Aim: Evaluation of b-mode and colour-duplex imaging, contrast-enhanced ultrasound (CEUS) and CT for the detection of liver lesions in comparison to intraoperative and histological findings.
Methods: Before laparotomy, 100 patients with suspected liver lesions were prospectively examined with b-mode and colour-duplex imaging followed by contrast-enhanced ultrasound (SonoVue) and CT-scan. Patients with nonresectable tumours (n=44) were excluded from the analysis. The diagnostic findings of 56 patients who displayed liver lesions were compared to the intraoperative and histological findings.
Results: CEUS enhanced the sensitivity for the number of detected lesions from 53 % (b-mode) to 86 % (CEUS) (p = 0.001), while CT-scan reached 76 %. The specificity of the three methods differed only slightly (87 % to 89 %). Contrast agents lead to an improvement in the results of ultrasound, particularly in cases of nodular metastases smaller than one centimeter (n = 7), after adjuvant chemotherapy (n = 4), near the surface (n = 6) and in lesions situated around the Lig. teres (n = 6).
Conclusions: CEUS leads to a significant improvement in the detection of liver lesions. For patients after adjuvant chemotherapy as well as for cases of small nodular metastases a CEUS should be carried out as a routine.