Visualization of liver lesions in standardized video-documented ultrasonography – inter-observer agreement and effect of contrast injection.

Carina Stenman, Robert Glavas, Joachim Davidsson, Anders Knutsson, Örjan Smedby


The aim of this study was to evaluate the inter-observer agreement and effect of contrast injection on the visibility of liver lesions by radiologists reviewing ultrasound examinations acquired by a radiographer using a standardized examination protocol. Material and method: A retrospective review was conducted by two radiologists, independently of each other, of 115 ultrasound examinations of the liver with standardized examination protocols between January 2008 and December 2012. All patients included in the study had undergone surgery for colorectal cancer. Patients attending the two-year follow-up were included. Results: Focal ndings, the most common of which were cysts, were seen in 42–43 out of the 115 patients before in- travenous contrast and in 46–47 patients after intravenous contrast (p=0.012). The inter-observer agreement for focal ndings was 86.1% before contrast, and 90.4% after contrast (n.s.), and the corresponding kappa values were 0.72 and 0.84, respec- tively. Conclusion: A good inter-observer agreement between two radiologists reviewing ultrasound examinations (standard- ized ultrasound cine-loop method acquired by a radiographer) after surgery for colorectal cancer was obtained. Injection of contrast medium increased the visibility of liver lesions.


standardized examination; inter-observer agreement; contrast-enhanced ultrasound (CEUS); liver abscess

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