Ultrasonographic evaluation of focal hepatic lesions: Comparison of pulse inversion harmonic, tissue harmonic, and conventional imaging techniques

A prospective study was performed to evaluate whether pulse inversion harmo nic imaging and tissue harmonic imaging improve the lesion conspicuity and change ultrasonographic characteristics of focal hepatic lesions. Three rad iologists evaluated 97 focal hepatic lesions by consensus: cirrhosis-relate d nodules (n = 23), metastases (n = 23), hemangiomas (n = 27), and cysts (n = 24). In our study, pulse inversion harmonic imaging was judged superior to both tissue harmonic imaging and conventional imaging in conspicuity and overall quality for cirrhosis-related nodules, metastases, and cysts (P < 0.05). Compared with conventional imaging, both pulse inversion harmonic im aging and tissue harmonic imaging provided better conspicuity, clearer inte rnal echogenicity, and stronger through-transmission of cysts (P < 0.05). Pulse inversion harmonic imaging was judged to be better in depicting inter nal morphology for cirrhosis-related nodules and metastases than convention al imaging (P < 0.05). For hemangiomas, no statistically significant differ ence was found in all parameters except better posterior enhancement by tis sue harmonic imaging than other techniques. In conclusion, pulse inversion harmonic imaging short ed the best conspicuity and also enhanced characteri stics of both cystic and solid hepatic lesions. Tissue harmonic imaging was judged superior to conventional imaging in evaluating cysts but was not be neficial for solid lesions. The results of this trial may be specific to th e machine used for this study.