Stellenwert der kontrastunterstützten Sonografie im Vergleich zur B-Bild-Sonografie in der Charakterisierung fokaler Leberläsionen bei zugrunde liegender maligner hämatologischer Erkrankung: Eine retrospektive Studie mit n = 61 Patienten

Abstract

The aim of the retrospective study is to illustrate the role of contrast-enhanced ultrasound (CEUS) in the dignity assessment of focal liver lesions compared to B-mode ultrasound (US) in patients with malignant haematological diseases (MHD). Focal liver lesions were diagnosed in n = 61 patients (24 female, 37 male) with MHD via US within the period from November 2005 to February 2009. After the presentation of a not clearly cystic liver lesion (n = 48), CEUS was performed and documented in addition to US. The underlying diagnoses were stem cell diseases (n = 31) and malignant lymphomas (n = 30). The detection of a lesion was documented in n = 17 patients with at this time point primary diagnosed haematological disease, n = 13 patients were in relapse and n = 31 in complete remission (CR). The diagnoses of the liver pathology were confirmed through sonographic follow-up studies and clinical courses (n = 22), CT/MRI (n = 18) and histology (n = 21). In total 67 % of the cases were diagnosed as benign and 33 % as malignant liver lesions. Regarding the therapeutic state, the numbers of benign lesions differ from those of malignant lesions: primary diagnosis 53 vs. 47 %, relapse 69 vs. 31 %, CR 90 vs. 10 %. The frequency distributions of benign versus malignant lesions were 94 vs. 6 % in patients with stem cell diseases and 40 vs. 60 % in patients with malignant lymphomas. Regarding dignity assessment of focal liver lesions, CEUS showed a sensitivity of 90 vs. 45 % and specificity of 96 vs. 18 % (p < 0.0001) compared to US. CEUS possesses a significant diagnostic value in the characterization of focal liver lesions and should be used in the context of staging procedures in patients with MHD.