Fumi Yoshioka

Effectiveness of galactose-based intravenous contrast medium on color Doppler sonography of deeply located hepatocellular carcinoma.

The purpose of this study is to examine the effectiveness of intravenously injectable sonographic contrast medium for color Doppler sonographic diagnosis of deeply located hepatocellular carcinoma. Subjects were 7 hepatocellular carcinomas, an adenomatous hyperplasia and a hemangioma located more than 7 cm below the abdominal surface. Levovist, a galactose-based sonographic contrast medium was injected through median cubital vein as a phase-two clinical study, and the pre- and post-enhanced color Doppler sonographic findings of these lesions were compared. The incidence of the positive findings for hepatocellular carcinoma increased from 29% (2/7) to 86% (6/7) of hepatocellular carcinoma after contrast enhancement. Positive findings were 0% in other cases even after enhancement. Levovist brought a certain improvement in the visualization of the tumor vessel by color Doppler sonography without any noteworthy side effects. Contrast enhancement was useful for the diagnosis of liver lesions suspected to be hepatocellular carcinoma by ordinary sonography, but could not be confirmed by color Doppler sonography.

Value of contrast-enhanced color Doppler sonography in diagnosing hepatocellular carcinoma with special attention to the "color-filled pattern".

The purpose of this study is to evaluate the effectiveness of contrast‐enhanced color Doppler sonography in the diagnosis of hepatocellular carcinoma (HCC), with special attention to the value of a “color‐filled pattern.”

Contrast-enhanced multiphase dynamic ultrasonography for the characterization of liver tumors

PurposeThe purpose of the study was to introduce our protocol for contrast-enhanced multiphase dynamic ultrasonography (US) and examine the effectiveness of this method for characterizing liver tumors.MethodsThe subjects were 142 patients with liver tumors. The final diagnoses were 58 hepatocellular carcinomas (HCCs), 4 cholangiocellular carcinomas (CCCs), 14 metastases, 29 hemangiomas, 6 cases of focal nodular hyperplasia (FNH), and 31 other benign lesions. The contrast agent used was Levovist. A wide-band pulse inversion harmonic imaging mode was employed. Multiphase dynamic US was achieved by changing the sound transmission interval automatically from 0.3 s to 15.0 s according to a preset menu. Early arterial-phase images were observed at the short interval, and an equilibrium-phase image was observed at the longest interval. After a series of vascular images, a postvascular liver parenchymal image was obtained. Based on previously published criteria, the most compatible diagnosis was noted. The accuracy of this multiphase dynamic US technique for diagnosing focal liver lesions was examined by comparing our results with the final diagnosis based on a prospective study.ResultsThe overall accuracy of all 142 cases was 93.7%. The sensitivity, specificity, and positive predictive value were, respectively, 100%, 92.9%, and 90.6% for HCC; 88.9%, 97.6%, and 84.2% for metastasis or CCC; 89.7%, 100%, and 100% for hemangioma; and 83.3%, 100%, and 100% for FNH.ConclusionContrast-enhanced multiphase dynamic US is a highly accurate, safe diagnostic tool for characterizing liver tumors.