Biology Reference
In-Depth Information
Chapter 18
Contrast-Enhanced Ultrasonography
for Characterization of Liver Lesions
in Dogs and Cats
G. Gnudi, A. Volta, S. Manfredi, and G. Bertoni
Abstract Liver nodules are common in dogs. Contrast-enhanced ultrasound (CEUS)
is commonly used to characterize focal hepatic lesions in humans. Three vascular
phases have been described in the liver: arterial phase, portal phase, and late phase.
Contrast-ultrasonographic features of canine liver lesions have also been described.
The hypoechogenicity at peak liver enhancement and during the portal phase has been
significantly associated with malignancy with high sensitivity and specificity. Few
reports on contrast ultrasonographic features of hepatic lesions in cats are available.
The aim of this study was to describe contrast ultrasonographic features of 16 liver
lesions in 13 dogs and two cats. All patients underwent fundamental abdominal
ultrasound, anesthesia, contrast-enhanced ultrasound with a second-generation con-
trast medium (sulfur hexafluoride-SonoVue
®
), fine-needle aspiration/tissue core
or surgical biopsy of the lesions, followed by cytological/histological examination.
Ten lesions were benign (four nodular hyperplasias, three simple cysts, two nodules of
focal hydropic degeneration, and one eosinophilic infiltration) and six were malignant
(four hepatocellular carcinomas, one biliary carcinoma, and one lymphoma). All
benign lesions, with the exception of the simple cysts, were iso- or hyperechoic to
the surrounding tissue in the portal phase, while all malignant lesions were
hypoechoic. The hypoechogenicity during the portal phase was significantly
associated with malignancy with high sensitivity and specificity (100% and 70%,
respectively). According to the literature, CEUS of the liver resulted in a safe
diagnostic procedure that was of value in differentiating benign from malignant
hepatic lesions. CEUS, however, is not able to define tumor cell type, and either
biopsy or fine-needle aspiration is recommended to achieve a final diagnosis.
Keywords Contrast • Ultrasound • Liver • Lesion • Dog • Cat
G. Gnudi (
*
) • A. Volta • S. Manfredi • G. Bertoni
Sezione di Radiologia and Diagnostica per Immagini, Dipartimento di Salute Animale, Facolt` di
Medicina Veterinaria, Universit` degli Studi di Parma, Parma, Italy
e-mail:
giacomo.gnudi@unipr.it
