Differentiation of focal liver lesions: usefulness of parametric imaging with contrast-enhanced US.
Purpose: To evaluate whether parametric imaging with contrast material-enhanced ultrasonography (US) is superior to visual assessment for the differential diagnosis of focal liver lesions (FLLs). Materials and Methods: This study had institutional review board approval, and verbal patient informed c...
| Publicado en: | Radiology Vol. 261; no. 1; pp. 300 - 311 |
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| Autores principales: | , , , , , , , , , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Wolters Kluwer Health
2011 Oct
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=108259553&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 108259553 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00338419 0IQ jtl: Radiology issn: 00338419 maglogo: N pubinfo: dt: 2011 Oct vid: 261 iid: 1 pid: 79357 pub: Wolters Kluwer Health place: New York, New York artinfo: ui: 108259553 108259553 NLM21746815 2011281556 10.1148/radiol.11101866 NLM21746815 108259553 ppf: 300 ppct: 11 formats: tig: atl: Differentiation of focal liver lesions: usefulness of parametric imaging with contrast-enhanced US. aug: au: Anaye A Perrenoud G Rognin N Arditi M Mercier L Frinking P Ruffieux C Peetrons P Meuli R Meuwly JY Anaye, Anass Perrenoud, Geneviève Rognin, Nicolas Arditi, Marcel Mercier, Laurent Frinking, Peter Ruffieux, Christiane Peetrons, Philippe Meuli, Reto Meuwly, Jean-Yves affil: Department of Diagnostic and Interventional Radiology and Center for Clinical Epidemiology, Institute for Social and Preventive Medicine, University Hospital Lausanne, Switzerland sug: subj: Liver Neoplasms Ultrasonography Adult Aged Aged, 80 and Over Contrast Media Diagnosis, Differential Female Image Interpretation, Computer Assisted Male Middle Age Prospective Studies Young Adult Adult: 19-44 years Aged: 65+ years Aged, 80 & over Middle Aged: 45-64 years Female Male ab: Purpose: To evaluate whether parametric imaging with contrast material-enhanced ultrasonography (US) is superior to visual assessment for the differential diagnosis of focal liver lesions (FLLs). Materials and Methods: This study had institutional review board approval, and verbal patient informed consent was obtained. Between August 2005 and October 2008, 146 FLLs in 145 patients (63 women, 82 men; mean age, 62.5 years; age range, 22-89 years) were imaged with real-time low-mechanical-index contrast-enhanced US after a bolus injection of 2.4 mL of a second-generation contrast agent. Clips showing contrast agent uptake kinetics (including arterial, portal, and late phases) were recorded and subsequently analyzed off-line with dedicated image processing software. Analysis of the dynamic vascular patterns (DVPs) of lesions with respect to adjacent parenchyma allowed mapping DVP signatures on a single parametric image. Cine loops of contrast-enhanced US and results from parametric imaging of DVP were assessed separately by three independent off-site readers who classified each lesion as benign, malignant, or indeterminate. Sensitivity, specificity, accuracy, and positive and negative predictive values were calculated for both techniques. Interobserver agreement (κ statistics) was determined. Results: Sensitivities for visual interpretation of cine loops for the three readers were 85.0%, 77.9%, and 87.6%, which improved significantly to 96.5%, 97.3%, and 96.5% for parametric imaging, respectively (P < .05, McNemar test), while retaining high specificity (90.9% for all three readers). Accuracy scores of parametric imaging were higher than those of conventional contrast-enhanced US for all three readers (P < .001, McNemar test). Interobserver agreement increased with DVP parametric imaging compared with conventional contrast-enhanced US (change of κ from 0.54 to 0.99). Conclusion: Parametric imaging of DVP improves diagnostic performance of contrast-enhanced US in the differentiation between malignant and benign FLLs; it also provides excellent interobserver agreement. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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