B-mode ultrasound and contrast-enhanced ultrasound (CEUS) of histological confirmed omental lesions: retrospective analysis of n = 44 patients.

INTRODUCTION

Little is known about the imaging of omental pathologies. The aim of the current study was to determine the value of B-mode ultrasound (B-US), contrast-enhanced ultrasound (CEUS), and ultrasound-guided core needle biopsy for the differential diagnosis of benign and malignant omental pathologies.

PATIENTS AND METHODS

A retrospective evaluation (2008-2017) was performed in 44 patients (median 65,5 years, mean 64 years [47-83], 27 male, 17 female) with histological (40/44 [91 %]) or cytological (4/44 [9 %]) proven omental lesions. Clinical signs and final diagnosis, size, B-US and CEUS findings, and complications were analyzed.

RESULTS

Omental thickening was in n = 36 (81.8 %) of the cases malignant (mOL) and in n = 8 (18.2 %) benign (bOL). Twenty-six (59.1 %) patients had ascites (n = 24 [66.7 %] mOL, n = 2 [25 %] bOL). The average tumor thickness was 23 mm (24 mm in mOL, 20 mm in bOL). Interventional complications were not observed.

DISCUSSION

The majority of omental lesions are malignant. The differentiation between a malignant or benign cause of thickening is not possible by any imaging method. CEUS is helpful to determine vital tissue before biopsy. Ultrasound-guided core-needle biopsy allows final diagnosis of omental thickening if > 10 mm and should be performed prior to the more invasive and complicative diagnostic laparoscopy.