Hepatic sonography: comparison of tissue harmonic and standard sonography techniques.

OBJECTIVE This study was performed to compare tissue harmonic sonography of the liver with conventional sonography of the liver. SUBJECTS AND METHODS Forty-eight patients underwent tissue harmonic and conventional sonography of the liver, using a randomized imaging sequence. Imaging parameters were standardized, but gain varied. Techniques were compared using predetermined impact analysis categories. If a finding was revealed by only one sonographic technique, additional confirmation was obtained by another imaging technique or by surgery. In a separate image quality analysis, masked images were reviewed by two experienced radiologists to evaluate fluid-solid differentiation, near-field, far-field, and overall image quality. Rankings were correlated with field of view of images and body habitus of patients as determined by body mass index. RESULTS Tissue harmonic sonography provided the same information as conventional sonography in 34 patients (71%) and added information in 14 patients (29%). The findings from tissue harmonic sonography resulted in altered treatment in five patients (10%). Eight patients (17%) had lesions revealed by tissue harmonic sonography only. Four patients (8%) had inadequate far-field visualization by both techniques. Both observers ranked tissue harmonic sonography the same as or better than standard sonography in 46 patients (96%) for fluid-solid differentiation, in 46 patients (96%) for near-field image quality, and in 45 patients (94%) for overall image quality. For far-field image quality, one observer ranked tissue harmonic sonography the same as or better than conventional sonography in 40 patients (83%), and the second observer, in 41 patients (85%). Image quality ratings showed no correlation with body habitus of the patients or field of view of images. CONCLUSION Tissue harmonic sonography of the liver provides more information and better image quality than does conventional sonography of the liver.

[1]  E. Carstensen,et al.  Finite amplitude distortion and its relationship to linear derating formulae for diagnostic ultrasound systems. , 1996, Ultrasound in medicine & biology.

[2]  R C Waag,et al.  Harmonic amplitude distribution in a wideband ultrasonic wavefront after propagation through human abdominal wall and breast specimens. , 1997, The Journal of the Acoustical Society of America.

[3]  M. Fatemi,et al.  Real-time assessment of the parameter of nonlinearity in tissue using "nonlinear shadowing". , 1996, Ultrasound in medicine & biology.

[4]  K. Brown,et al.  Diagnostic imaging approaches and relationship to hepatobiliary cancer staging and therapy. , 2000, Seminars in surgical oncology.

[5]  V F Humphrey,et al.  The development of harmonic distortion in pulsed finite-amplitude ultrasound passing through liver. , 1986, Physics in medicine and biology.

[6]  V F Humphrey,et al.  Evidence for ultrasonic finite-amplitude distortion in muscle using medical equipment. , 1985, The Journal of the Acoustical Society of America.

[7]  A. C. Baker,et al.  Nonlinear propagation applied to the improvement of resolution in diagnostic medical ultrasound. , 1997, The Journal of the Acoustical Society of America.

[8]  E. Carstensen,et al.  Prediction of nonlinear acoustic effects at biomedical frequencies and intensities. , 1980, Ultrasound in medicine & biology.

[9]  R. Shapiro,et al.  Tissue harmonic imaging sonography: evaluation of image quality compared with conventional sonography. , 1998, AJR. American journal of roentgenology.