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Ultrasonography |
1 From the Dept of Imaging, Hammersmith Hospital, Imperial College School of Medicine, 150 du Cane Rd, London W12 0HS, England (M.J.K.B., D.O.C., C.J.H., R.A.H., J.B.B., R.J.E.); Dept of Radiology, Kings College Hospital, London, England (P.S.S.); Dept of Radiology, Klinikum Benjamin Franklin, Berlin, Germany (T.A.); and Dept of Radiology, Univ of Chieti, Italy (R.B.). From the 1999 RSNA scientific assembly. Received Nov 23, 1999; revision requested Jan 5, 2000; final revision received Mar 6, 2001; accepted Apr 6. M.J.K.B. and C.J.H. supported by the Medical Research Council of the United Kingdom. Supported by Schering, Berlin, Germany, and Acuson, Stockley Park, England. Address correspondence to M.J.K.B. (e-mail: m.blomley@ic.ac.uk).
PURPOSE: To compare the uptake of SH U 508A in different types of liver lesions by using stimulated acoustic emission.
MATERIALS AND METHODS: Thirty-seven patients with characterized lesions (metastasis, n = 17; hepatocellular carcinoma, n = 4; hemangioma, n = 9; focal nodular hyperplasia, n = 7) received 2.5 g SH U 508A. After 5 minutes, stimulated acoustic emission was elicited by using a previously described method. Liver and/or lesional differences were assessed with videodensitometry (objective conspicuity score), and two observers assessed each lesion by using a six-point scale (subjective conspicuity score).
RESULTS: Metastases and hepatocellular carcinoma had low stimulated acoustic emission; median objective conspicuity scores were 70% and 68% (all scores were 
43%), respectively, and subjective conspicuity scores were 2 or higher for both observers. Hemangiomas had reduced stimulated acoustic emission, with more variability; the median objective conspicuity score was 41% (range, 9%–72%), and the median subjective conspicuity scores were 2 (range, 1–4) and 3.5 (range, 1–5) for observers 1 and 2, respectively. Focal nodular hyperplasia had stimulated acoustic emission comparable to that of the liver in all cases; the median objective conspicuity score was -4.7% (all scores were <6%), and the subjective conspicuity score was 1 or lower for both observers. This finding completely separated focal nodular hyperplasia and malignancies. Significant differences were seen between focal nodular hyperplasia and all other lesion types (P < .05).
CONCLUSION: Strong late-phase lesional uptake of SH U 508A is characteristic of focal nodular hyperplasia, is seen in some hemangiomas, and was not observed in malignancies.
Index terms: Liver neoplasms, diagnosis, 761.3198, 761.3194, 761.323, 761.33 • Liver neoplasms, US, 761.1296, 761.12981, 761.12983, 761.12988 • Ultrasound (US), contrast media, 761.12988
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