By Luigi Bolondi
In fresh years, the imaging-based prognosis of mass liver lesions has develop into more and more advanced end result of the quantity and morphological variability of lesions that smooth imaging concepts are at the moment capable of show. If the sensitivity in detection has vastly elevated, characterisation has remained tricky and represents a severe problem for the clinician.
The availability of blood-pool distinction brokers for ultrasound (US), particularly second-generation US distinction brokers in accordance with perfluorocarbon- or sulfur-hexafluoride-filled microbubbles, and the advance of contrast-specific software program and applied sciences have unfolded new views either for the instant characterisation of any mass lesion detected within the liver and for expanding the sensitivity folks within the detection of liver metastases.
Taking into consideration the nice effect of this new know-how on scientific perform, the ecu Federation of Societies for Ultrasound in medication and Biology (EFSUMB) organised, in January 2004, in Rotterdam, a consensus assembly of specialists in an effort to strengthen guidance for using US distinction brokers within the analysis of liver illnesses . those instructions, in addition to discussions of additional advances within the medical program of contrast-enhanced harmonic US are offered during this ebook through an across the world well known workforce of specialists. The ebook represents presents a massive place to begin for scientific implementation of this new diagnostic procedure.
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Extra info for Advances in Diagnostic Imaging: The Value of Contrast-Enhanced Ultrasound for Liver
The problem of truly hypovascular HCCs persists particularly in nodules of 1 to >2 cm. If a hypervascular pattern is detected by CEUS (even if missed by CT or MRI), an aggressive policy should be proposed that includes liver biopsy .
Multifocal HCC in a 64-year-old patient with chronic hepatitis C and HIV virus infections. 4 ml of SonoVue® (Bracco, Italy) using the VRI modality. The lesion strongly enhanced during the arterial phase (d, e) compared to baseline imaging (c). The increased vascularity of the anterior subcapsular HCC was better seen at CEUS than by CT. 56 Jean-Michel Correas et al. Fig. 4a-c. In the same patient as in Fig. 3, an additional small HCC was also detected in between segment III and II. This lesion was not seen on baseline imaging even during the review of the cineloops acquired during the examination.
Focal Fatty Changes As an area of focal fatty infiltration or fatty sparing does not differ in its vasculature from surrounding liver tissue, contrast enhancement does not differ as well from surrounding tissue (Table 3). Table 3. Characteristic features in circumscriptive fatty sparing and focal steatosis (from ) Tumor entity Arterial phase PV phase Delayed (late) phase Typical features Isoenhancing Isoenhancing Isoenhancing 25 26 Hans Peter Weskott Liver Cysts The diagnosis of liver cysts in B-mode US can be confirmed by CEUS.
Advances in Diagnostic Imaging: The Value of Contrast-Enhanced Ultrasound for Liver by Luigi Bolondi