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Contrast Media |
1 Department of Imaging, Hammersmith Hospital, Du Cane Rd, London W12 0HS, England (M.J.K.B., T.A., D.O.C., N.P., V.J., J.B.B., R.J.E.)
2 Clinical Development Diagnostics, Schering, Berlin, Germany (A.B., R.S.).
PURPOSE: To see whether stimulated acoustic emission (SAE) in the liver parenchyma in the late phase of enhancement with SH U 508A increases the conspicuity of occult metastases at ultrasonography (US).
MATERIALS AND METHODS: Eighteen patients with known hypo- or hypervascular hepatic metastases underwent US after SH U 508A administration, after a delay of at least 5 minutes, to ensure decay of blood pool enhancement. In 16 patients with visible metastases, conspicuity was compared on registered SAE and gray-scale scans by two blinded readers and by using computerized analysis of relative gray-scale and color Doppler conspicuity scores inside and outside the lesion. In nine patients, areas suspected of being involved but without definite gray-scale masses were imaged in the same way. Paired sections were analyzed by two blinded readers looking for parenchymal color defects without corresponding gray-scale masses; nine control images from three healthy volunteers were also included.
RESULTS: Intense, transient parenchymal SAE was seen in all subjects. All metastases appeared as areas of reduced or absent signal. The conspicuity score was 80% for SAE versus 9% for gray-scale US (P < .001, Wilcoxon signed rank test). SAE-specific defects were seen in all patients but in none of the volunteers. Metastases seen on SAE but undetectable on gray-scale images were proved in three patients.
CONCLUSION: SAE with SH U 508A improves the conspicuity of metastases. SAE-specific defects may reveal isoechoic or subtle metastases.
Index terms: Liver neoplasms, metastases, 761.33 • Liver neoplasms, US, 761.12983, 761.12988, 761.33 • Ultrasound (US), contrast media, 761.12988 • Ultrasound (US), Doppler studies, 761.12983 • Ultrasound (US), technology, 761.12989
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