Journal of Ultrasound in Medicine, Vol 20, Issue 5 509-515, Copyright © 2001 by American Institute of Ultrasound in Medicine
Detection of liver metastases: comparison of contrast-enhanced wide-band harmonic imaging with conventional ultrasonography
T. Bernatik, D. Strobel, E. G. Hahn and D. Becker
Department of Internal Medicine I, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.
OBJECTIVE: To compare the detection rate of conventional ultrasonography
and contrast-enhanced wide-band harmonic ultrasonographic imaging in the
detection of small liver metastases. METHODS: Consecutive patients with
histologically proved gastrointestinal carcinoma liver metastases were
studied. Biphasic helical computed tomography, conventional
ultrasonography, and contrast-enhanced wide-band harmonic imaging were
performed on all patients within a 5-day period. The biphasic helical
computed tomographic scans were reviewed and interpreted by a skilled
radiologist. The number of lesions and their descriptive characteristics
were recorded for analysis. In addition, videotape recordings of the
conventional ultrasonography and contrast-enhanced wide-band harmonic
imaging were blindly reviewed, after which the number of detected lesions
and their characteristics were then compared with those detected on
biphasic helical computed tomography, considered the standard of reference.
RESULTS: Twenty-eight patients (10 female and 18 male; age range, 45-72
years) were studied. Conventional ultrasonography detected 37 (59%) of all
lesions visualized by biphasic helical computed tomography. The detection
rate for contrast-enhanced wide-band harmonic imaging was significantly
higher (61 [97%] of 63). In our series, two 10-mm lesions near the
diaphragm were not visualized by wide-band harmonic imaging. CONCLUSIONS:
The use of contrast-enhanced imaging techniques significantly improves the
ultrasonographic detection of liver metastases. Our results achieved the
sensitivity of biphasic helical computed tomography.