Journal of Ultrasound in Medicine, Vol 13, Issue 2 81-86, Copyright © 1994 by American Institute of Ultrasound in Medicine
Carbon dioxide-enhanced ultrasonography of liver tumors
R. C. Chen, C. S. Wang, P. H. Chen, H. Y. Tu, L. C. Chiang and J. D. Liu
Department of Radiology, Taipei Municipal Jen-Ai Hospital, Taiwan, R.O.C.
CO2 gas-enhanced ultrasonography was performed in 37 patients (47 studies)
for the purpose of detecting small tumors and evaluating differential
diagnosis. With conventional ultrasonography, 62 lesions were identified in
25 patients with HCC, 13 tumors were identified in eight patients with
hemangioma, and multiple tumors were found in four patients with metastatic
adenocarcinoma. CO2-enhanced ultrasonography detected five additional
hemangiomas, 12 additional nodules in HCC, and the same number of
metastatic nodules. The patterns of CO2 enhancement were characterized as
homogeneous, heterogeneous, rim, internal spotted, negative, and mixed
(more than one pattern in one lesion). The rim enhancement pattern was
found to be specific for hemangioma. The internal spotted enhancement
pattern was found exclusively in HCC. All the lesions that demonstrated
negative enhancement were treated HCC. All the metastatic tumors
demonstrated the mixed rim and internal spotted enhancement pattern. We
suggest that CO2-enhanced ultrasonography is a useful tool in detecting
small liver tumors. It can also help in the differentiation among various
hepatic tumors.
