Three-dimensional multi-slice view, a new ultrasonographic technique for characterization of hepatobiliary lesions

Aim: The purpose of this analysis was to evaluate the potential role of Three-Dimensional Multi-Slice View (ultrasonographic software-Medison) for a better characterization of hepatobiliary lesions, by comparing the results obtained through this examination to those resulting from conventional 2D ultrasonography and/or CT or MRI.

Method: Three-dimensional ultrasonography (3D US) consists in acquiring a „virtual“ volume represented by a large number of US planes. 3D US examination is based on 2D US investigation, in which different echoes are collected and spatially distributed, according to a specific algorithm. The Multislice View is a function which subsequently slices the acquired 3D volume in equally spread planes, on a predefined distance (minimum 0.5mm) perpendicularly on any axis, creating adjoining Multi Slice images. We made a retrospective analysis (case series report) on 58 subjects with hepatobiliary disorders, examined by ultrasonography between September 2006 and February 2008 in the Laboratory of Ultrasonography, Internal Medicine Center, Fundeni Clinical Institute. Sectional imaging exam (CT or MRI) had been performed in 27 patients. Good-quality 3D volumes of the region of interest were obtained in each case.

Results: In comparison to 2D US, 3D US examination performed in these 58 subjects resulted in a better characterization of the following entities: nodular cirrhosis, primary or secondary liver tumors, portal vein thrombosis, dilatation of the biliary or pancreatic ducts, vascular anomalies of the portal system, arterio-portal shunts. The results obtained were similar to those of the CT exams regarding relations between anatomical structures and regional invasion. The Multislice View combined with Color and Power Doppler improved the characterisation of neoangiogenesis in the liver tumors, and was valuable in the staging of hepatocellular carcinoma by evaluating the extent of portal invasion and of the tumoral thrombus. This combination method was particularly useful for evaluating the reports between tumoral lesions and neighbouring vascular or biliary structures.

Conclusions: The Multi-Slice View technique increases the efficiency of examinations concerning hepatobiliary lesions, by a better characterization of diffuse and focal lesions, portal vein thrombosis, dilatation of the biliary or pancreatic ducts, vascular anomalies of the portal system and arterio-portal shunts, and also by shortening the examination time.