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By Luigi Bolondi

In fresh years, the imaging-based prognosis of mass liver lesions has develop into more and more advanced end result of the quantity and morphological variability of lesions that sleek imaging options are at present capable of reveal. If the sensitivity in detection has tremendously elevated, characterisation has remained tricky and represents a serious problem for the clinician.

The availability of blood-pool distinction brokers for ultrasound (US), particularly second-generation US distinction brokers in line with perfluorocarbon- or sulfur-hexafluoride-filled microbubbles, and the advance of contrast-specific software program and applied sciences have unfolded new views either for the instant characterisation of any mass lesion detected within the liver and for expanding the sensitivity folks within the detection of liver metastases.

Taking into consideration the nice impression of this new expertise on medical perform, the eu Federation of Societies for Ultrasound in drugs and Biology (EFSUMB) organised, in January 2004, in Rotterdam, a consensus assembly of specialists that allows you to enhance instructions for using US distinction brokers within the prognosis of liver ailments . those directions, in addition to discussions of extra advances within the medical program of contrast-enhanced harmonic US are provided during this e-book by means of an across the world popular crew of specialists. The e-book represents offers a huge place to begin for medical implementation of this new diagnostic procedure.

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South Medical Journal 22(8):357-361 Terkivatan T, de Wilt JH, de Man RA et al (2001) Indications and long-term outcome of treatment for benign hepatic tumors: a critical appraisal. Arch Surg 136(9):1033-1038 Ishak KG, Rabin L (1975) Benign tumors of the liver. Med Clin North Am 59:995-1013 Uggowitzer MM, Kugler C, Mischinger HJ et al (1999) Echoenhanced Doppler sonography of focal nodular hyperplasia of the liver. J Ultrasound Med 18(7): 445-451; quiz 453-454 Wang Y,Wang WP, Ding H et al (2004) Resistance index in differential The Role of Contrast-Enhanced Ultrasound (CEUS) in Identifying Focal Liver Lesions 33.

2) [23, 24]. It allows immediate repositioning of the electrodes in case of incomplete treatment. 1% in experienced hands [24]. ■ Clinical Management of HCC with and without the Use of USCA The clinical management of HCC was discussed at the EASL meeting in Barcelona, depending on the size of the nodule at US and serum AFP levels [7]. Four situations were found without the use of ultrasound contrast media. (1) If US failed to detect a nodule while serum AFP levels are increasing, a contrast-enhanced helical CT (CE-CT) is needed to rule out an HCC.

Accompanying the hepatic arteries, the central major portal-venous branches are already contrast-enhanced We have observed three patients (two female, one male, all between 50 and 55 years) with histological proven FNH, which showed marked wash-out during PV and late phases. CT, MR, and, in one case, (Fig. 16) radionuclide scans were inconclusive as well. Fig. 15. Typical time-intensity curve of a FNH. Yellow curve = FNH, green curve = liver tissue The Role of Contrast-Enhanced Ultrasound (CEUS) in Identifying Focal Liver Lesions a b c d 35 Fig.

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