Diagnostic Features of Real-Time Contrast-Enhanced Ultrasound in Focal Nodular Hyperplasia of the Liver
| Autor: | Fabio Fornari, Mikaela Mancini, Annamaria Venturi, Maria Grazia Mirarchi, Luigi Bolondi, Fabio Piscaglia, Gianpaolo Vidili, Fabrizio Magnolfi, F. Giangregorio |
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| Přispěvatelé: | Piscaglia F, Venturi A, Mancini M, Giangregorio F, Vidili G, Magnolfi F, Mirarchi M, Fornari F, Bolondi L. |
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Metabolic Clearance Rate media_common.quotation_subject Sulfur Hexafluoride Contrast Media Sensitivity and Specificity Lesion Young Adult Image Processing Computer-Assisted medicine Humans Contrast (vision) Radiology Nuclear Medicine and imaging Ultrasonography Doppler Color Phospholipids Aged media_common Ultrasonography Doppler Duplex medicine.diagnostic_test business.industry Ultrasound Focal nodular hyperplasia Magnetic resonance imaging Middle Aged Image Enhancement medicine.disease Magnetic Resonance Imaging Focal Nodular Hyperplasia Female Tomography Radiology medicine.symptom business Tomography Spiral Computed Perfusion Software Contrast-enhanced ultrasound |
| Zdroj: | Ultraschall in der Medizin - European Journal of Ultrasound. 31:276-282 |
| ISSN: | 1438-8782 0172-4614 |
| DOI: | 10.1055/s-0028-1109852 |
| Popis: | Purpose The typical appearance of focal nodular hyperplasia (FNH) in radiological contrast techniques (helical CT or MRI) includes homogeneous enhancement in the arterial phase, but the exact timing for the best visualization of this pattern is unknown. The aim of the present study was to assess the ultrasound pattern of FNH with special attention to real-time contrast-enhanced ultrasonography (CEUS) appearance and specifically to the timing of perfusion patterns. Materials and methods 72 patients (60 females, 12 males) with a total of 90 FNH nodules with a diameter ranging from 8 to 100 mm (mean +/- SD, 40.6 +/- 21.5 mm) were examined continuously for at least 4 minutes using CnTI and CPS methods (ESAOTE, Genoa, Italy and Acuson-Siemens) after bolus injection of SonoVue (BRACCO, Milan, Italy). Results 87 of 90 nodules showed the typical coin-like hyperechogenicity in the arterial phase. The remaining three nodules were all in the same patient and were diagnosed as FNH after resection. Contrast started to appear within the lesions after a mean of 15.7 +/- 4.6 seconds (range 7 - 27 s) and reached peak signal intensity, with the greatest differentiation between the lesion and the surrounding parenchyma, at around 22.6 +/- 7.0 seconds (range 14 - 72 s). In the late phase, 65 lesions (72.2 %) became isoechoic (after a mean of 80.8 +/- 85.7 s, range 20 - 300 s), 22 (24.4 %) slightly hyperechoic and 3 (3.3 %) faintly hypoechoic. Conclusion FNH shows a typical homogeneous hyperechoic pattern during the arterial phase in real-time CEUS which disappears slowly on average but occasionally even as soon as 20 seconds after contrast injection. If the first scans are taken later than 20 seconds after injection (which is still considered to be a full arterial phase), the ultrasound hyperechogenicity may be missed in some cases. Real-time study of these lesions is therefore strongly recommended to avoid possible false-negative results. |
| Databáze: | OpenAIRE |
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