Contrast-enhanced sonography of juxtapleural pulmonary tuberculoma.

OBJECTIVES

The purpose of this study was to describe the findings of juxtapleural pulmonary tuberculoma on contrast-enhanced sonography and investigate their correlation with histologic findings.

METHODS

From April 2008 to April 2012, 21 patients with biopsy or clinically proven juxtapleural pulmonary tuberculomas underwent contrast-enhanced sonography with an intravenous bolus injection of 4.8 mL of a sulfur hexafluoride-filled microbubble contrast agent. Enhancement patterns and functional parameters (time to enhancement, time to peak enhancement, and peak signal intensity) derived from a time-intensity curve were evaluated. Enhancement patterns were correlated with their histologic findings.

RESULTS

A rim enhancement pattern was presented in 12 (57.1%), a homogeneous enhancement pattern in 5 (23.8%), and a heterogeneous enhancement pattern in 4 (19.1%) of 21 tuberculomas. A pathologic study confirmed that the nonenhancing center of the rim enhancement pattern corresponded to caseous or liquefied necrosis, and homogeneously enhanced portions corresponded to granulomatous inflammation. The medians (25th-75th interquartile ranges) for the time to enhancement, time to peak enhancement, and peak signal intensity were 14 seconds (9-14 seconds), 22 seconds (21-26 seconds), and 83 dB (55-92 dB), respectively.

CONCLUSIONS

Contrast-enhanced sonography of juxtapleural pulmonary tuberculoma is feasible. Juxtapleural pulmonary tuberculomas usually show rim, homogeneous, or heterogeneous enhancement. Enhancement patterns of juxtapleural pulmonary tuberculomas are well correlated with their pathologic features.