Hepatic sonography: Comparison of tissue harmonic and standard sonography techniques

OBJECTIVE, This study was performed to compare tissue harmonic sonography o f the liver with conventional sonography of the liver, SUBJECTS AND METHODS. Forty-eight patients underwent tissue harmonic and co nventional sonography of the liver using a randomized imaging sequence. Ima ging parameters were standardized, but gain varied. Techniques were compare d using predetermined impact analysis categories. If a finding was revealed by only one sonographic technique, additional confirmation was obtained by another imaging technique or by surgery. In a separate image quality analy sis, masked images were reviewed by two experienced radiologists to evaluat e fluid-solid differentiation, near-field, far-field, and overall image qua lity. Rankings were correlated with field of view of images and body habitu s of patients as determined by body mass index. RESULTS. Tissue harmonic sonography provided the same information as conven tional sonography in 34 patients (71%) and added information in 14 patients (29%). The findings from tissue harmonic sonography resulted in altered tr eatment in five patients (10%), Eight patients (17%) had lesions revealed b y tissue harmonic sonography only. Four patients (8%) had inadequate far-fi eld visualization by both techniques. Both observers ranked tissue harmonic sonography the same as or better than standard sonography in 46 patients ( 96%) for fluid-solid differentiation, in 46 patients (96%) for near-field i mage quality, and in 45 patients (94%) for overall image quality. For far-f ield image quality, one observer ranked tissue harmonic sonography the same as or better than conventional sonography in 40 patients (83%), and the se cond observer, in 41 patients (85%). Image quality ratings showed no correl ation with body habitus of the patients or field of view of images. CONCLUSION. Tissue harmonic sonography of the liver provides more informati on and better image quality than does conventional sonography of the liver.