Background – Traditionally liver lesions are diagnosed by the use of computer tomography (CT), and if the diagnose is still unclear after this examination with CT, magnetic resonance imaging (MRI) can be used. The introduction of contrast enhanced ultrasound (CEUS) is another option in the diagnostics of these unclear lesions in the liver. More and more studies are made on this examination-method, but still, many refer to the seemingly safe option of CT or MRI. The aim of this assignment and study is to compare CEUS to the other safe options, like CT and MRI, and then try to give an answer to the question of which contributions contrast enhanced ultrasound can give to the diagnostics of unclear liver lesions.
Material and methods – The first section of this paper is a literary part, which mostly is based on the findings in different articles found by nonsystematic searching in pubmed. In addition to this first section of theory, there is a second study-section, which includes a material of 45 patients. The patients in the study were examined by CEUS in the timeframe from the beginning of Mai to the end of July 2009, and all had been referred to CEUS at Ullevål Hospital because of one or more unclear lesions in the liver. After going through the findings on contrast enhanced ultrasound, the study registered the findings of other methods,“golden-standards”, like follow-up CT, MRI and biopsies. In addition, clinics and blood tests also where a part of the standard diagnostics.
Results – 62 different lesions were diagnosed by CEUS, and 4 lesions were unclear even after contrast enhanced ultrasound. 42 benign and 20 malign diagnoses were registered with CEUS, with standard references there were diagnosed 40 benign and 22 malign lesions. This gives a specificity of 100 % and sensitivity of 91 % in diagnostics and differentiation of benign and malign liver lesions with CEUS. In diagnosing metastases, CEUS made 15 out of 16 correct diagnoses (93,8 %).
Conclusions – Contrast enhanced ultrasound is a good examination to differentiate benign and malign lesions in the liver, and has a high accuracy for detection of metastases. The results in this study show than CEUS can be compared to both CT and MRI in discovering these lesions, and especially that CEUS can reliable answer the question if a lesion is benign or malign.