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DOI: 10.1055/s-0029-1245921
© Georg Thieme Verlag KG Stuttgart · New York
Characterization by Biopsy or CEUS of Liver Lesions Guided by Image Fusion between Ultrasonography and CT, PET/CT or MRI
Charakterisierung von Leberläsionen mittels Biopsie oder CEUS anhand von Bildfusion zwischen Ultraschall und CT, PET/CT oder MRTPublikationsverlauf
received: 7.8.2009
accepted: 26.10.2010
Publikationsdatum:
11. Januar 2011 (online)
![](https://www.thieme-connect.de/media/ultraschall/201102/lookinside/thumbnails/10.1055-s-0029-1245921-1.jpg)
Zusammenfassung
Ziel: Ziel der Studie war es, die Anzahl der Fälle aufzuzeigen, in denen der Einsatz fusionsgestützten Ultraschalls zu einer konklusiven Diagnose von Läsionen führte, die sich im CT, MRT oder PET/CT darstellten. Als Läsion wurde eine durch Verletzung oder Erkrankung geschädigte Region definiert. Material und Methoden: 40 Patienten mit Leberläsionen entsprechend CT (n = 35), MRI (n = 2) oder PET/CT (n = 3), von denen 34 eine bekannte neoplastische Grunderkrankung hatten, wurden zur US-Untersuchung oder US-gestützten Biopsie prospektiv in die Studie eingeschlossen. Zur Untersuchung wurde ein LOGIQ-Prototypensystem mit geräteinhärenter Software zur Fusionsbildgebung mit einem 4 MHz-Konvexschallkopf (GE Healthcare, Chalfont St. Giles, UK) verwandt. Alle Patienten wurden zunächst mit B-Mode-US, dann mit fusionsgestütztem US und einige zusätzlich mit CEUS untersucht. Alle Patienten erhielten eine Follow-up-Untersuchung nach wenigstens einem Jahr. Ergebnisse: 26 Läsionen waren im US initial nicht darstellbar. Von diesen konnten 9 mithilfe des fusionsgestützten Ultraschalls und weitere 4 mithilfe von CEUS dargestellt werden, was die endgültige Diagnose bei 11 dieser 13 Patienten erleichterte. Die mittlere Läsionsgröße aller in die Studie eingeschlossenen Raumforderungen lag bei 1,5 cm (Interquartilsabstand: 1,0 – 2,4 cm). Zwischen den Gruppen bestand kein signifikanter Unterschied in der Größe der Läsionen. Schlussfolgerung: Wir konnten erfolgreich zeigen, dass, verglichen zum konventionellen B-Mode-US, der fusionsgestützte Ultraschall eine verbesserte Charakterisierung von Leberläsionen erlaubt.
Abstract
Purpose: The aim of this study was to show the number of cases in which the use of fusion-guided ultrasonography (US) provided conclusive diagnosis of lesions in the liver seen on CT or MRI or PET/CT. A lesion is defined as a region that has suffered damage due to injury or disease. Materials and Methods: Forty patients of whom 34 had confirmed neoplastic disease, referred to US evaluation or US-guided biopsy of liver lesions seen on CT (n = 35), MRI (n = 2) or PET/CT (n = 3), were prospectively included in the study. We used a LOGIQ prototype system with incorporated software for fusion imaging, and a convex-array 4 MHz transducer (GE Healthcare, Chalfont St. Giles, UK). All patients were initially examined with B-mode US, then by fusion-guided US and for some patients also with CEUS. All patients received follow-up after at least one year. Results: Twenty-six lesions were initially indistinguishable with US. Of these, 9 became visible with fusion-guided US and another 4 became visible with CEUS, which facilitated a final diagnosis in 11 of these 13 patients. The median tumor size for all lesions included in the study was 1.5 cm (interquartile range: 1.0 – 2.4). There was no statistically significant difference in tumor size between the groups. Conclusion: We have successfully demonstrated an increase in the characterization of liver lesions by using fusion-guided US compared with conventional B-mode US.
Key words
abdomen - interventional procedures - ultrasound - technology assessment
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Dr. Caroline Ewertsen
Department of Radiology, Copenhagen University Hospital, Rigshospitalet
Blegdamsvej 9
2100 Copenhagen OE
Denmark
Telefon: ++ 45/35 45 34 19
Fax: ++ 45/35 45 20 58
eMail: caroline.ewertsen@dadlnet.dk