Journal of Diagnostics Concepts & Practice >
Advances in the application of contrast-enhanced ultrasound in the diagnosis and treatment of focal liver lesions
Received date: 2021-10-13
Online published: 2023-04-23
Ultrasonography is recommended as an ideal imaging technique for surveillance and screening of liver tumors by guidelines in many countries. Contrast-enhanced ultrasound (CEUS) based on conventional ultrasound can provide function information of tissue microcirculation and perfusion.CEUS has advantages over contrast-enhanced CT/MRI in providing real-time, continuous, dynamic monitoring without radiation damage. The ultrasound contrast microbubbles is excreted through the lung,with no evidence of any effect on cardiac, renal and thyroid function. Contrast microbubbles can be applied to patients with renal insufficiency. There is a very low incidence of allergic reaction about ultrasound contrast agents. CEUS has been recommended as a first-line enhanced imaging technique for the diagnosis and differential diagnosis of focal liver lesions by domestic and international guidelines. Compared with conventional ultrasound, CEUS has better performance in detection,diagnosis and differential diagnosis of focal liver lesions(FLL). The contrast-enhanced ultrasound liver imaging reporting and data system (LI-RADS) issued by the American College of Radiology (ACR) is used to describe the full spectrum of intrahepatic lesions in high-risk patients, predicte the risk stratification of focal liver lesions, and recommend clinical management strategies. CEUS LI-RADS aimed to achieve an extremely high (ideally 100 %) positive predictive value for the diagnosis of hepatocellular carcinoma. CEUS LI-RADS is also applicable to the Chinese population. In the aspect of intervention, CEUS is helpful to optimizing of the path and identification of target in puncture biopsy of FLL, improving the success rate of puncture and positive rate of specimen, and is applied in the guidance during ablation surgery, instant assessment, long-term efficacy evaluation and postoperative follow-up. In addition, intraoperative application of CEUS can improve the detection rate of small liver metastases and identify disappearing liver metastases carcinoma after chemotherapy on regular images, thus helping clinicians to revise surgical protocols. CEUS also has certain application value in evaluating the efficacy of systemic treatment of liver malignancies. In conclusion, CEUS is playing an increasingly important role in the diagnosis and treatment of liver tumors
REN Xinping, LI Junjian, ZHANG Jie, ZHAN Weiwei . Advances in the application of contrast-enhanced ultrasound in the diagnosis and treatment of focal liver lesions[J]. Journal of Diagnostics Concepts & Practice, 2022 , 21(06) : 684 -690 . DOI: 10.16150/j.1671-2870.2022.06.004
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