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. 2016 Mar;10(2):283-7.
doi: 10.5009/gnl14324.

Evaluation of Liver Metastases Using Contrast-Enhanced Ultrasound: Enhancement Patterns and Influencing Factors

Wen-Tao Kong  1 , Zheng-Biao Ji  1 , Wen-Ping Wang  1 , Hao Cai  1 , Bei-Jian Huang  1 , Hong Ding  1
Affiliations

Evaluation of Liver Metastases Using Contrast-Enhanced Ultrasound: Enhancement Patterns and Influencing Factors

Wen-Tao Kong et al. Gut Liver. 2016 Mar.

Abstract

Background/aims: To evaluate the enhancement patterns of liver metastases and their influencing factors using dynamic contrast-enhanced ultrasound (CEUS).

Methods: A total of 240 patients (139 male and 101 female; 58.5 ± 11.2 years of age) diagnosed with liver metastases in our hospital were enrolled in this study to evaluate tumor characteristics using CEUS. A comparison of enhancement patterns with tumor size and primary tumor type was performed using the chi-square test. The differences between quantitative variables were evaluated with the independent-sample t-test and one-way analysis of variance.

Results: The enhancement patterns of liver metastases on CEUS were categorized as diffuse homogeneous hyperenhancement (133/240, 55.4%), rim-like hyperenhancement (80/240, 33.3%), heterogeneous hyperenhancement (10/240, 4.2%), and isoenhancement (17/240, 7.1%). There were significant differences in the enhancement patterns during the arterial phase based on the nodule size (p=0.001). A total of 231 of the nodules showed complete washout during the portal phase, and 237 nodules were hypoenhanced during the delayed phase. The washout time was correlated with tumor vascularity, with a longer washout time observed in hypervascular metastases compared to hypovascular metastases (p=0.033).

Conclusions: Diffuse homogeneous hyperenhancement followed by rapid washout was the most common enhancement pattern of liver metastases on CEUS and was affected by the nodule size and tumor vascularity. Small metastases were prone to show diffuse homogeneous hyperenhancement. Hypervascular metastases showed a significantly longer washout time compared to hypovascular metastases.

Keywords: Contrast enhanced ultrasound; Enhancement pattern; Liver metastases.

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Figures

Fig. 1
Fig. 1
Contrast-enhanced ultrasound of a 46-year-old man with pancreatic neuroendocrine carcinoma and liver metastases. (A) Conventional ultrasound showed a hypoechoic lesion (arrows) with blood flow. (B) The arterial phase showed homogeneous hyperenhancement of the lesion (arrows). (C) The lesion (arrows) remained isoechoic during the portal phase.
See this image and copyright information in PMC

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