Limits...
Focal hepatic lesions: contrast-enhancement patterns at pulse-inversion harmonic US using a microbubble contrast agent.

Kim EA, Yoon KH, Lee YH, Kim HW, Juhng SK, Won JJ - Korean J Radiol (2003 Oct-Dec)

Bottom Line: To analyze the contrast-enhancement patterns obtained at pulse-inversion harmonic imaging (PIHI) of focal hepatic lesions, and to thus determine tumor vascularity and the acoustic emission effect.Tumoral vascularity at vascular phase imaging and the acoustic emission effect at delayed phase imaging were each classified as one of four patterns.Contrast-enhancement patterns depicting tumoral vascularity and the acoustic emission effect at PIHI can help differentiate focal hepatic lesions.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Institute of Medical Science, Wonkwang University School of Medicine, Jeonbuk, Korea. yoonkh@wmc.wonkwang.ac.kr

ABSTRACT

Objective: To analyze the contrast-enhancement patterns obtained at pulse-inversion harmonic imaging (PIHI) of focal hepatic lesions, and to thus determine tumor vascularity and the acoustic emission effect.

Materials and methods: We reviewed pulse-inversion images in 90 consecutive patients with focal hepatic lesions, namely hepatocellular carcinoma (HCC) (n=43), metastases (n=30), and hemangioma (n=17). Vascular and delayed phase images were obtained immediately and five minutes following the injection of a microbubble contrast agent. Tumoral vascularity at vascular phase imaging and the acoustic emission effect at delayed phase imaging were each classified as one of four patterns.

Results: Vascular phase images depicted internal vessels in 93% of HCCs, marginal vessels in 83% of metastases, and peripheral nodular enhancement in 71% of hemangiomas. Delayed phase images showed inhomogeneous enhancement in 86% of HCCs; hypoechoic, decreased enhancement in 93% of metastases; and hypoechoic and reversed echogenicity in 65% of hemangiomas. Vascular and delayed phase enhancement patterns were associated with a specificity of 91% or greater, and 92% or greater, respectively, and with positive predictive values of 71% or greater, and 85% or greater, respectively.

Conclusion: Contrast-enhancement patterns depicting tumoral vascularity and the acoustic emission effect at PIHI can help differentiate focal hepatic lesions.

Show MeSH

Related in: MedlinePlus

Metastasis from stomach cancer, exhibiting the 'hypoechoic, decreased enhancement' pattern on delayed phase image.A. Pulse-inversion harmonic US image obtained prior to contrast injection depicts a hypoechoic nodule (arrow).B. Delayed phase image (high MI) shows a hypoechoic mass with decreased enhancement (arrow) compared to homogenous bright echogenic hepatic parenchyma.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2698100&req=5

Figure 6: Metastasis from stomach cancer, exhibiting the 'hypoechoic, decreased enhancement' pattern on delayed phase image.A. Pulse-inversion harmonic US image obtained prior to contrast injection depicts a hypoechoic nodule (arrow).B. Delayed phase image (high MI) shows a hypoechoic mass with decreased enhancement (arrow) compared to homogenous bright echogenic hepatic parenchyma.

Mentions: Table 4 summarizes the delayed phase the acoustic emission effect patterns associated with each diagnosis, and the corresponding sensitivity, specificity, and PPV values. For HCCs, three enhancement patterns were observed: 'inhomogeneous enhancement' [86% (37/43) (Fig. 3)], 'hypoechoic, decreased enhancement' [12% (5/43)], and 'isoechoic, homogeneous enhancement' [2% (1/43)]. For metastases, two patterns were apparent: 'hypoechoic, decreased enhancement' [93% (28/30) (Fig. 6)], and 'inhomogeneous enhancement' [7% (2/30)]. Neither conventional nor unenhanced US revealed the presence of a hyperechoic lesion. Hemangiomas showed two enhancement patterns: 'hypoechoic and reversed echogenicity' [65% (11/17) (Fig. 7)], and 'isoechoic, homogeneous enhancement' [35% (6/17) (Fig. 5)]. The above patterns were associated with a specificity of 92% or greater, and PPVs of 85% or greater: 'inhomogeneous enhancement' for HCCs; 'hypoechoic, decreased enhancement' for metastases; and for hemangiomas, 'hypoechoic and reversed echogenicity' or 'isoechoic, homogeneous enhancement'.


