Characterization of focal liver lesions in real time using harmonic imaging with high mechanical index and contrast agent levovist.

OBJECTIVE. The aim of this study was to characterize focal hepatic lesions using agent detection imaging and Levovist.MATERIALS AND METHODS. Sixty-five patients (21 male and 44 female; age range, 8–82 years; mean ± standard deviation, 58.1 ± 14.5 years) were independently evaluated by two observers in a blinded manner using stored sonographic images. Seventy-five lesions were found: 15 hepatocellular carcinomas, nine focal nodular hyperplasias, two adenomas, 21 hemangiomas, 23 metastases, and five regenerative nodules. Nine patients were excluded (six because of technical failures, three with unproven diagnoses). New high-mechanical-index software was used to reveal power harmonic responses from contrast microbubble destruction. After a venous bolus injection of 4 g of Levovist at a strength of 400 mg/mL, delayed imaging was used to study lesion enhancement in the arterial, portal, and parenchymal phases. Two comparisons were made. The first was between the B-mode image and the first contrast-enhanced ima...