Verbesserte Detektion von Leberläsionen durch Ultraschall-Kontrastmittel der zweiten Generation im Vergleich zur konventionellen Sonografie

Autor:	François Tranquart, A. Ignee, L. Bolondi, T. Albrecht, T. Livraghi, Christoph F. Dietrich
Rok vydání:	2009
Předmět:	High rate medicine.medical_specialty business.industry Ultrasound Gastroenterology Gold standard (test) Conventional ultrasound Predictive value Spiral computed tomography Contrast medium medicine Radiology Nuclear Medicine and imaging Surgery Radiology business Contrast-enhanced ultrasound
Zdroj:	Endoskopie heute. 22:105-109
ISSN:	1439-2577 0933-811X
DOI:	10.1055/s-0029-1224498
Popis:	AIM: Aim of this first prospective international multicentre phase III b study was the comparison of unenhanced (US) and contrast enhanced ultrasound (CEUS) with contrast enhanced spiral computed tomography (CT) and/or contrast enhanced magnetic resonance imaging (MRI) in the detec-tion of focal liver lesions. METHODS: 77 patients (73 per protocol) with liver lesions (primary or secondary liver lesions) were enrolled. After conventional ultrasound examination up to 3 injections of 2.4 or 4.8 mL SonoVue® were injected. Scans were repeated using contrast-specific imaging. Detection of lesions before and after contrast medium injection was com-pared using MRI and / or CT as the standard of reference. RESULTS: US detected 106 / 160 reference con-firmed liver lesions (sensitivity and positive predictive value (PPV) of 66 % and 77 %, respectively). CEUS detected 127 / 160 reference confirmed liver lesions (sensitivity and PPV of 79 % and 83 %, re-spectively). Five lesions were only detected using conventional unenhanced B-mode ultrasound, 26 lesions were only detected with CEUS. 27 / 154 lesions in 73 patients (17.5 %) detected by CEUS could not be confirmed by the reference method and thus were considered false positive. No adverse events were reported. DISCUSSION: CEUS with SonoVue® improves the ability of ultrasound to detect liver lesions. The high rate of lesions detected with CEUS and not by the reference methods (false positive) is actually a general bias in detection studies, in which no absolute non-invasive gold standard is available. Therefore, the true PPV of CEUS may be higher than that reported in this study.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::f3d6d496675332de69f6c7c0d8e625e2 https://doi.org/10.1055/s-0029-1224498 Zobrazit plný text záznamu