Washout appearance of hepatocellular carcinomas using standardized contrast-enhanced ultrasound (CEUS) including an extended late phase observation - Real-world data from the prospective multicentre DEGUM study.

BACKGROUND: Non-invasive diagnosis of hepatocellular carcinoma (HCC) in contrast-enhanced ultrasound (CEUS) is based on the combination of arterial phase hyperenhancement (APHE) and subsequent late (>60 seconds) and mild contrast washout (WO). Whereas APHE is seen in the majority of HCC, wash-out pattern may vary in onset and intensity. In some HCC lesions, even no washout is seen at all. OBJECTIVE: Our prospective multicentre DEGUM HCC CEUS study aimed at identifying typical and atypical washout appearance of HCC in a real-life setting. METHODS: High-risked patients for HCC with focal liver lesions upon B-mode ultrasound were recruited prospectively. In a multicentre real-life setting, a standardised CEUS examination including an extended late phase up to 6 minutes was performed. CEUS patterns of HCC were recorded, and onset and intensity of washout appearance were assessed with respect to patient and tumour characteristics. Histological findings served as reference standard. RESULTS: In 230/316 HCC (72.8%), a CEUS pattern of APHE followed by WO was observed. In 158 cases (68.7%), WO was typical (onset > 60 seconds, mild intensity). 72 cases (31.3%) showed marked and / or early WO, whereas in 41 HCCs (13%), APHE was followed by sustained isoenhancement.Atypical WO upon CEUS was associated with macroinvasion of the liver vessels, portal vein thrombosis and diffuse growth pattern, but not tumour size and histological grading. CONCLUSIONS: In a prospective multicentre real-life setting, APHE is followed by atypical washout appearance or no washout at all in almost half of the HCCs with APHE. The examiner has to bear in mind that in spite of a characteristic APHE in HCCs, washout appearance can be atypical in CEUS, especially in HCCs with macrovascular invasion or diffuse growth pattern.

Eosinophilic infiltration of the liver and pancreas mimicking metastatic disease.

Contrast-enhanced ultrasound (CEUS) has significantly improved the differentiation of hepatic lesions and the detection of liver metastases. Metastases are usually represented as hypoenhanced areas in the late phase and must then be confirmed histologically. Other lesions presenting hypoenhancement in the late phase are abscesses, hepatocellular and cholangiocellular carcinomas, adenomas, avascular necrosis, haematomas and rarely inflammatory masses. The differentiation between these relies on the patient's history, the number of lesions presenting, the B-image morphology and the enhancement pattern in the early phase of CEUS. We report the case of a 49-year-old woman with a in CT assumed pancreatic tumour in whom liver metastases were suspected and investigated by CEUS. In the late phase of this examination hypoenhanced hepatic lesions were observed, prompting us to perform a needle biopsy. The histopathological work-up surprisingly identified the hepatic lesions to be eosinophilic infiltration. After a spontaneous remission we concluded an allergic reaction to a fluoroquinolone.

Coupling sol-gel synthesis and microwave-assisted techniques: a new route from amorphous to crystalline high-surface-area aluminium fluoride.

A non-aqueous sol-gel Al-based fluoride has been subjected to the microwave solvothermal process. The final material depends on the temperature heat treatment used. Three types of material have been prepared: 1) for low temperature heat treatment (90 degrees C) X-ray amorphous alkoxy fluoride was obtained; 2) for the highest temperature used (200 degrees C) the metastable form beta-AlF3 was obtained with a very large surface area of 125 m2 g(-1). The mechanism of the amorphous=crystalline transformation has been rationalised by the occurrence of a decomposition reaction of the gel fluoride induced by the microwave irradiation. 3) Finally, at intermediate temperature (180 degrees C) a multi-component material mixture exhibiting a huge surface area of 525 m2 g(-1) has been obtained and further investigated after mild post-treatment fluorination using F2 gas. The resulting aluminium-based fluoride still possesses a high-surface-area of 330 m2 g(-1). HRTEM revealed that the solid is built from large particles (50 nm) identified as alpha-AlF3, and small ones (10 nm), relative to an unidentified phase. This new high-surface-area material exhibits strong Lewis acidity as revealed by pyridine adsorption and catalytic tests. By comparison with other materials, it has been shown that whatever the composition/structure of the Al-based fluoride materials, the number of strong Lewis acid sites is related to the surface area, highlighting the role of surface reconstruction occurring on a nanoscopic scale on the formation of the strongest Lewis acid sites.

The fluorolytic sol-gel route to metal fluorides--a versatile process opening a variety of application fields.

The recently developed fluorolytic sol-gel route to metal fluorides opens a very broad range of both scientific and technical applications of the accessible high surface area metal fluorides, many of them have already been applied or tested. Specific chemical properties such as high Lewis acidity and physical properties such as high surface area, meso-porosity and nano-size as well as the possibility to apply metal fluorides on surfaces via a non-aqueous sol make the fluorolytic synthesis route a very versatile one. The scope of its scientific and technical use and the state of the art are presented.

Vibrational analysis study of aluminum trifluoride phases.

The vibrational modes of three solid AlF3 phases (alpha, beta, and amorphous high surface area AlF3) are investigated. Calculations have been performed using hybrid exchange correlation functionals to determine the equilibrium geometries and Gamma-point phonon frequencies for the alpha-AlF3 and beta-AlF3 phases. The calculated optical modes are in excellent agreement with experiment. The IR absorption of the amorphous, glasslike high surface area (HS)-AlF3 is also discussed. Deconvolution of the broad envelope of IR stretches and bending vibrations identifies the components of the observed broad band. From the IR vibrational spectrum it has been shown that both short-range and medium-range disorder are present within HS-AlF3. Structural phase transitions are identified by their phase transition temperature Tc, measured by thermal analysis.

Aluminum chloride as a solid is not a strong Lewis acid.

Aluminum chloride is used extensively as Lewis acid catalyst in a variety of industrial processes, including Friedel-Crafts and Cl/F exchange reactions. There is a common misconception that pure AlCl3 is itself a Lewis acid. In the current study, we use experimental and computational methods to investigate the surface structure and catalytic properties of solid AlCl3. The catalytic activity of AlCl3 for two halide isomerization reactions is studied and compared with different AlF3 phases. It is shown that pure solid AlCl3 does not catalyze these reactions. The (001) surface of crystalline AlCl(3) is the natural cleavage plane and its structure is predicted via first principles calculations. The chlorine ions in the outermost layer of the material mask the Al3+ ions from the external gas phase. Hence, the experimentally found catalytic properties of pure solid AlCl3 are supported by the predicted surface structure of AlCl3.