Indeterminate focal liver lesions incidentally discovered at gray-scale US: role of contrast-enhanced sonography.

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OBJECTIVES: to assess the role of contrast-enhanced ultrasound (CEUS) in thecharacterization of focal liver lesions (FLLs) incidentally discovered butindeterminate at gray-scale ultrasound (US).MATERIALS AND METHODS: one hundred forty-two consecutive patients with 174 FLLs(169 benign and 5 malignant) incidentally discovered but indeterminate atgray-scale US, underwent CEUS after the administration of SonoVue. Two readersindependently reviewed CEUS scans and: (1) classified each lesion as malignant orbenign on a 5-point scale of confidence by means of definite diagnostic criteria;(2) provided if possible a specific diagnosis; (3) were requested if furtherimaging was needed for lesion characterization. Sensitivity, specificity, andareas under the receiver-operating characteristic curve (Az) as well asinterobserver agreement were calculated.RESULTS: at CEUS, both readers correctly differentiated benign from malignantlesions in 168 of 174 (96.5%) cases (P < 0.0001). A specific correct diagnosiswas provided in 123 of 174 (70.7%) and 127 of 174 (72.9%) cases for reader 1 and 2, respectively (P < 0.0001). A further imaging study to characterize the lesion after CEUS was requested in 67 cases (38.5%) for reader 1 (P < 0.001) and 46cases (26.4%) for reader 2 (P < 0.001). Receiver-operating characteristicanalysis after CEUS revealed Az value of 1 for both readers and sensitivity andspecificity values of 100% and 97.04% for reader 1 and 100% and 96.45 for reader 2 respectively (P < 0.0001). Inter-reader agreement at CEUS was good (weighted k = 0.779).CONCLUSION: CEUS improves the diagnostic performance of radiologists in thecharacterization of indeterminate FLLs incidentally discovered at US and reduces the need for further radiologic work-up.
Lingua originaleEnglish
pagine (da-a)106-115
Numero di pagine10
RivistaInvestigative Radiology
Stato di pubblicazionePublished - 2011

All Science Journal Classification (ASJC) codes

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