No coin nor oath required. For personal study only.
To assess the value of a new transpumonary, galactose-baseQ intravascular contrast agent, SHLJ 508A (Lcvovist"), without and with the combimmtion of harmonic imaging and the three-dimensional power Doppler mode in the depiction of the intratumoral vascularity and the assessment of hemodynamic parameters (RI) in FNH's of the liver. Methods and Material: 12 patients with anamncstically known or histologically proven FNH's of the liver underwent examination with 400 mg/ml SHU 508A (L.cvovist@) after informed consent to evaluate the intratumoral vascular pattern of their lesions. In some patients the three-dimensional power Doppler mode and the first harmonic response after administration of the contrast agent were applied. The protocol was approved by the Ethics Committee of the Chamber of Physicians. Results: The mean signal enhancement of SHU 508A in the lesions was 3 IO sec. Only in superficially located lesions in the left lobe of the liver, the improved signal-to clutter ratio of the contrast agent enabled a clear depiction of the tumor vascularity compared with power Doppler. Lesions less than 3 cm show no typical vascular pattern. Three-dimensional power mode and harmonic imaging shows a "glomcrula-like" vascular appearance of lesions larger than 3 cm. Mean RI's (0,5 1) ofthe feeding artery were iignificantly lower than the mean RI's (0,68) of the main hepatic arteries. Conclusion: New technical development in sonography, such as power Doppler, harmonic imaging and three-dimensional ultrasound, and transpuhnonary "microbubble contrast agents" enable the depiction of a typical intratumoral vascular pattern of FNH's of the liver. Lesions with a diameter less than 3 cm however remain sonographically indifferent.
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