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Do Different Types of Liver Lesions Differ in Their Uptake of the Microbubble Contrast Agent SH U 508A in the Late Liver Phase? Early Experience¹

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).

View larger version (14K): [in a new window]   Figure 1a. Scatterplots for all types of liver lesions. Note that all malignancies have high values (ie, large difference between lesion and liver), while all FNHs and some hemangiomas have low values (ie, little or no difference compared with adjacent liver). All three evaluations show that all FNHs behaved like liver, with complete separation from all malignancies, which appeared as defects. Hemangiomas were more variable; some but not all had high SAE. (a) OCSs. Horizontal lines indicate median values. (b) SCSs for observer 1. (c) SCSs for observer 2.

View larger version (12K): [in a new window]   Figure 1b. Scatterplots for all types of liver lesions. Note that all malignancies have high values (ie, large difference between lesion and liver), while all FNHs and some hemangiomas have low values (ie, little or no difference compared with adjacent liver). All three evaluations show that all FNHs behaved like liver, with complete separation from all malignancies, which appeared as defects. Hemangiomas were more variable; some but not all had high SAE. (a) OCSs. Horizontal lines indicate median values. (b) SCSs for observer 1. (c) SCSs for observer 2.

View larger version (12K): [in a new window]   Figure 1c. Scatterplots for all types of liver lesions. Note that all malignancies have high values (ie, large difference between lesion and liver), while all FNHs and some hemangiomas have low values (ie, little or no difference compared with adjacent liver). All three evaluations show that all FNHs behaved like liver, with complete separation from all malignancies, which appeared as defects. Hemangiomas were more variable; some but not all had high SAE. (a) OCSs. Horizontal lines indicate median values. (b) SCSs for observer 1. (c) SCSs for observer 2.

View larger version (98K): [in a new window]   Figure 2. Coronal US section through the right lobe of the liver obtained 5 minutes after the administration of SH U 508A. SAE has been elicited in the liver of a patient with known metastases. One metastasis (long horizontal arrow) appears as a low-SAE area in the liver near the kidney (short horizontal arrow). A large lesion (vertical arrows) is seen as a defect in the near field.

View larger version (120K): [in a new window]   Figure 3. Coronal US section through the right lobe of the liver obtained 5 minutes after the administration of SH U 508A shows HCC (long arrow) with low SAE. The effect, incidentally, helps in the identification of a presumed satellite lesion (short arrow).

View larger version (89K): [in a new window]   Figure 4a. Coronal US sections through the left lobe of the liver obtained 5 minutes after the administration of SH U 508A show hemangioma. (a) Note the moderate amount of SAE within both the lesion (arrows) and adjacent liver at the level of the focal zone. (b) For clarity, the lesion (arrows) is depicted without color SAE data.

View larger version (86K): [in a new window]   Figure 4b. Coronal US sections through the left lobe of the liver obtained 5 minutes after the administration of SH U 508A show hemangioma. (a) Note the moderate amount of SAE within both the lesion (arrows) and adjacent liver at the level of the focal zone. (b) For clarity, the lesion (arrows) is depicted without color SAE data.

View larger version (102K): [in a new window]   Figure 5a. Oblique US sections through the right lobe of the liver obtained 5 minutes after the administration of SH U 508A show FNH. (a) Note the large amount of SAE within the lesion, which highlights the central scar (arrow). Subsequent images showed comparable uptake in the adjacent liver as the focal zone was moved deeper. (b) For clarity, the lesion (arrows) is depicted without color SAE data.

View larger version (110K): [in a new window]   Figure 5b. Oblique US sections through the right lobe of the liver obtained 5 minutes after the administration of SH U 508A show FNH. (a) Note the large amount of SAE within the lesion, which highlights the central scar (arrow). Subsequent images showed comparable uptake in the adjacent liver as the focal zone was moved deeper. (b) For clarity, the lesion (arrows) is depicted without color SAE data.