Flow characteristics of hepatic tumors at color Doppler sonography: correlation with arteriographic findings.

Numata, Kazushi; Tanaka, Katsuaki; Mitsui, Konomi; Morimoto, Manabu; Inoue, Shuji; Yonezawa, Hideo

doi:10.2214/ajr.160.3.8381573

Cited by 72 publications

(55 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[3][4][5] On gray scale ultrasonography, HCA and focal nodular hyperplasia (FNH) are not distinguishable because both have a heterogeneous appearance with all echo structural patterns observed. 6 On the basis of Doppler investigations, several authors 7,8 have shown a continuous (venous) waveform in most cases of HCA, as opposed to the pulsatile wave observed in malignant lesions or the spoked wheel appearance observed in most cases of FNH. However, despite the improved results achieved with the use of newer Doppler ultrasound technologies such as power Doppler imaging, reliable assessment of intratumoral blood flow has not been possible, particularly when lesions are located in the left lobe because of motion artifacts from cardiac pulsation.…”

mentioning

confidence: 99%

Behavior of Hepatocellular Adenoma on Real-time Low-Mechanical Index Contrast-Enhanced Ultrasonography With a Second-Generation Contrast Agent

Ricci

Cantisani

D’Onofrio

et al. 2008

Journal of Ultrasound in Medicine

View full text Add to dashboard Cite

Objective. The purpose of this study was to describe the behavior of histologically proven hepatocellular adenoma (HCA) on low-mechanical index (MI) contrastenhanced ultrasonography (CEUS). Methods. A review of the databases from 4 academic hospitals revealed 18 patients (15 female and 3 male; mean age, 40 years; range, 25-71 years) with 25 histologically proven HCA lesions who were studied with CEUS at a low MI (0.04-0.1). Results. Twenty-four of 25 lesions (96%; 95% confidence interval [CI], 80.5%-99.3%) showed high-intensity enhancement, scored as 3 on a scale of 0 to 3, whereas only 1 lesion (4%; 95% CI, 0.7%-19.5%) was scored as 2. The time of peak enhancement ranged between 10 and 19 seconds (average, 13 seconds). All but 1 of the 25 lesions (96%; 95% CI, 80.5%-99.3%) showed early homogeneous and centripetal enhancement during the hepatic arterial phase. No portal venous phase enhancement was observed in any lesion because all showed rapid wash-out (100%; 95% CI, 86.7%-100%). Twenty lesions (80%; 95% CI, 60.9%-91.1%) were found to be isoechoic to slightly hypoechoic during the portal phase, and 19 (76%; 95% CI, 56.6%-88.5%) were isoechoic to mildly hypoechoic, whereas 7 (24%; 95% CI, 11.5%-43.4%) were hypoechoic during the late phase. Conclusions. Contrast-enhanced ultrasonography is an effective technique for identifying the microvascular and macrovascular characteristics of HCA. Typically, HCA shows early (10-19 seconds) and centripetal enhancement during the arterial phase and isoechogenicity or mild hypoechogenicity during the portal phase, remaining slightly hypoechoic or isoechoic during the late phase in most cases.

show abstract

mentioning

confidence: 99%

Behavior of Hepatocellular Adenoma on Real-time Low-Mechanical Index Contrast-Enhanced Ultrasonography With a Second-Generation Contrast Agent

Ricci

Cantisani

D’Onofrio

et al. 2008

Journal of Ultrasound in Medicine

View full text Add to dashboard Cite

show abstract

“…Numata et al [9] found that the mean of SPV in hepatocarcinomas was significantly higher than that of metastases, and hemangiomas. They also correlated the findings by Doppler angiography and hepatic pathology in both experimental animals and human beings, the high velocities of systolic peak was related with the presence of arterial venous shunts and the low resistant spectra were associated with vascular channels in the absence of muscle layer [10] . Since then, many attempts have been made to assess the usefulness of Doppler in the study of liver tumors [11] .…”

Section: Discussionmentioning

confidence: 62%

Resistance index in differential diagnosis of liver lesions by color doppler ultrasonography

