Characterization of a hepatic haemangioma with contrast-enhanced ultrasound in an infant

Focal liver lesions are uncommon in the paediatric population, majority are benign but need to be clearly identified as benign. Contrast-enhanced ultrasound has recently received approval for paediatric hepatic use and represents an inexpensive and safe alternative to computed tomography and magnetic resonance imaging for focal liver lesion characterization. We report a case of an incidental focal liver lesion in a four-month-old infant, indeterminate on B-mode ultrasound but successfully characterized with contrast-enhanced ultrasound as a haemangioma, without recourse to other imaging techniques, and with minimal patient discomfort.

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Contrast-enhanced ultrasound of benign and malignant liver lesions in children

Pediatric Radiology ◽

10.1007/s00247-021-04976-2 ◽

2021 ◽

Author(s):

Cheng Fang ◽

Sudha A. Anupindi ◽

Susan J. Back ◽

Doris Franke ◽

Thomas G. Green ◽

...

Keyword(s):

Liver Lesion ◽

Focal Liver Lesion ◽

Ultrasound Contrast Agents ◽

Focal Liver Lesions ◽

Liver Lesions ◽

Contrast Enhanced Ultrasound ◽

Cross Sectional ◽

Pediatric Liver ◽

Contrast Enhanced

AbstractContrast-enhanced ultrasound (CEUS) is increasingly being used in children. One of the most common referrals for CEUS performance is characterization of indeterminate focal liver lesions and follow-up of known liver lesions. In this setting, CEUS is performed with intravenous administration of ultrasound contrast agents (UCAs). When injected into a vein, UCA microbubbles remain confined within the vascular network until they dissipate. Therefore, visualization of UCA within the tissues and lesions corresponds to true blood flow. CEUS enables continuous, real-time observation of the enhancement pattern of a focal liver lesion, allowing in most cases for a definite diagnosis and obviating the need for further cross-sectional imaging or other interventional procedures. The recent approval of Lumason (Bracco Diagnostics, Monroe Township, NJ) for pediatric liver CEUS applications has spurred the widespread use of CEUS. In this review article we describe the role of CEUS in pediatric liver applications, focusing on the examination technique and interpretation of main imaging findings of the most commonly encountered benign and malignant focal liver lesions. We also compare the diagnostic performance of CEUS with other imaging modalities for accurate characterization of focal liver lesions.

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Deep Neural Architectures for Contrast Enhanced Ultrasound (CEUS) Focal Liver Lesions Automated Diagnosis

Sensors ◽

10.3390/s21124126 ◽

2021 ◽

Vol 21 (12) ◽

pp. 4126

Author(s):

Cătălin Daniel Căleanu ◽

Cristina Laura Sîrbu ◽

Georgiana Simion

Keyword(s):

Liver Lesion ◽

Focal Liver Lesion ◽

Evaluation Procedure ◽

Focal Liver Lesions ◽

Contrast Enhanced Ultrasound ◽

Biomedical Image Processing ◽

Biomedical Image ◽

Cad System ◽

Image Sensing ◽

Contrast Enhanced

Computer vision, biomedical image processing and deep learning are related fields with a tremendous impact on the interpretation of medical images today. Among biomedical image sensing modalities, ultrasound (US) is one of the most widely used in practice, since it is noninvasive, accessible, and cheap. Its main drawback, compared to other imaging modalities, like computed tomography (CT) or magnetic resonance imaging (MRI), consists of the increased dependence on the human operator. One important step toward reducing this dependence is the implementation of a computer-aided diagnosis (CAD) system for US imaging. The aim of the paper is to examine the application of contrast enhanced ultrasound imaging (CEUS) to the problem of automated focal liver lesion (FLL) diagnosis using deep neural networks (DNN). Custom DNN designs are compared with state-of-the-art architectures, either pre-trained or trained from scratch. Our work improves on and broadens previous work in the field in several aspects, e.g., a novel leave-one-patient-out evaluation procedure, which further enabled us to formulate a hard-voting classification scheme. We show the effectiveness of our models, i.e., 88% accuracy reported against a higher number of liver lesion types: hepatocellular carcinomas (HCC), hypervascular metastases (HYPERM), hypovascular metastases (HYPOM), hemangiomas (HEM), and focal nodular hyperplasia (FNH).

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Contrast-Enhanced Ultrasound LI-RADS LR-5 in Hepatic Tuberculosis: Case Report and Literature Review of Imaging Features

Gastroenterology Insights ◽

10.3390/gastroent12010001 ◽

2021 ◽

Vol 12 (1) ◽

pp. 1-9

Author(s):

Antonella Forgione ◽

Francesco Tovoli ◽

Matteo Ravaioli ◽

Matteo Renzulli ◽

Francesco Vasuri ◽

...

Keyword(s):

Liver Lesion ◽

Focal Liver Lesion ◽

Focal Liver Lesions ◽

Liver Imaging ◽

Imaging Features ◽

Contrast Enhanced Ultrasound ◽

Mri Findings ◽

Tuberculosis Case ◽

Contrast Enhanced ◽

Hepatic Tuberculosis

Background: The liver is involved in disseminated tuberculosis in more than 80% of cases while primary liver involvement is rare, representing <1% of all cases. Hepatic tuberculosis (TB) can be treated by conventional anti-TB therapy; however, diagnosing this disease remains a challenge. The diagnosis might be particularly difficult in patients with a single liver lesion that could be misdiagnosed as a tumor or other focal liver lesions. Although computed tomography (CT) and magnetic resonance imaging (MRI) findings have been described, there is a paucity of literature on contrast-enhanced ultrasound (CEUS) features of hepatic TB. Case Summary: herein, we describe a case of a patient with tuberculous lymphadenopathy and chronic Hepatitis C Virus (HCV)-related liver disease who developed a single macronodular hepatic TB lesion. Due to the finding of a hepatocellular carcinoma (HCC) highly suggestive CEUS pattern, specifically a LR5 category according to the Liver Imaging Reporting and Data System (LI-RADS), and a good response to antitubercular therapy, a non-invasive diagnosis of HCC was made, and the patient underwent liver resection. We also review the published literature on imaging features of hepatic TB and discuss the diagnostic challenge represented by hepatic TB when occurs as a single focal liver lesion. Conclusions: this report shows for the first time that the CEUS pattern of hepatic TB might be misinterpreted as HCC and specific imaging features are lacking. Personal history and epidemiological data are mandatory in interpreting CEUS findings of a focal liver lesion even when the imaging pattern is highly suggestive of HCC.

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