Hepatic focal nodular hyperplasia: findings on color Doppler ultrasound

Wang, L.-Y.; Wang, J.-H.; Lin, Zu‐Yau; Yu, Ming‐Lung; Lu, Sheng–Nan; Chuang, Wan‐Long; Chen, S.-C.; Hseih, M.-Y.; Tsai, Jung‐Fa; Chang, Wei‐An

doi:10.1007/s002619900167

Cited by 51 publications

(30 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…3 The diagnosis of most hepatic masses by color Doppler sonography is not definitive, however, despite the demonstration of the lesionsÕ vascularity, and CT, MRI, or biopsy is still needed for a definite diagnosis. Moreover, lesions such as small, isoechoic metastases are not readily visible on gray-scale sonography, and color or power Doppler sonography does not help to detect them.…”

mentioning

confidence: 99%

Detection and differential diagnosis of hepatic masses using pulse inversion harmonic imaging during the liver‐specific late phase of contrast enhancement with levovist

Yücel

Özdemi̇r

Gürel

et al. 2002

J of Clinical Ultrasound

View full text Add to dashboard Cite

show abstract

mentioning

confidence: 99%

Detection and differential diagnosis of hepatic masses using pulse inversion harmonic imaging during the liver‐specific late phase of contrast enhancement with levovist

Yücel

Özdemi̇r

Gürel

et al. 2002

J of Clinical Ultrasound

View full text Add to dashboard Cite

show abstract

“…In patients with nonmalignant nodules AFP mean serum level was 8.3 Ϯ 6.2 (range [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20].…”

Section: Resultsmentioning

confidence: 99%

“…Several reports [7][8][9][10][11][12][30][31][32] indicated the usefulness of Doppler analysis in discriminating HCC from metastases or from focal nodular hyperplasia or hemangioma. Spectral analysis showed that high impedance indices and peak frequency are Low-grade dysplastic nodules Low-resistance arterial flow 0.7 0.5 3.…”

Section: Discussionmentioning

confidence: 99%

Contrast-enhanced doppler ultrasonography in the diagnosis of hepatocellular carcinoma and premalignant lesions in patients with cirrhosis

et al. 2001

View full text Add to dashboard Cite

Hepatocellular carcinogenesis in cirrhosis is a multistage process that includes large regenerative nodules, dysplastic nodules, and hepatocarcinoma. The aim of this study was to establish whether contrast-enhanced Doppler ultrasonography (US) is able to distinguish between early hepatocellular carcinoma (HCC) and small nonmalignant nodules in cirrhosis. Between January 1998 and December 1999, 500 cirrhotic patients with no previous history of HCC or evidence of hepatic focal lesions were enrolled and prospectively fol- The availability of new imaging technology has drawn attention to nodular lesions arising in the liver of patients with cirrhosis. In these patients small focal lesions are almost exclusively represented by early hepatocellular carcinoma (HCC) and macronodules, and the correct classification of ultrasonography (US)-detectable small nodules in cirrhosis is mandatory for planning follow-up and therapy.It is widely accepted that carcinogenesis in cirrhosis is a multistage process, in which HCC is preceded by sizable lesions including large regenerative and dysplastic nodules, the latter being considered the true HCC precursors. 1-4 However, the correct distinction between these lesions and early HCC can be extremely difficult and histologic classification by fineneedle biopsy is often unable to predict the outcome of USdetected nonmalignant lesions correctly. 5,6 Moreover, focal lesions of different nature can coexist in the same liver.In hepatic masses, the detection and characterization of tumor vascularity are important for differential diagnosis, selection of treatment, and assessment of therapeutic response. Tumor vascularity has been studied with angiography, computed tomography, and magnetic resonance imaging after injection of contrast agents.Recent reports have stressed the importance of the role of color and power Doppler sonography in the diagnosis of HCC in comparison with other liver tumors, such as metastases, hemangioma, and focal nodular hyperplasia 7-9 in particular when color-filled pattern 10 or intra-and peritumoral flow signal are analyzed. 11,12 Very recently, contrast-enhanced Doppler US has been reported to be able to differentiate HCC from macronodules. 13,14 Because of the simplicity of its execution, absence of adverse effects, and relative inexpensiveness, the use of ultrasonography with a contrast agent in the evaluation of tumor vascularity is a very attractive option with the potential of widespread application in the follow-up of patients with cirrhosis.The aim of this report was to investigate in a prospective study the usefulness of Doppler US with a contrast agent in the evaluation and characterization of tumor vascularity in US detected liver focal lesions of patients with cirrhosis to distinguish HCC from nonmalignant lesions. MATERIALS AND METHODS Patients.Five hundred consecutive patients with cirrhosis attending our outpatient liver units, without previous history of HCC or evidence of hepatic masses, were enrolled in the study between January 1998 and Decembe...

show abstract

“…Color Doppler US is able to show peri- and intratumoral vessels [10,11,12]. Bartolozzi et al [13] performed a Doppler US study in which they compared power Doppler and color Doppler sonography in 29 patients with 22 histologically proven FNHs and 9 HCAs.…”

Section: Resultsmentioning

confidence: 99%

Imaging Modalities for Focal Nodular Hyperplasia and Hepatocellular Adenoma

Esschert¹,

Gulik²,

Phoa

2010

Dig Surg

View full text Add to dashboard Cite

Background/Aims: There are several imaging modalities available for the detection of focal liver lesions. Differentiation between focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA) is important because of the consequences for management. However, differentiation based on imaging alone still shows limitations. Methods: We reviewed the literature for typical features of FNH and HCA on radiologic and nuclear imaging with emphasis on differentiation of both lesions. Results: Seven articles describe the performance of an imaging modality for the differentiation between FNH and HCA. Limitations of these studies are the small sample size and/or the lack of comparison with the ‘gold standard’, i.e. histological diagnosis. No studies are available that compare the accuracy of several imaging modalities in the differentiation of FNH and HCA. Conventional ultrasound (US) is not useful in the differentiation because of the non-specific features. On contrast-enhanced US, the arterial filling direction of FNH is centrifugal and centripetal in case of HCA. The parenchymal enhancement of FNH is sustained in the portal venous and delayed phases, but shows rapid washout in case of HCA. Multiphase CT scan can differentiate FNH from HCA when there is a central scar. FNH may have a slightly higher relative enhancement in the arterial phase. On MRI with hepatocyte-specific contrast agents, HCA does not show contrast uptake in the hepatobiliary phase in contrast to FNH. Conclusion: We conclude that there is limited evidence of the diagnostic performance of currently used imaging modalities for the differentiation of FNH and HCA. We therefore propose a prospective study (DiFA trial) to determine the accuracy of several radiologic and nuclear imaging studies in differentiating FNH and HCA.

show abstract

Hepatic focal nodular hyperplasia: findings on color Doppler ultrasound

Abstract: Color Doppler US is capable of demonstrating the typical findings of a central feeding artery and stellate vascular pattern in many cases of FNH.

Cited by 51 publications

References 12 publications

Detection and differential diagnosis of hepatic masses using pulse inversion harmonic imaging during the liver‐specific late phase of contrast enhancement with levovist

Detection and differential diagnosis of hepatic masses using pulse inversion harmonic imaging during the liver‐specific late phase of contrast enhancement with levovist

Contrast-enhanced doppler ultrasonography in the diagnosis of hepatocellular carcinoma and premalignant lesions in patients with cirrhosis

Imaging Modalities for Focal Nodular Hyperplasia and Hepatocellular Adenoma

Contact Info

Product

Resources

About