Article

Contrast-Enhanced Ultrasound in the Diagnosis of Malignant Mesenchymal Liver Tumors

Department of Internal Medicine, Division of Gastroenterology, Johann Wolfgang Goethe-University Medical Centre, Frankfurt/Main, Germany.
Journal of Clinical Ultrasound (Impact Factor: 0.8). 01/2010; 38(5):227-31. DOI: 10.1002/jcu.20690
Source: PubMed

ABSTRACT Contrast-enhanced ultrasound can differentiate malignant from benign hepatic tumors, but has not been studied in malignant mesenchymal liver tumors.
We describe the findings of contrast-enhanced ultrasound in a cohort of five patients with histological-proven malignant hepatic mesenchymal tumors.
The presence of imaging features such as peripheral (nodular) enhancement, chaotic central vascularization, and absence of contrast enhancement in the late phase allowed differentiation from hemangiomas.
If these findings are demonstrated in large hepatic tumors, then the diagnosis of hemangioma is unlikely and further workup is necessary.

0 Followers
 · 
118 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Primary hepatic angiosarcoma (PHA) is a very rare malignant tumour with imaging characteristics that can mimic atypical haemangioma (HA). This is a case report of a 47-year-old male with PHA. Contrast-enhanced ultrasound (CEUS) has shown to be effective in differentiating PHA from HA, CT has more variable findings, in MRI PHA can mimic HA, arteriovenous malformations and cystic metastases, and PET/CT can be used to verify the diagnosis. In this case CEUS was supplied with a contrast CT, MRI and PET/CT. An elevated fluorodeoxyglucose uptake within the left liver lobe was shown on PET/CT.
    Ugeskrift for laeger 08/2014; 2014(176):V01140046.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Ultrasound technology is always connected to possible artefacts. Since introduction of ultrasound technology the knowledge of those artefacts is eminent to avoid misinterpretations. It is important to know that with the introduction of new ultrasound technology the possibility of artefacts are rising. Whereas artefacts initially were limited to B-mode sonography, every technological step (colour Doppler sonography, contrast enhanced sonography) comes with a range of new artefacts. This article is written to explain the technological basics of ultrasound artefacts and provide the reader with examples in daily practice and how to avoid them.
    Ultraschall in der Medizin 01/2014; 35(2). DOI:10.1055/s-0033-1355872 · 4.65 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Malignant vascular tumors of the liver are rare. The aim of this study was to investigate the applicability of gray scale and contrast-enhanced ultrasonography in patients with epithelioid hemangioendothelioma (EHE) of the liver and hepatic angiosarcoma (HA) and to describe the clinical presentation. We retrospectively analyzed all patients with epithelioid hemangioendothelioma or hemangiosarcoma of the liver from 1998 to 2011, who underwent ultrasound investigation. We describe the findings in gray scale and contrast-enhanced ultrasound and the clinical course of the disease of seven patients with EHE and five patients with HA. Ultrasound investigation in EHE showed mostly multiple hypoechoic irregular lesions close to the liver capsule and with a halo in some cases. Contrast enhancement revealed inhomogeneously and through all contrast phases vascularized tumors with a rim enhancement in 50%, with or without early wash out. All tumors had avascular parts. HA presented as multiple and irregular hypo-, iso- or hyperechoic lesions. After contrast enhancement, hypervascularization with individual patterns was evident in all patients. Of five, three had liquid parts. Patients with HA were significantly older (58 vs. 37 years, p = 0.014) and presented with lower thrombocyte counts (84 vs. 264, p = 0.0025) and with higher CEA levels (4.6 vs. 1.5, p = 0.03). EHE and HA are inhomogeneous tumors, explaining the high inter-individual variability and heterogeneity in ultrasound examination. The presence of multifocal lesions, heterogeneity and undefined margins may differentiate EHE or HA from hemangioma. A biopsy is essential in the diagnosis of vascular tumors.
    02/2015; 3(1):63-71. DOI:10.1177/2050640614560604