Przydatność szarokopasmowego odwróconego w fazie obrazowania harmonicznego z wykorzystaniem Dopplera mocy w diagnostyce naczyniaków wątroby

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Background: The purpose of this study was to assess the sensitivity of echo-enhanced phase-inversion power Doppler sonography (PI) in depicting the vascular enhancement of hemangiomas, thus confirming the exact diagnosis. Material/Methods: Twenty patients were examined. The presence of hemangioma was confirmed by surgical resection (n=2), two-phase (hepatic arterial and portal phases) contrast-enhanced spiral computed tomography (n=8), or sonographic follow-up, which showed no change in lesion size for at least 6 months (n=10). Prior to enhanced sonography, all patients had undergone both native B-mode and tissue harmonic imaging mode sonography, color Doppler, and power Doppler helical CT examinations. After injection of 2.5 g of Levovist intravenously, analysis of the arrival of contrast agent was performed by phase-inversion power Doppler sonography. Results: Evaluation of the 20 patients revealed 37 hemangiomas. Color and power Doppler sonography were non-specific for hemangioma in our examination. However, based on the phase-inversion power Doppler sonography findings, the 20 patients with the 37 hemangiomas were diagnosed. Typical features of hemangioma, such as peripheral globular and rim-like enhancement followed by a slow centripetal fill-in, were clearly visible. In 3 cases of small hemangiomas, computed tomography had failed to disclose the pathology, while phase-inversion sonographic images were completely suggestive of what was later confirmed at 6 months follow-up. Conclusions: Based on our results, we can recommend phase-inversion power Doppler sonography in the differential diagnosis of hemangioma by visualizing the characteristic rim-like enhancement pattern followed by a slow centripetal fill-in as an excellent diagnostic modality.