Value of Liver Contrast-enhanced Sonography to Diagnose Malignant or Benign Tumors

Purpose: To evaluate the diagnostic benefit of contrast-enhanced ultrasound for the differential diagnosis of liver tumors in clinical practice.
Methods: From January 2010 to October 2010, 14 patients with focal liver lesions without an accurate diagnosis based on B-mode ultrasound and power Doppler ultrasound were examined by contrast-enhanced ultrasound. All 14 patients were referred for CEUS following identification of 1 or more focal liver lesions on conventional ultrasound or CT imaging. After baseline US examination (GE LOGIQ 9), a bolus of 2.4 ml of SonoVue (Bracco, UK) was administered intravenously. The characterization as benign or malignant liver lesion was assessed based on the vascularity pattern and contrast enhancement seen in focal lesions during the arterial, portal, and late phase.
Result: The final diagnosis of liver lesions included 10 benign lesions ( hemangiomas n=6, focal nodular hyperplasia n=1, focal fatty sparing n=1, regenerating nodule n=1, hydatic cyst n=1) and 4 malignant lesions ( hepatocellular carcinoma n=3, metastases n=1).
Conclusion: Contrast-enhanced US (CEUS) allows the differentiation between benign and malignant liver lesions based on the vascularity pattern and contrast enhancement seen in focal lesions during the arterial, portal, and late phase. The sensitivity and the specificity of CEUS in detecting hepatic tumors is up to 90%.