von Herbay A, Haeussinger D, Gregor M, Vogt C
Department of Medicine, University of Tübingen.
Ultraschall Med. 2007 Apr;28(2):168-75. doi: 10.1055/s-2007-963070.
SonoVue and Levovist (SH U 508A) are both ultrasound contrast agents, which are helpful in characterization and detection of malignant liver lesions. This study was performed to compare both contrast agents according to the capability to diagnose hepatocellular carcinoma (HCC).
In a prospective study, 65 patients with histologically proven hepatocellular carcinoma (HCC) were examined with both, Levovist and SonoVue. In all patients HCC lesions had been detected by B-mode sonography before the study start. After injection of 2.4 ml SonoVue i. v., the liver was examined continuously for up to three minutes using "low MI"-pulse inversion sonography. For the Levovist-examinations 2.5 g Levovist were injected i. v. After a delay of at least 2.5 minutes without scanning, the liver was examined with three different scans using "high-MI"-pulse-inversion sonography.
The examination was technically sufficient in 98% after SonoVue-injection and in 92% after Levovist-injection (n. s.). Comparison of the results was performed for the 60/65 patients (61 lesions), in which both methods were technically sufficient. After SonoVue-injection contrast-enhancement in the arterial phase was found in 79% (48/61) of the lesions. Demarcation of the HCC-lesion in the late phase was found in 89% of the SonoVue-examinations and in 98% of the Levovist-examinations (p < 0.05). Early SonoVue-enhancement and/or demarcation in SonoVue late-phase was found in 93% of the HCC-lesions (n. s. compared to Levovist-late phase).
Levovist-late phase has a higher sensitivity in predicting lesion dignity of HCC-lesions compared to SonoVue-late phase, but not compared to combination of SonoVue-early phase and late phase.
声诺维（SonoVue）和利维显（Levovist，SH U 508A）均为超声造影剂，有助于肝脏恶性病变的特征性诊断和检测。本研究旨在根据诊断肝细胞癌（HCC）的能力对这两种造影剂进行比较。
在一项前瞻性研究中，对65例经组织学证实为肝细胞癌（HCC）的患者分别使用利维显和声诺维进行检查。在研究开始前，所有患者的HCC病变均已通过B超检查发现。静脉注射2.4 ml声诺维后，使用“低机械指数”脉冲反转超声持续检查肝脏长达3分钟。利维显检查时，静脉注射2.5 g利维显。在至少延迟2.5分钟且未进行扫描后，使用“高机械指数”脉冲反转超声对肝脏进行三种不同扫描。
注射声诺维后，98%的检查在技术上是充分的；注射利维显后，92%的检查在技术上是充分的（无统计学差异）。对60/65例患者（61个病变）进行了两种方法技术上均充分的结果比较。注射声诺维后，79%（48/61）的病变在动脉期出现造影剂增强。在声诺维检查的晚期，89%的HCC病变可清晰界定；在利维显检查的晚期，98%的病变可清晰界定（p < 0.05）。93%的HCC病变在声诺维早期出现增强和/或在声诺维晚期清晰界定（与利维显晚期相比无统计学差异）。
与声诺维晚期相比，利维显晚期在预测HCC病变的性质方面具有更高的敏感性，但与声诺维早期和晚期联合相比则不然。
