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Ultrasonography |
1 From the Department of Radiology and Institute of Radiation Medicine, Seoul National University Hospital, 28, Yongon-dong, Chongno-gu, Seoul 110-744, South Korea. From the 1999 RSNA scientific assembly. Received September 7, 1999; revision requested October 14; revision received November 12; accepted November 16. Supported in part by a grant from the 1999 Korean Highly Advanced National Projects on the Development of Biomedical Engineering and Technology. Address correspondence to B.I.C. (e-mail: choibi@radcom.snu.ac.kr).
PURPOSE: To evaluate contrast agent–enhancement patterns in hepatic hemangiomas, hepatic metastases, and hepatocellular carcinomas (HCCs) at pulse-inversion harmonic ultrasonography (US) with a microbubble contrast agent.
MATERIALS AND METHODS: Twenty hepatic hemangiomas in 20 patients and 41 malignant hepatic tumors in 23 patients (33 metastases and eight HCCs) were evaluated with pulse-inversion harmonic US. US images were obtained before injection and every 10–15 seconds after injection of a 4-g bolus (300 mg/mL) of SH U 508A (a microbubble contrast agent) for 5 minutes. The contrast-enhancement patterns of 61 hepatic lesions were assessed.
RESULTS: Of 20 hemangiomas, 19 revealed peripheral enhancement, which was globular in 14 (70%) and rimlike in five (25%), with centripetal fill-in; the remaining one (5%) showed homogeneous enhancement. In 33 metastases, the enhancement was rimlike in 16 (48%), homogeneous in seven (21%), and stippled in two (6%); in the remaining eight metastases (24%), no enhancement was seen. Of eight HCCs, four (50%) showed homogeneous enhancement and the remaining four (50%) showed heterogeneous enhancement. Centripetal fill-in of lesions with intratumoral enhancement was not seen in any malignancy.
CONCLUSION: Pulse-inversion harmonic US with a microbubble contrast agent is potentially useful for the specific diagnosis of hemangiomas that demonstrate characteristic enhancement features.
Index terms: Angioma, gastrointestinal tract, 761.3194 • Liver neoplasms, 761.323 • Liver neoplasms, secondary, 761.3327, 761.3320 • Liver neoplasms, US, 761.12988, 761.323, 761.3327, 761.3320 • Ultrasound (US), contrast media, 761.12988 • Ultrasound (US), harmonic study • Ultrasound (US), technology, 761.12988
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