Comparative diagnostic value of contrast-enhanced ultrasonography, computed tomography, and magnetic resonance imaging in diagnosis of hepatic hemangiomas

Kristina Žvinienė¹, Inga Zaborienė¹, Algidas Basevičius¹, Nemira Jurkienė¹, Giedrius Barauskas², Juozas Pundzius²

¹Department of Radiology, Kaunas University of Medicine, ²Department of Surgery, Kaunas University of Medicine, Lithuania

Key words: contrast-enhanced ultrasonography; computed tomography; SonoVue; hemangioma; magnetic resonance imaging.

Summary. Aim. To compare the value of intravenous contrast-enhanced ultrasonography (US), intravenous contrast-enhanced computed tomography (CT), and magnetic resonance imaging (MRI) in the diagnosis of hepatic hemangiomas.

Material and methods. The study enrolled 48 patients, aged between 20 and 79 years (35 [72.9%] women, 13 [27.1%] men; mean age, 53.5±12.855 years), who were examined and treated in the Departments of Gastroenterology, Surgery, and Oncology, Hospital of Kaunas University of Medicine, in the year 2007. All patients underwent intravenous contrast-enhanced US, intravenous contrast-enhanced CT, and MRI and were diagnosed with hepatic hemangioma according to the findings of these examinations.

Results. The size of hemangiomas was ≤2.0 cm in 20 cases (41.7%) and >2.0 cm in 28 (58.3%). No association between hepatic hemangioma and patient’s age was found (χ²=0.547, df=2, P=0.761).

Nearly one-third of hemangiomas were located in the segment IV of the left hepatic lobe. There were a few complicated hemangiomas in the study sample: 2 with calcification and 1 with necrosis.

The sensitivity of CT in the diagnosis of hepatic hemangioma was 76.92%; specificity, 33.3%; positive prognostic value, 83.3%; and negative prognostic value, 25.0%. The sensitivity of intravenous contrast-enhanced US in the diagnosis of hepatic hemangioma was 77.8%; specificity, 100%; positive prognostic value, 100%; and negative prognostic value, 23.1%.

Conclusions. Intravenous contrast-enhanced US is more specific than intravenous contrast-enhanced CT in the diagnosis of hepatic hemangioma (P=0.0005) and has a higher positive prognostic value (P=0.001).

Correspondence to K. Žvinienė, Department of Radiology, Kaunas University of Medicine, Eivenių 2, 50009 Kaunas, Lithuania. E-mail kristinazviniene@gmail.com

Received 27 February 2009, accepted 7 May 2010