Comparison of contrast harmonic imaging in B-Mode with stimulated acoustic emission, conventional B-Mode US and spiral CT in the detection of liver lesions

Purpose: Comparison between contrast harmonic imaging (CHI) in B-mode with stimulated acoustic emission (SAE), conventional B-mode US, and spiral CT in the detection of focal liver lesions. Methods: In this pilot, study 26 patients with liver lesions diagnosed by B-mode US and contrast-enhanced spiral-CT were additionally examined with CHI in B-mode. Each examination started with a bolus injection of 4 g of the US contrast agent Levovist (300 mg/ml) after a delay of at least 5 minutes to ensure liver-specific phase. All examinations were documented on video tapes and analysed by two radiologists. Results: 81 liver lesions were diagnosed with both US examinations and spiral CT. B-mode US detected 66 lesions, CHI with SAE 72 lesions, and spiral CT 73 lesions. Compared to spiral CT 8 lesions in 3 patients could be depicted additionally with both US methods. Metastases and HCC present in CHI with SAE as not-enhancing signal contrast agent areas. Delineation of haemangiomas and FNH was often worse compared to the native examinations. Conclusion: The new US method CHI with SAE depicted more lesions than conventional B-mode US and is in some cases superior to spiral CT.