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

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.

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

Sensors ◽  
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).

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

Ultrasound ◽  
2017 ◽  
Vol 26 (3) ◽  
pp. 178-181 ◽  
Author(s):  
Marta Anna Piorkowska ◽  
Rok Dezman ◽  
Maria E Sellars ◽  
Annamaria Deganello ◽  
Paul S Sidhu
Keyword(s):  
Imaging Techniques ◽  
Paediatric Population ◽  
Liver Lesion ◽  
Focal Liver Lesion ◽  
Focal Liver Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Safe Alternative ◽  
Contrast Enhanced ◽  
Hepatic Haemangioma

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.

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

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.

Characterization of Malignant Focal Liver Lesions with Contrast-Enhanced 40 MHz Ultrasound Imaging in Hepatitis B Virus X Transgenic Mice: A Feasibility Study

2008 ◽  
Vol 30 (4) ◽  
pp. 203-216 ◽  
Author(s):  
Ai-Ho Liao ◽  
Ya-Chien Cheng ◽  
Chien-Hsiu Weng ◽  
Ting-Fen Tsai ◽  
Wei-Hsiang Lin ◽  
...  
Keyword(s):  
Transgenic Mice ◽  
Liver Parenchyma ◽  
Liver Lesion ◽  
Focal Liver Lesion ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Preclinical Research ◽  
Post Contrast ◽  
Contrast Enhanced ◽  
B Virus

Contrast-enhanced ultrasound (CEUS) imaging has been a reliable clinical method of detecting three vascular contrast phases and characterizing focal liver lesions. Previous results were all from human (i.e., clinical studies). The main purpose of this study was to extend this to small animals and to investigate the feasibility of using CEUS in preclinical research. Specifically, high-frequency (40 MHz) ultrasound liver imaging with albumin-shelled microbubbles was employed to detect the three vascular contrast phases and characterize focal liver lesions that developed in thirteen Hepatitis B virus X (HBx) transgenic mice at around 14 to 16 months of age. Previous studies indicated that 90–100% incidence of hepatocellular carcinoma (HCC) was observed in HBx transgenic male mice. After injecting the contrast agent, the time-intensity curves (TICs) of focal liver lesions, vessels in focal liver lesions and surrounding liver parenchyma tissues were measured for 30 minutes. The peak of mean intensity relative to the baseline increased 7.36 dB (p<0.02). On the other hand, the mean contrast between the focal liver lesion and the liver parenchyma increased by 7.74 (p<0.05) dB, thus allowing clear detection of the lesion margin. Histopathology investigations confirmed the development of the lesion in these mice. In addition, guidelines of European Federation of Societies for Ultrasound in Medicine and Biology were followed as an attempt to characterize features of the TICs in mice. The arterial phase was defined as 2 to 60 seconds post contrast injection, and the parenchyma phase was defined as the time period from 10 to 30 minutes post contrast injection. Comparing the imaging with the pathology results, the sensitivity, specificity and accuracy of CEUS for the detection of malignant focal liver lesion in HBx transgenic mice were 91%, 100% and 92%. These results demonstrated that high-frequency CEUS imaging potentially can be used for detecting the three vascular contrast phases of malignant focal liver lesions and characterizing malignant focal liver lesions in mice. Thus can be a valuable tool in preclinical research.

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