Characterization of solid liver focal lesions by CEUS: monocentric Italian experience

BACKGROUND: Ultrasonography (US) is the first imaging modality to diagnose neoplastic and chronic hepatic dis-eases. To increase the sensitivity and specificity, in particular for the detection of focal liver lesions (FLL) is possible the addition of contrast-enhanced ultrasound (CEUS), an essential radiologic tool comparable to three-phase contrast -enhanced computed tomography (CECT). CEUS represents a beneficial imaging method that can provide, with the ap-propriate indications, unique and accurate diagnostic information. CEUS can also avoid, in some specific cases, the use of CT, MRI, or even biopsy in the study of FLL.METHODS: The study was conducted retrospectively, and 153 FLL were examined in 72 patients, of which 37 were males and 35 females, aged between 30 and 90 years. Only patients with a history of prior lesions identified with the B -mode US or other imaging modalities but not definitively diagnosed were included. After having subjected all patients to preliminary B-mode, color, and power Doppler ultrasound examinations, we continued with the execution of the contrast examination through intravenous injection (IV) of 5.0 mL of SonoVue (Bracco, Milan, Italy). Also, a specific contrast mode with a low Mechanical Index (MI<0.2) was used for image acquisition.RESULTS: CEUS was able to find 112 of 153 (73%) FLLs. A total of 39 lesions (26%) could not be detected. In two cases (1%) was not possible to carry out an ultrasound with medium contrast because of the intense entero-colic meteorism of the patients.CONCLUSIONS: CEUS proved to be a beneficial imaging method for the early detection of FLL if it is used following the appropriate indications that can provide rapid diagnostic information in some cases superior to the performance of CT and MRI.