Aim: The aim is to present our large monocentric experience in the characterization of focal liver lesions (FLLs) using Contrast Enhanced Ultrasound (CEUS).
Material and Method: We performed a large retrospective study in the Gastroenterology and Hepatology Department Timișoara, between September 2009 and January 2013, which included 1041 patients (mean age 58.7±12.7 years) with a total of 1298 FLLs evaluated using CEUS. A CEUS examination was considered conclusive if the lesion respected one of the typical enhancement patterns described in the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Guidelines.
Results: From the 1298 FLLs, 857 (65.8%) were evaluated in patients without known chronic hepatopathy and 444 (34.2%) in patients with chronic hepatopathy. CEUS was conclusive for a specific pathology in 1076 cases (82.9%). For the differentiation of benign/malignant lesions, CEUS reached a conclusive diagnosis in 1168 (90%) cases.
The percentage of conclusive CEUS examinations was significantly higher in patients without chronic liver disease compared with those with chronic hepatopathies: 90.8% vs. 81.5%, p<0.0001. On the other hand, there was no significant statistical difference between the proportion of conclusive CEUS examinations for FLLs smaller, respectively larger than 3 cm (86.9% vs. 88.6%, p = 0.4174)
Conclusion: CEUS was conclusive for the pathological type in approximately 83% of the FLL discovered in ultrasound examination and the benign or malignant character of the FLL was discovered in 90% of cases. Based on this evidence, we can recommend CEUS as a first line imaging method to characterize FLLs.
