the characterisation of focal liver lesions. Eur Radiol 11:27–34
42.
Zurück zum Zitat Nicolau C, Catala V, Bru C (2003) Characterization of focal liver lesions with contrast-enhanced ultrasound. Eur Radiol 13 (Suppl 3):N70–N78 Nicolau C, Catala V, Bru C (2003) Characterization of focal liver lesions with contrast-enhanced ultrasound. Eur Radiol 13 (Suppl 3):N70–N78
43.
Zurück zum Zitat Albrecht T, Oldenburg A, Hohmann J et al (2003) Imaging of liver metastases with contrast-specific low-MI real-time ultrasound and SonoVue. Eur Radiol 13 (Suppl 3):N79–N86 Albrecht T, Oldenburg A, Hohmann J et al (2003) Imaging of liver metastases with contrast-specific low-MI real-time ultrasound and SonoVue. Eur Radiol 13 (Suppl 3):N79–N86
44.
Zurück zum Zitat Quaia E, Bertolotto M, Forgacs B et al (2003) Detection of liver metastases by pulse inversion harmonic imaging during Levovist late phase: comparison with conventional ultrasound and helical CT in 160 patients. Eur Radiol. 13:475–483PubMed Quaia E, Bertolotto M, Forgacs B et al (2003) Detection of liver metastases by pulse inversion harmonic imaging during Levovist late phase: comparison with conventional ultrasound and helical CT in 160 patients. Eur Radiol. 13:475–483PubMed
45.
Zurück zum Zitat Tranquart F, Correas JM, Martegani A et al (2004) Feasibility of real time contrast enhanced ultrasound in renal disease. J Radiol 85:31–36 Tranquart F, Correas JM, Martegani A et al (2004) Feasibility of real time contrast enhanced ultrasound in renal disease. J Radiol 85:31–36
46.
Zurück zum Zitat Bartolotta TV, Midiri M, Galia M et al (2001) Benign hepatic tumors: MRI features before and after superparamagnetic iron oxide administration. Radiol Med 101:219–229 Bartolotta TV, Midiri M, Galia M et al (2001) Benign hepatic tumors: MRI features before and after superparamagnetic iron oxide administration. Radiol Med 101:219–229
47.
Zurück zum Zitat Kim S, Chung JJ, Kim MJ et al (2000) Atypical inside-out pattern of hepatic hemangiomas. Am J Roentgenol 174:1571–1574 Kim S, Chung JJ, Kim MJ et al (2000) Atypical inside-out pattern of hepatic hemangiomas. Am J Roentgenol 174:1571–1574
48.
Zurück zum Zitat Konno K, Ishida H, Sato M et al (2001) Liver tumors in fatty liver: difficulty in ultrasonographic interpretation. Abdom Imaging 26:487–491CrossRef Konno K, Ishida H, Sato M et al (2001) Liver tumors in fatty liver: difficulty in ultrasonographic interpretation. Abdom Imaging 26:487–491CrossRef
Metadaten
Titel
Liver haemangiomas undetermined at grey-scale ultrasound: contrast-enhancement patterns with SonoVue and pulse-inversion US
verfasst von
Tommaso Vincenzo Bartolotta
Massimo Midiri
Emilio Quaia
Michele Bertolotto
Massimo Galia
Filippo Cademartiri
Roberto Lagalla
Publikationsdatum
01.04.2005
Erschienen in
European Radiology / Ausgabe 4/2005
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-004-2569-9

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