title: Atypical liver hemangiomas: contrast-enhancement patterns with SH U 508A and pulse-inversion US.
abstract: OBJECTIVE
  To describe the enhancement patterns of atypical hepatic haemangiomas with Pulse Inversion Harmonic Imaging (PIHI) using SH U 508A (Levovist).
  
  
  METHODS
  Twenty-five patients (15 women, 10 men; age range: 29-65 years, mean: 48.2 years) with 28 hepatic haemangiomas (size: 1.5 - 11.5 cm; mean: 4.6 cm) underwent PIHI before and after i.v. administration of Levovist. Selected images obtained at baseline and 25-30s, 55-60s and 240s after Levovist injection were sequentially reviewed to determine the changes in echogenicity of haemangiomas in comparison to surrounding liver parenchyma.
  
  
  RESULTS
  At the baseline US study, 22/28 (79%) haemangiomas revealed highly inhomogeneous echotexture; 5/28 (18%) were homogeneously hypoechoic and 1/28 (3%) was isoechoic with respect to hepatic parenchyma. After Levovist administration, 16/28 (57%) haemangiomas showed peripheral hyperechoic nodules in the arterial phase with progressive centripetal fill-in in portal and late phases; such fill-in was complete in 14/16 cases and incomplete in 2/16. Four of twenty-eight (14%) haemangiomas revealed a rapid and complete homogeneous fill-in on arterial phase that lasted throughout the portal and late phases. Finally, 8/28 (29%) showed a rim-like enhancement with progressive and complete centripetal fill-in on portal and late phases.
  
  
  CONCLUSIONS
  According to our results, PIHI with Levovist allows demonstration of typical enhancement patterns in most of atypical haemangiomas, thus providing useful diagnostic information for their characterization.
authors: Dipartimento di Biotecnologie Mediche e Medicina Legale, Sezione di Diagnostica per Immagini, Policlinico Universitario, Palermo, Italy. tv_bartolotta@yahoo.com
authors: Tommaso Vincenzo
authors: TV
authors: Bartolotta
authors: Massimo
authors: M
authors: Midiri
authors: Massimo
authors: M
authors: Galia
authors: Angelo
authors: A
authors: Iovane
authors: Giuseppe
authors: G
authors: Runza
authors: Aldo
authors: A
authors: Carcione
authors: Roberto
authors: R
authors: Lagalla
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D005260:Female; D006391:Hemangioma / Q000000981:diagnostic imaging*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides; D014463:Ultrasonography / Q000379:methods
chemical_list: D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508