The Value Of Sono Vue-Enhanced Ultrasonography In The Diagnosis Of Different Liver Nodules

Focal liver lesions are very common in liver diseases. It is much essential to distinguish benign from malignant lesions because of far different principles of treatment. Conventional gray scale sonography is the first choice to differentiate various liver lesions for its no injury, low cost and convenience. But it's unreliable in the characterization of liver lesions. Colour Doppler and power Doppler improve the sensitivity, but the efficacy can't be compared with contrast-enhanced CT or MRI. The microbubble ultrasound contrast agent and imaging technique make the most sensitive sonographic technique, and improve the detection rate of liver lesions.Objective: To explore the differential diagnostic value of real time contrast-enhanced ultrasound(CEUS)in focal liver lesions.Method: From November 2005 to May 2008,the SoNo Vue-enhancedsonographic images of 69 focal liver lesions in 62 patients were retrospectively analyzed. The enhancing characteristics during arterial, portal-venous and delayed liver phase were oberseved respectively, and the time when enhancement started, reached peak and started receding were recorded.Result: The examined group consisted of 62 patients,69 lesions intotal,including 20 primary hepatocellular carcinomas,2 cholangiocarcinomas,12 metastatic hepatic carcinomas, 13 hepatic hemangiomas,5 hepatic focal nodular hyperplasia,3 hepatocellular adenomas,2 inflammatory pseudotumors, 12 regenerating nodules. The image of nodules change over time, and most lesions have specific characterization due to typical vascularity and perfusion patterns. The time when enhancement started ,reached peak and started receding differed among the nodules with significant differeces(p<0.05).In most malignant nodules such as primary and secondary liver cancer, the enhancement started and receded rapidly. In hemangioma, on the contrary, this period was the longest with slow enhancement and slow receding.Conclusion:Real-time SoNo Vue-enhanced ultrasound reflects differentcharacteristics of blood perfusion in focal liver lesions,and shows particularly advantages in the differentiation of benign and malignant lesions in liver.