Youk Ji Hyun, Kim Chong Soo, Lee Jeong Min
Department of Radiology, Chonbuk National University Hospital, Jeonju, South Korea.
J Ultrasound Med. 2003 Sep;22(9):897-910. doi: 10.7863/jum.2003.22.9.897.
To assess the value of SH U 508A-enhanced agent detection imaging in the characterization of focal hepatic lesions.
Contrast-enhanced agent detection imaging was performed on 78 focal hepatic lesions: 34 hepatocellular carcinomas, 22 metastases, 9 hemangiomas, 9 abscesses, 3 cysts, and 1 focal nodular hyperplasia. After administration of SH U 508A, interval delay scanning with agent detection imaging was performed with intervals of approximately 7 seconds (phase I), 30 seconds (phase II), and 90 seconds (phase III) after the first arrival of the contrast agent to the liver. Two observers blinded to the final diagnosis reviewed selected images and assessed the enhancement patterns of the lesions. For quantitative analysis, we calculated the enhancement ratio of the lesions and the difference of enhancement between the lesions and the liver parenchyma.
Agent detection imaging showed a distinctive enhancement pattern in focal liver lesions compared with that in the liver. Hepatocellular carcinomas were characterized by early enhancement (phase I) and washout (phases II and III; sensitivity, 94.1%; specificity, 93.2%; positive predictive value, 91.4%). Metastases showed peripheral rim or targetlike enhancement (phase I, phase II, or both) and a defect (phase III) and had sensitivity of 77.3%, specificity of 100%, and a positive predictive value of 100%. Hemangiomas showed peripheral nodular or inhomogeneous (phase I, phase II, or both) and gradually centripetal (phase II, phase III, or both) enhancement (sensitivity, 88.9%; specificity, 100%; positive predictive value, 100%). Abscesses were partially enhanced from phase I to phase III (sensitivity, 66.7%; specificity, 95%; positive predictive value, 85.7%). The results of the quantitative analysis of lesion enhancement were compatible with those of the qualitative analysis.
SH U 508A-enhanced agent detection imaging may yield distinctive enhancement characteristics in focal liver lesions that would contribute positively to the characterization of these hepatic lesions.
评估SH U 508A增强剂检测成像在肝脏局灶性病变特征描述中的价值。
对78个肝脏局灶性病变进行对比增强剂检测成像，其中包括34例肝细胞癌、22例转移瘤、9例血管瘤、9例肝脓肿、3例囊肿和1例局灶性结节性增生。注射SH U 508A后，在对比剂首次到达肝脏后，分别于约7秒（I期）、30秒（II期）和90秒（III期）进行增强剂检测成像的间隔延迟扫描。两位对最终诊断不知情的观察者查看选定图像并评估病变的强化模式。为进行定量分析，我们计算了病变的强化率以及病变与肝实质之间的强化差异。
与肝脏相比，增强剂检测成像显示肝脏局灶性病变有独特的强化模式。肝细胞癌的特征为早期强化（I期）和廓清（II期和III期；敏感性为94.1%；特异性为93.2%；阳性预测值为91.4%）。转移瘤表现为周边环形或靶样强化（I期、II期或两者均有）以及缺损（III期），敏感性为77.3%，特异性为100%，阳性预测值为100%。血管瘤表现为周边结节状或不均匀强化（I期、II期或两者均有）并逐渐向心性强化（II期、III期或两者均有）（敏感性为88.9%；特异性为100%；阳性预测值为100%）。肝脓肿从I期到III期呈部分强化（敏感性为66.7%；特异性为95%；阳性预测值为85.7%）。病变强化的定量分析结果与定性分析结果相符。
SH U 508A增强剂检测成像可能在肝脏局灶性病变中产生独特的强化特征，这将有助于对这些肝脏病变进行特征描述。
