Contrast enhanced ultrasound for the diagnosis of liver hemangiomas – results of a Romanian multicentre study.

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Contrast enhanced ultrasound for the diagnosis of liver hemangiomas – results of a Romanian multicentre study.

Roxana Sirli, Ioan Sporea, Daniela Larisa Sandulescu, Alina Popescu, Mirela Danila, Adrian Saftoiu, Zeno Sparchez, Radu Badea

Abstract

Background and aim: Contrast enhanced ultrasound (CEUS) has been proven to be a reliable method for the charac- terization of focal liver lesions (FLL). The aim of this paper was to evaluate the performance of CEUS for the diagnosis of liver hemangiomas in a large cohort of patients. Material and method: We performed a multicentre prospective study which included successive CEUS examinations from fourteen centers from Romania. CEUS examinations were performed in de novo FLL, using low mechanical index ultrasound, following an intravenous bolus of 2.4 ml SonoVue. CEUS was considered conclusive for hemangioma if a typical pattern was present following contrast (centripetal ll in during the arterial phase, hyperenhanced lesion during venous and late phases). In all cases a reference method was available (contrast CT or MRI or biopsy). The trial was registered in clinicaltrials.gov (Identi er NCT01329458). Results: During February 2011 – May 2015, 1153 CEUS examinations were performed for the evaluation of de novo FLL. Out of the 1153 de novo FLL, 238 cases were diagnosed as hemangiomas by CEUS (typical enhancing pattern). Contrast CT/MRI and biopsy diagnosed additional 24 he- mangiomas. From the 238 cases diagnosed as hemangiomas by CEUS, in 11 the nal diagnosis was different. Considering contrast CT/MRI and biopsy as reference methods, CEUS had 90.4% sensitivity, 98.8% speci city, 95.4% positive predictive value, 97.4% negative predictive value, resulting in 96.9% diagnostic accuracy for the diagnosis of hemangiomas. Conclu- sion: CEUS is a sensitive and very speci c method for the diagnosis of hemangiomas.

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