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Caratterizzazione di lesioni focali epatiche in pazienti cirrotici mediante tecnica ecografica contrasto-specifica Pulse Inversion Harmonic Imaging con mezzo di contrasto Levovist
No full textPurpose. To evaluate the capabilities of Pulse
Inversion Harmonic Imaging (PIHI) with hepatospecific
US contrast agent Levovist in the characterization
of focal liver lesions in cirrhotic patients.
Materials and methods. Thirty-nine focal hepatic
lesions in 25 consecutive cirrhotic patients identified
by conventional ultrasound (US), were evaluated by
color Doppler (CD), power Doppler (PD) with spectral
analysis of tumoural vessels and PIHI. PIHI was
performed 30 seconds (vascular phase) and 3-5 minutes
(late phase) after Levovist injection. To definitely
characterize the evaluated focal hepatic lesions,
helical-CT (HCT) enhancement patterns (15 patients)
and/or surgical/bioptic histologic findings (10 patients)
were considered as reference procedures.
Results. Thirty focal hepatic lesions classified as
hepatocellular carcinoma (HCC) by reference procedures
appeared hypoechoic (n=19), isoechoic (n=5)
or hyperechoic (n=6) on conventional US, with basket
arterial pattern (n=10), vessels within the tumor
(n=6), peripheral arterial pattern (n=4) or no vascular
pattern (n=10) on CD/PD evaluation. On PIHI
they appeared hyperechoic (n=26) or isoechoic (n=4)
in the vascular phase, if compared to the surrounding
liver parenchyma, and hypoechoic (n=23) or isoechoic
(n=7) in the late phase. Four focal hepatic
lesions classified as regenerative nodules (RNs) by
reference procedures appeared hypoechoic on conventional
US, with peripheral venous/arterial pattern
(n=1) or no vascular pattern (n=3) on CD/PD.
On PIHI they appeared hypoechoic (n=3) or isoechoic
(n=1) in the vascular phase, remaining prevalently
hypoechoic (n=3) or isoechoic (n=1) in the
late phase. Five focal hepatic lesions classified as
hemangioma by reference procedures appeared
hyperechoic (n=4) or hypoechoic (n=1) on conventional
US with few peripheral venous vessels on
CD/PD. On PIHI they revealed progressive fill-in
from the periphery toward the centre during the vascular
and late phase after Levovist injection.
Conclusions. PIHI seems to be a reliable technique
to characterize focal lesions in cirrhotic patients
Small liver lesions in oncologic patients: characterization with CT, MRI and contrast-enhanced US
Full text linkFocal liver lesions (FLLs) are frequently discovered during ultrasound examinations either in healthy subjects without a clinical history of cancer or during staging or follow-up procedures in oncologic patients or in routine surveillance of hepatopathic patients. In oncologic patients, the liver is the most common target of metastatic disease and accurate detection and characterisation of FLLs is prognostically fundamental during the initial staging as well as before and after pre-operative chemotherapy, as it can help to identify patients who are most likely to benefit from liver surgery. Moreover, early detection of primary or secondary liver malignancies increases the possibility of curative surgical resection or successful percutaneous ablation. As many FLLs in these patients are benign, a precise and preferably non-invasive method of differentiation from malignant metastatic nodules is needed. Moreover, the continuous follow-up of cancer patients requires an easily available, reliable and cost-effective diagnostic tool for the detection and characterization of FLLs
Evaluation of renal parenchymal perfusion in normal subjects by Pulse Inversion Harmonic Imaging (PIHI) with SonoVue. Work in progress
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Evaluation of renal parenchymal perfusion in normal subjects by Pulse Inversion Harmonic Imaging (PIHI) with SonoVue. Work in progress.
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