8 research outputs found
Caratterizzazione di lesioni focali epatiche in pazienti cirrotici mediante tecnica ecografica contrasto-specifica Pulse Inversion Harmonic Imaging con mezzo di contrasto Levovist
Purpose. 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
Characterization of focal liver lesions by pulse inversion harmonic imaging (PIHI) with Levovist in patients with cirrhosis
5nonenoneForgacs B; Quaia E; Bertolotto M; Crocè L; Dalla Palma L.Forgacs, B; Quaia, Emilio; Bertolotto, Michele; Croce', Saveria; Dalla Palma, L
Characterization of focal hepatic lesions in cirrhotic patients by Pulse Inversion Harmonic Imaging US contrast specific technique with Levovist
PURPOSE:
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 injectio