Specific features of hepatic lesions on pulse inversion and intermittent imaging after ultrasound contrast agent injection

The role of Pulse Inversion and Intermittent Imaging (PI&II) after bolus injection of ultrasound (US) contrast agent for characterization of hepatic lesions is determined. 45 haemangiomas in the liver in 40 patients and 56 malignant hepatic tumors in 35 patients are evaluated with pulse inversion harmonic US using HDI-5000 scanner (ATL). The evaluation is performed with PI&II acquiring images in arterial, portal and late phases. Haemangiomas showed peripheral enhancement with centripetal fill-in (86.6%) or homogeneous enhancement (13.3%) in arterial phase with enhancement similar to liver parenchyma in late phase. PI&II seems to be specific for diagnosis of haemangiomas demonstrating characteristic enhancement features, equivalent to dynamic CT.