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Solid focal liver lesions indeterminate by contrast-enhanced CT or MR imaging: the added diagnostic value of contrast-enhanced ultrasound

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Abstract

The main clinically recognized application of contrast-enhanced US (CEUS) with microbubble contrast agents is the characterization of incidental focal liver lesions. CEUS with low transmit power insonation allows the real-time assessment of contrast enhancement in a focal liver lesion after microbubble contrast agent injection, during the arterial (10–25 s), portal venous (from 35 s up to 2 min) and late phase (4–6 min after microbubble injection). During the portal venous and late phase benign lesions appear hyper or iso-enhancing in comparison to the adjacent liver parenchyma, while malignant lesions prevalently present contrast washout with hypo-enhancing appearance. CEUS may provide an added diagnostic value in those incidental focal liver lesions in which contrast-enhanced CT or MR imaging are not conclusive. In particular, CEUS may provide an added diagnostic value in those focal liver lesions appearing indeterminate on single-phase CT scan, or on CT scans performed by an incorrect delay time or also after injection of a low dose of iodinated contrast agent, or also in those focal liver lesions revealing equivocal enhancement patterns on contrast-enhanced CT or MR imaging. CEUS may have an added diagnostic value also in hepatocellular nodules in a cirrhotic liver and can be considered a complementary imaging technique to CT.

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  1. Department of Radiology, Cattinara Hospital, University of Trieste (Italy), Strada di Fiume 447, 34149, Trieste, Italy

    Emilio Quaia

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  1. Emilio Quaia
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Correspondence to Emilio Quaia.

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Quaia, E. Solid focal liver lesions indeterminate by contrast-enhanced CT or MR imaging: the added diagnostic value of contrast-enhanced ultrasound. Abdom Imaging 37, 580–590 (2012). https://doi.org/10.1007/s00261-011-9788-8

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  • DOI: https://doi.org/10.1007/s00261-011-9788-8

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