DYNAMIC CONTRAST-ENHANCED ULTRASOUND WITH CARBON-DIOXIDE MICROBUBBLESAS ADJUNCT TO ARTERIOGRAPHY OF LIVER-TUMORS

Purpose: The goal of the study is to evaluate utility of contrast-enha nced ultrasound (US) with carbon dioxide microbubbles in evaluation of hepatic lesions. Methods: Twenty-eight patients with single or multip le hepatic lesions (11 hepatocellular carcinoma, 8 hemangiomas, 5 meta stases, 1 adenoma, 1 focal nodular hyperplasia, 2 regenerative nodules ) were examined. US exam was performed during intraarterial injection of 10 ml Of CO2 through the same catheter employed for liver arteriogr aphy. The US exam was videotaped in its salient phases. Characteristic s of enhancement were evaluated and correlated with histological findi ngs or patient follow-up. Results: Sonographic angiography clearly dem onstrated vascularization of the lesions. Hepatocellular carcinoma, he mangioma, metastases, focal nodular hyperplasia, and regenerative nodu les had very characteristic patterns. The injection Of CO2 allowed det ection of small additional nodules. Conclusion: Sonographic angiograph y can improve characterization and staging of hepatic tumors. Low cost and the simplicity of the technique should encourage further experime ntation.