Comparison Between SonoVue and Sonazoid Contrast-Enhanced Ultrasound in Characterization of Focal Nodular Hyperplasia Smaller Than 3 cm.

Abstract

OBJECTIVES:

This study aimed to compare the diagnostic efficacy of contrast-enhanced ultrasound (CEUS), including SonoVue (SV; sulfur hexafluoride; Bracco SpA, Milan, Italy) and Sonazoid (SZ; perflubutane; GE Healthcare, Oslo, Norway), and explore the differences between them in the characterization of CEUS features in focal nodular hyperplasia (FNH) smaller than 3 cm.

METHODS:

This retrospective study included 31 lesions smaller than 3 cm diagnosed as FNH by CEUS between April 2019 and November 2019. Nine patients underwent SZ CEUS examinations, and 22 patients underwent SV CEUS examinations; all of them were confirmed by pathologic examinations or 2 other kinds of CEUS methods. We compared the CEUS features between SZ and SV in different phases, including arterial, portal venous, delayed, and Kupffer (SZ) phases.

RESULTS:

Twenty-eight lesions were eventually diagnosed as FNH; 3 were misdiagnosed as FNH by SV CEUS. The overall diagnostic accuracy of CEUS including SZ and SV was 90.3% (28 of 31). No significant difference was found (P > .05) for the positive predictive value. Likewise, no significant difference in depicting centrifugal filling (9 of 9 versus 19 of 19), spoke wheel artery (6 of 9 versus 8 of 19), or feeding artery (2 of 9 versus 10 of 19) features was found between the contrast agents; However, SZ was significantly better at depicting the presence of a central scar than SV (5 of 9 versus 3 of 19; P = .030). Misdiagnosed cases are discussed in detail.

CONCLUSIONS:

Contrast-enhanced ultrasound enables an accurate diagnosis in FNH smaller than 3 cm. Sonazoid CEUS and SV CEUS were comparable in diagnosing small FNH, and both agents were highly capable of depicting the centrifugal filling dynamic process of FNH smaller than 3 cm. Sonazoid CEUS might be better than SV CEUS at depicting a central scar.

• Authors: Mengna He, Lu Zhu, Min Huang, Liyun Zhong, Zhengdu Ye, Tian'an Jiang
• Journal: Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine (J Ultrasound Med) Vol. 40 Issue 10 Pg. 2095-2104 (Oct 2021) ISSN: 1550-9613 [Electronic] England
• PMID: 33305869 (Publication Type: Journal Article)
• Copyright: © 2020 American Institute of Ultrasound in Medicine.

Chemical References

• Contrast Media
• Ferric Compounds
• Oxides
• Phospholipids
• Sonazoid
• contrast agent BR1
• Iron
• Sulfur Hexafluoride

Topics

• Contrast Media
• Diagnosis, Differential
• Ferric Compounds
• Focal Nodular Hyperplasia (diagnostic imaging)
• Humans
• Iron
• Liver Neoplasms
• Oxides
• Phospholipids
• Retrospective Studies
• Sulfur Hexafluoride
• Ultrasonography