Evaluation of the diagnostic accuracy of CEUS in children with benign and malignant liver lesions and portal vein anomalies

Issue title: Selected Presentations held at the 34th Conference of the German Society for Clinical Microcirculation and Hemorheology, Regensburg, Germany, 27–28 November, 2015

Guest editors: L. Prantl, E.M. Jung and F. Jung

Article type: Research Article

Authors: Pschierer, K.^a | Grothues, D.^b | Rennert, J.^a | da Silva, N. Platz Batista^a | Schreyer, A.G.^a | Melter, M.^b | Stroszczysnski, C.^a | Jung, E.M.^{a; *}

Affiliations: [a] Department of Radiology, University Hospital Regensburg, Franz-Josef-Strauss-Allee, Regensburg, Germany | [b] Department of Paediatrics and Juvenile Medicine (KUNO), University Hospital Regensburg, Franz-Josef-Strauss-Allee, Regensburg, Germany

Correspondence: [*] Corresponding author: E.M. Jung, MD, Department of Radiology, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, D-93053 Regensburg, Germany. Tel.: 0941 944 7473; Fax: 0941 944 7409; E-mail: ernst-michael.jung@klinik.uni-regensburg.de

Abstract: OBJECTIVE:Comparison of the diagnostic findings of MRI, CT and CEUS in children with benign and malignant and portal venous anomalies of the liver. MATERIALS/METHODS:Retrospective analysis of the diagnostic findings of CEUS, MRI and CT scans in 56 children (age 0–17 years) with a total of 60 benign and malignant liver lesions and anomalies of the portal vein/perfusion. All patients underwent CEUS using sulphur hexafluoride microbubbles and a multi-frequency probe (1–5 MHz, 6–9 MHz). Cine-loops were stored up to 3 minutes. MRI was performed in 38 lesions. CT was performed in 8 lesions. RESULTS:Out of the 56 patients 49 liver lesions (48 benign, 1 malignant), 9 anomalies of the portal vein/perfusion and 2 of the biliary system were detected. 16/49 lesions were analyzed histopathologically. Using CEUS, the characterization of the lesions was possible in 45 out of 49 cases. In 32 cases, CEUS provided the exact diagnosis. Only two benign lesions were falsely categorized as malignant.Findings of MRI and CEUS were concordant in 84% of cases (n = 32/38). CEUS considered 1 benign lesion to be malignant. 2 lesions were not detectable and in 3 lesions no definite diagnosis was established using MRI.Findings of CT and CEUS were concordant in 5 of 8 cases. In 21 lesions CEUS as the only imaging modality was found to be sufficient for diagnostics. CONCLUSION:Despite the restricted indications for using CEUS in children, it offers a high diagnostic detection rate (93%) for characterization of liver lesions and portal vein anomalies.

Keywords: Contrast enhanced ultrasound (CEUS), children, liver, diagnostic value, safety

DOI: 10.3233/CH-152003

Journal: Clinical Hemorheology and Microcirculation, vol. 61, no. 2, pp. 333-345, 2015