Copyright
©The Author(s) 2022.
World J Radiol. Apr 28, 2022; 14(4): 70-81
Published online Apr 28, 2022. doi: 10.4329/wjr.v14.i4.70
Published online Apr 28, 2022. doi: 10.4329/wjr.v14.i4.70
Table 1 Characteristics of contrast agents SonoVue and Sonazoid for contrast-enhanced ultrasound
Agent | SonoVue | Sonazoid |
Gas | Sulfurhexafluoride (SF6) | Perfluorobutane (C4F10) |
Envelope | Monolayer of phospholipid (DSPC, DPPG-Na) | Monolayer of phospholipid (Hydrogenated egg phosphatidyl serine Na) |
MI | Low MI (< 0.1) | Intermediate MI (> 0.2) |
Mean size | 1.5-2.5 µm | 2.3-2.9 µm |
Distribution after injection | Pure blood pool agent | Blood pool agent with uptake by hepatic Kupffer cells after 1 min by injection |
Table 2 Imaging enhancement pattern of cirrhotic nodules and malignant focal liver lesions on Contrast-enhanced ultrasound
Lesion | Arterial phase | Portal venous phase | Late phase | Post-vascular phase |
RN | Hypo-enhance | Iso-enhance | Iso-enhance | Iso-enhance |
DN | Hypo-enhance or partial hyper-enhanced within lesion (early-HCC) | Iso-enhance | Iso-enhance | Iso-enhance |
HCC | Hyper-enhance | Hypo-enhance or iso-enhance | Hypo-enhance or iso-enhance1 | Hypo-enhance (mild and late washout) or iso-enhance1 |
ICC | Rim-enhance or Hyper-enhance with early washout (< 60 seconds) | Hypo-enhance | Hypo-enhance | Hypo-enhance |
Metastasis | Rim-enhance or Hyper-enhance with early washout (< 60 seconds) | Hypo-enhance | Hypo-enhance | Hypo-enhance |
Table 3 Recommendations contrast-enhanced ultrasound in cirrhotic liver
Recommendations | Notes |
Characterization FLLs found in patients with liver cirrhosis to establish a diagnosis of malignancy | CT or MR imaging is required for a complete staging |
In nodules not suitable for biopsy | When CT or MR are inconclusive |
Selection of FLLs with different contrast pattern in a cirrhotic liver to be biopsied | |
Monitoring changes in enhancement patterns in FLLs in cirrhotic liver requiring follow-up | |
Guiding percutaneous biopsies to increase the diagnostic outcome | To compare to B-mode US |
Table 4 Imaging enhancement pattern of benign focal liver lesions on contrast-enhanced ultrasound
Lesion | Arterial phase | Portal venous phase | Late phase | Post-vascular phase |
Hepatic cysts | Non-enhance | Non-enhance | Non-enhance | Non-enhance |
Cystic hydatid disease | Non-enhance cysts and septa | Non-enhance cysts and septa | Non-enhance cysts and septa | Non-enhance cysts and septa |
Abscess | Rim-enhance with enhanced septa; no central enhancement | Rim-enhance with enhanced septa; no central enhancement | Hypo-enhance rim; no central enhancement | Hypo-enhance rim; no central enhancement |
Hemangioma | Peripheral, discontinuous and globular hyper-enhance | Peripheral, globular iso enhance and fill-in | Iso-enhance or hypo-enhance | Iso-enhance or hypo-enhance |
FNH | Hyper-enhance from the center to peripheral region spoke-wheel vascularity | Hyper-enhance with/without un-enhanced central scar | Iso-enhance or hyper-enhance with/without un-enhanced central scar | Iso-enhance or hypo-enhance |
HA | Hyper-enhance | Iso-enhance | Iso-enhance | Iso-enhance or hypo-enhance |
Pseudo lesions | Hyper-enhance | Hyper-enhance or iso-enhance | Iso-enhance | Iso-enhance |
- Citation: Bartolotta TV, Randazzo A, Bruno E, Taibbi A. Focal liver lesions in cirrhosis: Role of contrast-enhanced ultrasonography. World J Radiol 2022; 14(4): 70-81
- URL: https://www.wjgnet.com/1949-8470/full/v14/i4/70.htm
- DOI: https://dx.doi.org/10.4329/wjr.v14.i4.70