Hepatic hemangioma: quantitative color power US angiography--facts and fallacies.
OBJECTIVE
To explore the origin of signals detected with color power ultrasound (US) angiography (CPA) and evaluate a semiquantitative method to assess signals in hepatic hemangiomas.


METHODS
Twenty-four adult patients with 27 hepatic hemangiomas (< 2 cm in diameter) and five patients with five hyperechoic hepatic metastases underwent CPA and conventional color Doppler US in this prospective study. A sponge phantom was studied to determine whether the origin of CPA signals was related to architecture. The mean number of signals and the signal density in each lesion were scored.


RESULTS
A "diffuse blush" was seen in all capillary hemangiomas at CPA, whereas no signal was seen at color Doppler US. The sponge phantom test produced a CPA appearance similar to that of capillary hemangiomas. Quantitative analysis of CPA images of hepatic hemangiomas showed a mean of 16.1 signals per cubic centimeter and a mean signal area of 25%. Hyperechoic avascular hepatic metastases resulted in CPA images similar to those of hepatic hemangiomas, with no quantitative difference in signal count, despite a mild qualitative difference at CPA.


CONCLUSIONS
CPA signals in hepatic hemangiomas appear to be related more to architecture than to true capillary flow. There is a qualitative difference in the strength of the blush at CPA between hepatic hemangiomas and metastases, which may be the only possible differentiating factor.
Young
L K
LK
Department of Diagnostic Radiology and Organ Imaging, Chinese University of Hong Kong, Prince of Wales Hospital, Yuen Chau Kok, Shatin, China.
Yang
W T
WT
Chan
K W
KW
Metreweli
C
C
D000328:Adult; D000368:Aged; D005260:Female; D006391:Hemangioma / Q000098:blood supply / Q000000981:diagnostic imaging*; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D019047:Phantoms, Imaging; D018615:Ultrasonography, Doppler, Color