Additional value of contrast-enhanced ultrasound (CEUS) on arterial phase non-hyperenhancement observations (≥ 2 cm) of CT/MRI for high-risk patients: focusing on the CT/MRI LI-RADS categories LR-3 and LR-4
In: Abdominal Radiology, Jg. 45 (2019-07-23), S. 55-63
Online
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Zugriff:
To determine the added value of CEUS on arterial phase non-hyperenhancement (APNHE) observations (LR-3 and LR-4) of CT/MRI in high-risk patients. Forty-three patients with APNHE observations (≥ 2 cm) from CT/MRI were prospectively enrolled in this IRB-approved study and underwent CEUS. All observations were assessed by LI-RADS for CT/MRI and CEUS. The hemodynamic findings were compared. The mean follow-up period was 11.8 ± 2.1 months. Reference standard was made on 34-APNHE observations based on biopsy (n = 2), surgery (n = 2), and follow-up image (n = 30). The median of observation size was 2.3 cm (IQR 2.0–2.5 cm). Among the 43-APNHE observations, 12-observations (27.9%) were further presented as arterial phase hyperenhancement (APHE) in CEUS with early (n = 1, CEUS LR-M), late (n = 10, CEUS LR-5), or no (n = 1, CEUS LR-4) washout. Compared to CT, CEUS presented concordant enhancement patterns in 16 (44.4%) in AP and 20 (55.6%) in PVP, respectively. Similarly, 13 (59.1%) and 14 (63.6%) observations showed concordant enhancement patterns between CEUS and MRI in AP and PVP, respectively. Of the 34-APNHE observations with final diagnosis (hepatocellular carcinoma [HCC] n = 12; intrahepatic cholangiocarcinoma [IHCC], n = 1; non-malignancy, n = 21), 4 HCCs (33.3%) and 1 IHCC (100%) were additionally diagnosed by CEUS, while 1 non-malignant lesion (4.5%) was misdiagnosed as HCC by CEUS. Adding CEUS to APNHE observations from CT/MRI would be useful not only for definitely diagnosing HCC (CEUS LR-5) but also for other malignancies (CEUS LR-M). The discordance of dynamic features between the LI-RADS for CEUS and CT/MRI may reflect the different properties of contrast media, although the systems are not interchangeable.
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Additional value of contrast-enhanced ultrasound (CEUS) on arterial phase non-hyperenhancement observations (≥ 2 cm) of CT/MRI for high-risk patients: focusing on the CT/MRI LI-RADS categories LR-3 and LR-4
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Autor/in / Beteiligte Person: | Jung Hoon Kim ; Hyo Jin Kang ; Joo, Ijin ; Joon Koo Han |
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Zeitschrift: | Abdominal Radiology, Jg. 45 (2019-07-23), S. 55-63 |
Veröffentlichung: | Springer Science and Business Media LLC, 2019 |
Medientyp: | unknown |
ISSN: | 2366-0058 (print) ; 2366-004X (print) |
DOI: | 10.1007/s00261-019-02132-x |
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