Focal hepatic lesions: contrast-enhancement patterns at pulse-inversion harmonic US using a microbubble contrast agent.

Kim EA, Yoon KH, Lee YH, Kim HW, Juhng SK, Won JJ - Korean J Radiol (2003 Oct-Dec)

Metastasis from stomach cancer, exhibiting the 'hypoechoic, decreased enhancement' pattern on delayed phase image.A. Pulse-inversion harmonic US image obtained prior to contrast injection depicts a hypoechoic nodule (arrow).B. Delayed phase image (high MI) shows a hypoechoic mass with decreased enhancement (arrow) compared to homogenous bright echogenic hepatic parenchyma.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2698100&req=5

Figure 6: Metastasis from stomach cancer, exhibiting the 'hypoechoic, decreased enhancement' pattern on delayed phase image.A. Pulse-inversion harmonic US image obtained prior to contrast injection depicts a hypoechoic nodule (arrow).B. Delayed phase image (high MI) shows a hypoechoic mass with decreased enhancement (arrow) compared to homogenous bright echogenic hepatic parenchyma.
Mentions: Table 4 summarizes the delayed phase the acoustic emission effect patterns associated with each diagnosis, and the corresponding sensitivity, specificity, and PPV values. For HCCs, three enhancement patterns were observed: 'inhomogeneous enhancement' [86% (37/43) (Fig. 3)], 'hypoechoic, decreased enhancement' [12% (5/43)], and 'isoechoic, homogeneous enhancement' [2% (1/43)]. For metastases, two patterns were apparent: 'hypoechoic, decreased enhancement' [93% (28/30) (Fig. 6)], and 'inhomogeneous enhancement' [7% (2/30)]. Neither conventional nor unenhanced US revealed the presence of a hyperechoic lesion. Hemangiomas showed two enhancement patterns: 'hypoechoic and reversed echogenicity' [65% (11/17) (Fig. 7)], and 'isoechoic, homogeneous enhancement' [35% (6/17) (Fig. 5)]. The above patterns were associated with a specificity of 92% or greater, and PPVs of 85% or greater: 'inhomogeneous enhancement' for HCCs; 'hypoechoic, decreased enhancement' for metastases; and for hemangiomas, 'hypoechoic and reversed echogenicity' or 'isoechoic, homogeneous enhancement'.

Bottom Line: To analyze the contrast-enhancement patterns obtained at pulse-inversion harmonic imaging (PIHI) of focal hepatic lesions, and to thus determine tumor vascularity and the acoustic emission effect.Tumoral vascularity at vascular phase imaging and the acoustic emission effect at delayed phase imaging were each classified as one of four patterns.Contrast-enhancement patterns depicting tumoral vascularity and the acoustic emission effect at PIHI can help differentiate focal hepatic lesions.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Institute of Medical Science, Wonkwang University School of Medicine, Jeonbuk, Korea. yoonkh@wmc.wonkwang.ac.kr

ABSTRACT

Objective: To analyze the contrast-enhancement patterns obtained at pulse-inversion harmonic imaging (PIHI) of focal hepatic lesions, and to thus determine tumor vascularity and the acoustic emission effect.

Materials and methods: We reviewed pulse-inversion images in 90 consecutive patients with focal hepatic lesions, namely hepatocellular carcinoma (HCC) (n=43), metastases (n=30), and hemangioma (n=17). Vascular and delayed phase images were obtained immediately and five minutes following the injection of a microbubble contrast agent. Tumoral vascularity at vascular phase imaging and the acoustic emission effect at delayed phase imaging were each classified as one of four patterns.

Results: Vascular phase images depicted internal vessels in 93% of HCCs, marginal vessels in 83% of metastases, and peripheral nodular enhancement in 71% of hemangiomas. Delayed phase images showed inhomogeneous enhancement in 86% of HCCs; hypoechoic, decreased enhancement in 93% of metastases; and hypoechoic and reversed echogenicity in 65% of hemangiomas. Vascular and delayed phase enhancement patterns were associated with a specificity of 91% or greater, and 92% or greater, respectively, and with positive predictive values of 71% or greater, and 85% or greater, respectively.

Conclusion: Contrast-enhancement patterns depicting tumoral vascularity and the acoustic emission effect at PIHI can help differentiate focal hepatic lesions.

Show MeSH
Related in: MedlinePlus