Wang¹,

Wang²,

Ding³

et al. 2004

WJG

View full text Add to dashboard Cite

AIM:To investigate the specific value of resistance index (RI) in color Doppler ultrasonography in the diagnosis of focal hepatic lesions. METHODS:Eight hundred patients with 893 hepatic solid lesions were studied with color Doppler flow imaging (CDFI) and pulsed Doppler, including 644 malignant cases (596 primary malignant liver tumors, and 48 metastatic liver tumors), 156 benign cases. All were confirmed by operation and pathology. RESULTS:The detection rate of arterial flow in malignant tumors was 92%, and 52% in benign lesions. Doppler spectrum analysis showed that the resistance index in primary malignant tumors was 0.75±0.12, 0.73±0.09 in metastatic tumors, and was below 0.6 in benign lesions. The difference was significant (P<0.001). This difference was related with its histopathologic structure. CONCLUSION:The arterial flow with RI 0.6 identified by CDFI within the liver lesion can be regarded as a criterion of malignant tumors, RI<0.6 can be regarded as benign disorders. RI is useful in differential diagnosis of liver neoplasms.

show abstract

“…Large metastatic? lesions may have radiating vascular patterns similar to those of FNH [63,64]. In all three types of lesions, spectral tracings may present high peak systolic frequency values, but the RI of an FNH nodule is generally lower than that of a malignant lesion, which is usually >0.70 [65].…”

Section: Sonographic Featuresmentioning

confidence: 98%

Diagnosis and management of hepatic focal nodular hyperplasia

Venturi

Piscaglia

Vidili

et al. 2007

Journal of Ultrasound

View full text Add to dashboard Cite

Focal nodular hyperplasia (FNH) is the second most common benign tumor of the liver, after hemangioma. It is generally found incidentally and is most common in reproductive-aged women, but it also affects males and can be diagnosed at any age. Patients are rarely symptomatic, but FNH sometimes causes epigastric or right upper quadrant pain. The main clinical task is to differentiate it from other hypervascular hepatic lesions such as hepatic adenoma, hepatocellular carcinoma, or hypervascular metastases, but invasive diagnostic procedures can generally be avoided with the appropriate use of imaging techniques. Magnetic resonance (MR) imaging is more sensitive and specific than conventional ultrasonography (US) or computed tomography (CT), but Doppler US and contrast-enhanced US (CEUS) can greatly improve the accuracy in the diagnosis of FNH. Once a correct diagnosis has been made, in most cases there is no indication for surgery, and treatment includes conservative clinical follow-up in asymptomatic patients.Sommario L'iperplasia nodosa focale (FNH) è il tumore epatico benigno più frequente dopo l'angioma. E' di solito rilevata in modo occasionale, per lo più nelle donne in età fertile, anche se si può riscontrare in entrambi i sessi e ad ogni età. I soggetti portatori raramente sono sintomatici, nonostante l'FNH possa essere causa di dolore ai quadranti addominali superiori. Nella gestione dell'FNH il problema clinico principale è rappresentato dalla difficoltà di differenziarla dalle altre lesioni epatiche ipervascolarizzate, come l'adenoma, l'epatocarcinoma o le metastasi ipervascolari, tuttavia utilizzando le opportune tecniche diagnostiche è oggi possibile evitare il ricorso ad esami invasivi. La Risonanza Magnetica (RM) ha una sensibilità e una specificità superiori rispetto a quelle dell'ecografia convenzionale e della Tomografia Assiale Computerizzata (TC) per la diagnosi di FNH. L'uso dell'angioecografia perfusionale (CEUS) e dell'eco-Doppler può tuttavia aumentare in modo significativo la confidenza diagnostica

show abstract

Flow characteristics of hepatic tumors at color Doppler sonography: correlation with arteriographic findings.

Cited by 72 publications

References 3 publications

Behavior of Hepatocellular Adenoma on Real-time Low-Mechanical Index Contrast-Enhanced Ultrasonography With a Second-Generation Contrast Agent

Behavior of Hepatocellular Adenoma on Real-time Low-Mechanical Index Contrast-Enhanced Ultrasonography With a Second-Generation Contrast Agent

Resistance index in differential diagnosis of liver lesions by color doppler ultrasonography

Diagnosis and management of hepatic focal nodular hyperplasia

Contact Info

Product

Resources

About