Phase inversion harmonic imaging versus contrast-enhanced power Doppler sonography for the characterization of focal liver lesions

Background and aims: We compared contrast-enhanced power Doppler sonography (CEPD) and phase-inversion harmonic imaging (PIHI) in the assessment of liver lesion vascularity and characterization of focal liver lesions. Materials and methods: We examined 101 focal liver lesions by CEPD and PIHI using Optison as echo-enhancing agent. Amount and architecture of lesion vascularity and the kinetics of contrast enhancement in the lesions were analyzed. A tumor diagnosis was assessed after each examination. Results: Analysis of tumor vascularity was not possible in 30 liver lesions (30%) due to motion or blooming artifacts by CEPD. Vascularity was detected in 61% of liver lesions by CEPD and in 95% by PIHI. PIHI identified significantly more tumor vascularity pattern (93%) than CEPD (57%). Specific lesion diagnosis based on PIHI led to correct results in 92% compared to 59% by CEPD. Conclusion: PIHI is highly efficient in detecting tumor vascularity and is superior to CEPD in characterizing focal liver lesions.