Contrast enhanced ultrasound of splenic lymphoma involvement

Abstract

Objective The aim of this study was to compare the value of contrast-enhanced ultrasonography (CEUS) with standard B-mode ultrasound (US) for diagnosis of splenic lymphoma involvement. Methods From 04/2005 to 10/2008 n = 250 lymphoma patients were investigated by standard B-mode US. A homogeneous splenic echotexture was found in 199 patients (79%). To clarify the benefit of CEUS in this group a pilot series was performed with 16 of the 199 lymphoma patients. All patients with an abnormal splenic echotexture on standard B-Mode US ( n = 51) including focal hypoechoic splenic lesions ( n = 41) and an inhomogeneous splenic texture ( n = 10) were studied by CEUS. CEUS data were retrospectively evaluated. The diagnoses included indolent lymphoma ( n = 27), aggressive lymphoma ( n = 14), and Hodgkin's disease ( n = 10). Number and size of lesions were determined by B-mode US and CEUS. The visualisation of splenic lymphoma involvement by CEUS in comparison to B-mode US was classified as worse, equal, or better. Results All patients with a homogeneous spleen on B-mode US ( n = 16) had no visible focal lesions on CEUS. Study patients with focal lesions ( n = 41) had a hypoechoic ( n = 22) or isoechoic ( n = 19) enhancement during the arterial phase, and a hypoechoic enhancement during the parenchymal phase ( n = 41). The visualisation of focal splenic lymphoma was equal ( n = 32), better ( n = 6), or worse ( n = 3). In all study patients with an inhomogeneous spleen on B-mode US ( n = 10) no focal lesions were found by CEUS and the value of CEUS therefore was classified as worse. Conclusion CEUS has no clear advantage for diagnosis of splenic lymphoma involvement.