1. Contrast-enhanced ultrasound of focal nodular hyperplasia: a matter of size.
- Author
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Bertin C, Egels S, Wagner M, Huynh-Charlier I, Vilgrain V, and Lucidarme O
- Subjects
- Adult, Aged, Biopsy, Contrast Media, Diagnosis, Differential, Female, Focal Nodular Hyperplasia pathology, Humans, Magnetic Resonance Imaging methods, Male, Middle Aged, Reproducibility of Results, Retrospective Studies, Young Adult, Focal Nodular Hyperplasia diagnostic imaging, Phospholipids, Sulfur Hexafluoride, Ultrasonography, Doppler methods
- Abstract
Objectives: To assess the contrast-enhanced ultrasound (CEUS) frequencies of centrifugal enhancement, spoke-wheel sign and central scar in focal nodular hyperplasia (FNH) as a function of lesion size., Methods: Ninety-four FNHs were retrospectively reviewed to assess their largest diameter and enhancement pattern, including centrifugal enhancement from one central artery, spoke-wheel sign, diffuse or centripetal enhancement, central scar and late-phase washout., Results: Mean FNH-lesion size was 3.7 ± 2.1 cm. Only 43.6 % of FNHs had centrifugal enhancement, with a spoke-wheel pattern (23.4 %) or without (20.2 %), while 56.4 % showed diffuse or centripetal enhancement. Centrifugal enhancement was observed in 73.9 % of FNHs ≤3.1 cm and 14.6 % of FNHs >3.1 cm (P < 10(-4)). Size and frequency of centrifugal enhancement were negatively correlated (r = -0.57, P < 10(-4)). The spoke-wheel pattern was also seen more frequently in smaller (37 %) than in larger FNHs (10.4 %) (P < 10(-3)). Late-phase washout was described in 5.3 % of FNHs and was not size-dependent. Lesions with a central scar were larger than those without, respectively, 5.7 ± 1.7 and 3.6 ± 2.0 cm (P = 0.012)., Conclusions: Typical centrifugal enhancement yielding a confident FNH diagnosis is seen significantly more frequently when the lesion is ≤3.1 cm., Key Points: • CEUS yields confident diagnoses of FNHs ≤3.1 cm • The larger the FNH, the lower the diagnostic sensitivity of CEUS • Final diagnosis of FNHs >3.1 cm should be obtained with MRI not CEUS.
- Published
- 2014
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