This Article Abstract Full Text Full Text (PDF) Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Furuse, J Articles by Yoshino, M Search for Related Content PubMed PubMed Citation Articles by Furuse, J Articles by Yoshino, M

Contrast enhancement patterns of hepatic tumours during the vascular phase using coded harmonic imaging and Levovist to differentiate hepatocellular carcinoma from other focal lesions

Division of Hepatobiliary Pancreatic Medical Oncology, National Cancer Centre Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan

View larger version (10K): [in a new window]   Figure 1. Flow chart of the examination procedure.

View larger version (77K): [in a new window]   Figure 2. 64-year-old woman with hepatocellular carcinoma who underwent hepatectomy. (a) Grey scale fundamental ultrasound shows hypoechoic lesion, 2.8 cm in diameter, in S4 of the liver (arrows). (b) Contrast-enhanced ultrasound images by coded harmonic imaging at 60 s after administration of Levovist. Tumour vessels are observed as fine images flowing into the tumour (arrow). (c) Contrast-enhanced ultrasound images acquired by 1-s intermittent transmission at 80 s after administration. Perfusion flow is imaged as an area of diffusely increased vascularity within the tumour (arrows).

View larger version (60K): [in a new window]   Figure 3. 49-year-old man with intrahepatic cholangiocarcinoma histologically diagnosed by needle biopsy and who underwent radiotherapy. (a) Grey scale fundamental ultrasound shows a hyperechoic lesion with hypoechoic periphery 6.4 cm in diameter, in S6 of the liver (arrows). (b) Contrast-enhanced ultrasound images by coded harmonic imaging at 45 s after administration of Levovist. Tumour vessels are observed only in tumour periphery (arrows). (c) Contrast-enhanced ultrasound images acquired from 1-s intermittent transmissions at 90 s after administration. Vascularity is homogeneously increased only in the tumour periphery (arrows). No vascular enhancement was evident within the tumour throughout the whole examination.

View larger version (59K): [in a new window]   Figure 4. 70-year-old man with hepatic metastasis from colon carcinoma who underwent hepatectomy. (a) Grey scale fundamental ultrasound shows a hypoechoic lesion, 4.4 cm in diameter, in S5 of the liver (arrows). (b) Contrast-enhanced ultrasound images by coded harmonic imaging at 50 s after administration of Levovist. A tortuous artery flows into the tumour (arrow). Tumour vessels are observed as fine vascularity only in the periphery. (c) Contrast-enhanced ultrasound images acquired from 1-s intermittent transmissions at 90 s after administration. Vascularity is homogeneously increased only in the tumour periphery (arrows). No vascular enhancement was evident within the tumour throughout the whole examination.

View larger version (63K): [in a new window]   Figure 5. 44-year-old woman with hepatic haemangioma. (a) Grey scale fundamental ultrasound shows a hypoechoic lesion, 6.4 cm in diameter, in S7 of the liver (arrows). (b) Contrast-enhanced ultrasound images by coded harmonic imaging at 40 s after administration of Levovist. Vessels are observed around a portion of the periphery of the mass (arrows). (c) Contrast-enhanced ultrasound images acquired by 1-s intermittent transmission at 70 s after administration. The contrast is seen to be slowly filling portions of the haemangioma (arrowheads).

View larger version (60K): [in a new window]   Figure 6. 25-year-old man with focal nodular hyperplasia. (a) Grey scale fundamental ultrasound shows a hyperechoic lesion, 6.4 cm in diameter, in S4 of the liver (arrows). (b) Contrast-enhanced ultrasound images by coded harmonic imaging at 30 s after administration of Levovist. A tortuous artery flows into tumour centre (arrow). Vessels appear to be radially located in the mass (arrowheads). (c) Contrast-enhanced ultrasound images acquired by 1-s intermittent transmissions at 90 s after administration. Perfusion flow images are seen as a diffuse vascular pattern within the tumour similar to findings seen in hepatocellular carcinoma (arrows).