Document Detail


Which continuous US scanning mode is optimal for the detection of vascularity in liver lesions when enhanced with a second generation contrast agent?
MedLine Citation:
PMID:  11861092     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Microbubble echo-enhancers help in the assessment of focal liver masses by enhancing the signal from blood vessels. A variety of linear and nonlinear scanning modes are now available, but it is unclear which is optimal. A controlled comparison was performed during the infusion of such an agent (SonoVue: Bracco, Milan, Italy). METHODS AND MATERIALS: Ten patients with known focal liver lesions were studied. The diagnoses, confirmed on dual phase helical computed tomography (CT) at the same attendance were metastasis (n = 7), haemangioma (n = 2) and focal nodular hyperplasia FNH (n = 1). A dose of 12 ml SonoVue concentrated at 5 mg/ml was infused intravenously at a rate of 1 ml/min. The enhancement level was monitored with a continuous wave (CW) Doppler probe over the right radial artery and the intensity of the signal was registered at 1 s intervals. When a plateau of enhancement was reached, a single lesion in each patient was imaged using five different continuous scanning modes, fundamental grey scale (FGS); fundamental colour Doppler (FCD); fundamental power Doppler (FPD); second harmonic grey scale (HGS); and pulse inversion mode (Pim) using an HDI5000 scanner and C5-2 probe (ATL, Bothell, WA). The order of scanning modes was varied between patients using a predefined randomisation protocol. The videos (super video home system (SVHS)) were analysed offsite by two blinded readers, both experienced in contrast ultrasound of the liver. The readers were asked to score each mode in terms of its ability to detect vessels within/around the lesion at optimal enhancement. This was done using a ranking system (1, worst; 5, best) for each patient. RESULTS: Both observers scored FPD as the optimal imaging method, followed by Pim. (Scores summed across all patients, observer 1: FPD 48, Pim 42, FCD 37, HGS 21, FGS 10; observer 2: FPD 49, Pim 40, FCD 38, HGS 21, FGS 10). The differences from FPD were significant for FCD, HGS and FGS using a unpaired analysis of variance (ANOVA) comparison, with Bonferroni multiple corrections, (P<0.01, both observers). The differences between FPD and Pim were also significant both for observer 2 and for both observers combined (P<0.01), but did not reach significance for observer 1 (P = 0.19). CONCLUSIONS: In this study, FPD performed best, and the non-linear modes, performed continuously (pulse inversion and second HGS), showed no clear advantage.
Authors:
Raffaella Basilico; Martin J K Blomley; Christopher J Harvey; Antonella Filippone; Rolf A Heckemann; Robert J Eckersley; David O Cosgrove
Publication Detail:
Type:  Clinical Trial; Clinical Trial, Phase III; Journal Article; Multicenter Study    
Journal Detail:
Title:  European journal of radiology     Volume:  41     ISSN:  0720-048X     ISO Abbreviation:  Eur J Radiol     Publication Date:  2002 Mar 
Date Detail:
Created Date:  2002-02-25     Completed Date:  2002-04-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8106411     Medline TA:  Eur J Radiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  184-91     Citation Subset:  IM    
Affiliation:
Department of Radiology, University of Chieti, Policlinico SS Annunziata, Via dei Vestini, 66013 Chieti, Italy. r.basilico@radiol.unich.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Contrast Media*
Humans
Liver Neoplasms / blood supply,  secondary,  ultrasonography*
Middle Aged
Phospholipids / diagnostic use*
Sulfur Hexafluoride / diagnostic use*
Ultrasonography, Doppler / methods
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Phospholipids; 0/contrast agent BR1; 2551-62-4/Sulfur Hexafluoride

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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