Sa1008 Evaluation of Stiffness of the Spleen (Fibrospleen) in a Real Life Cohort of Patients With All Stages of Liver Diseases

Abstract

Background and aim. Contrast enhanced ultrasound (CEUS) has improved the diagnostic work up of focal liver lesions and, according to international guidelines, is often used as the first method of choice in differentiating benign from malign lesions. However, interpretation of the contrast-enhancement patterns is a subjective modality with a certain degree of inter-observer variability. In the last years, quantitative approaches able to measure the amount and the time course of contrast uptake have shown great promise in revealing tumour response to anti-angiogenic drugs in patients with different types of malignant lesions. We evaluate the feasibility of dynamic CEUS (D-CEUS) with perfusion software as a diagnostic tool in characterizing different types of liver lesions. Patients and methods. CEUS with second generation contrast agent (Sonovue, Bracco) was performed in 22 benign and 15 malignant hepatic lesions in 32 patients 15 female and 17 male; aged 51±12 years). All cases were confirmed by MRI. Lesion vasculature was assessed in a specific harmonic mode associated with a perfusion and quantification software (Q-Lab, Philips). Five D-CEUS functional parameters (peak intensity, PI; time to PI, TP; area under the curve, AUC; slope of wash in, Pw; mean transit time, MTT) were extracted from time intensity curves and were compared among groups and applied to characterize different types of lesions. Statistical analysis was performed by a non-parametric test and a p value < 0.01 was considered statistically significant. Results. We report the preliminary results obtained in 14 hemangiomas, 8 focal nodular hyperplasias (FNH) and 20 hepatocellular carcinomas (HCC). Comparison between benign and malignant lesions revealed no statistically significant differences in all the perfusion parameters except for MTT that was longer in the first group (p = 0.005). For individual analysis, PI, AUC, and Pwi, were significantly higher in FNH than both in hemangiomas and HCC, while TTP was significantly shorter in FNH than in HCC. When we compared hemagiomas and HCC, PI, Pwi and TTP were significantly lower in the former than in the latter. Conclusion. Quantitative analysis provide a more reliable characterization of different types of liver lesions and could be an excellent tool to improve the diagnostic accuracy of CEUS. However further studies with a greater number of patients are required to confirm these results.