Document Detail

Undetermined focal liver lesions on gray-scale ultrasound in patients with fatty liver: characterization with contrast-enhanced ultrasound.
MedLine Citation:
PMID:  18713302     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND AIM: The purpose of this study was to assess the clinical value and potential impact of contrast-enhanced ultrasound (CEUS) in the characterization of undetermined focal liver lesions (FLLs) in patients with fatty liver. METHODS: Fifty-two patients (34 men, 18 women) with fatty liver with 67 FLLs (size range, 1-8.6 cm; mean, 4.1 +/- 3.1 cm) undetermined at baseline ultrasound (US) underwent contrast-enhanced US. CEUS examinations were analyzed by two experienced sonologists blinded to the final diagnosis. Readers evaluated by consensus the baseline echogenicity, the dynamic enhancement pattern in comparison with peripheral liver parenchyma. The final diagnosis was based on consensus interpreting of all examinations by another two expert observers with access to histological data. The characterization accuracy, sensitivity, and specificity of CEUS in characterizing the lesion as benign or malignant, and as the correct pathologic type, were analyzed. RESULTS: After CEUS, two hemangiomas, three inflammatory pseudotumors, and one hepatocellular carcinoma were misdiagnosed. The overall characterization accuracy, sensitivity and specificity of CEUS were 91% (61/67), 91.7% (11/12), and 90.9% (50/55), respectively. Forty-three benign lesions were diagnosed as the correct pathologic type. The portal venous phase and late phase were important in the characterization of the lesions. The characterization accuracy had no relationship with the size of FLLs. CONCLUSION: CEUS can improve the characterization of undetermined FLLs arising from fatty liver.
Zhi-Li Wang; Jie Tang; Hance Peter Weskott; Jun-Lai Li; Wei Wang; Yu-Kun Luo; Li-Chun An; Jian-Hong Xu
Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2008-08-17
Journal Detail:
Title:  Journal of gastroenterology and hepatology     Volume:  23     ISSN:  1440-1746     ISO Abbreviation:  J. Gastroenterol. Hepatol.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2009-01-05     Completed Date:  2009-04-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607909     Medline TA:  J Gastroenterol Hepatol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  1511-9     Citation Subset:  IM    
Department of Ultrasound, Chinese People's Liberation Army General Hospital, Beijing, China.
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MeSH Terms
Aged, 80 and over
Bile Duct Neoplasms / etiology,  ultrasonography*
Bile Ducts, Intrahepatic / ultrasonography
Carcinoma, Hepatocellular / ultrasonography
Cholangiocarcinoma / ultrasonography
Contrast Media / diagnostic use*
Diagnostic Errors*
Fatty Liver / complications,  ultrasonography*
Granuloma, Plasma Cell / ultrasonography
Hemangioma / ultrasonography
Image Interpretation, Computer-Assisted
Liver Neoplasms / etiology,  ultrasonography*
Lymphoma / ultrasonography
Middle Aged
Phospholipids / diagnostic use*
Predictive Value of Tests
Sensitivity and Specificity
Sulfur Hexafluoride / diagnostic use*
Ultrasonography, Doppler, Color*
Young Adult
Reg. No./Substance:
0/Contrast Media; 0/Phospholipids; 0/contrast agent BR1; 2551-62-4/Sulfur Hexafluoride
Comment In:
J Gastroenterol Hepatol. 2008 Oct;23(10):1465-6   [PMID:  19120843 ]

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