Ultraschall Med 2016; 37 - SL1_3
DOI: 10.1055/s-0036-1587713

Contrast enhanced ultrasound as a first line imaging method in the evaluation of FLL in daily practice. A large monocentric experience.

TV Moga 1, CS Ivascu 1, C Pienar 1, A Popescu 1, R Sirli 1, M Danila 1, I Sporea 1
  • 1University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania

Background: Contrast enhanced ultrasound (CEUS) has become the first line imaging method in our center, used for the characterization of focal liver lesions (FLL), after it proved to be a cost-efficient method (1). We present you a monocentric experience in the evaluation of focal liver lesions by CEUS in daily practice routine in our center.

Material and methods: The retrospective study performed between September 2009-December 2015, included 2037 patients, in whom CEUS was performed. We evaluated 2427 FLL “de novo. The evaluation by CEUS was considered conclusive if the FLL had a typical enhancement pattern following contrast bolus as described in the European Guidelines for the use of CEUS, issued by the European Federation of Societies of Ultrasound in Medicine and Biology (EFSUMB) (2).

Results: From the 2427 FLL examined by CEUS, a positive diagnosis of malignant vs. benign could be established by CEUS in 2138/2427, (88.1%): 49.9% (1068) benign and 50.1% (1070) malignant, the latter with typical wash-out pattern in the late phase. In 289/2427 (11.9%) cases, CEUS was inconclusive, other methods being required (CT, MRI or biopsy) for the final diagnosis. From the total of 2427 lesions evaluated by CEUS, we were able to provide the correct classification in 1931 (79.6%) of cases. From all the FLLs evaluated by CEUS, 442 (22.9%) were hepatocellular carcinomas; 490 (25.4%) were liver metastases; 373 (19.2%) hemangiomas; 257 (13.4%) focal fatty liver alterations; 75 (3.9%) FNH; 1.2% (22) Adenomas, 82 (4.2%) hepatic cyst; 48 (2.5%) liver abscesses; 80 (4.1%) regenerative nodules; 0.5% (10) Cholangiocarcinoma; 0.1% (2) other malignant lesions; 2.5% (48) other benign lesions.

Conclusion: CEUS demonstrated its efficiency as a good first-line imaging method for the characterization of focal liver lesions detected by ultrasound, with a positive diagnosis in 79.6% cases and differentiation between malignant and benign lesions in 88.1% cases.