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Journal of Ultrasound in Medicine, Vol 19, Issue 5 293-299, Copyright © 2000 by American Institute of Ultrasound in Medicine
Ultrasonographic evaluation of focal hepatic lesions: comparison of pulse inversion harmonic, tissue harmonic, and conventional imaging techniques
H. J. Jang, H. K. Lim, W. J. Lee, S. H. Kim, K. A. Kim and E. Y. Kim
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
A prospective study was performed to evaluate whether pulse inversion
harmonic imaging and tissue harmonic imaging improve the lesion conspicuity
and change ultrasonographic characteristics of focal hepatic lesions. Three
radiologists evaluated 97 focal hepatic lesions by consensus:
cirrhosis-related nodules (n = 23), metastases (n = 23), hemangiomas (n =
27), and cysts (n = 24). In our study, pulse inversion harmonic imaging was
judged superior to both tissue harmonic imaging and conventional imaging in
conspicuity and overall quality for cirrhosis-related nodules, metastases,
and cysts (P < 0.05). Compared with conventional imaging, both pulse
inversion harmonic imaging and tissue harmonic imaging provided better
conspicuity, clearer internal echogenicity, and stronger
through-transmission of cysts (P < 0.05). Pulse inversion harmonic
imaging was judged to be better in depicting internal morphology for
cirrhosis-related nodules and metastases than conventional imaging (P <
0.05). For hemangiomas, no statistically significant difference was found
in all parameters except better posterior enhancement by tissue harmonic
imaging than other techniques. In conclusion, pulse inversion harmonic
imaging showed the best conspicuity and also enhanced characteristics of
both cystic and solid hepatic lesions. Tissue harmonic imaging was judged
superior to conventional imaging in evaluating cysts but was not beneficial
for solid lesions. The results of this trial may be specific to the machine
used for this study.
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