Evaluation of hepatic focal nodular hyperplasia with contrast-enhanced gray scale harmonic sonography: initial experience.
OBJECTIVE
To assess the potential of contrast-enhanced gray scale harmonic sonography in the evaluation of the typical vascular and enhancement patterns of hepatic focal nodular hyperplasia.


METHODS
Thirteen patients with 13 lesions of hepatic focal nodular hyperplasia underwent contrast-enhanced gray scale harmonic sonography. After the injection of a microbubble contrast agent (SH U 508A), gray scale harmonic sonographic studies using a Coded Harmonic Angio technique were performed with a combination of a period of continuous scanning to assess the vascular pattern (vascular imaging) and interval delay scanning to determine the sequential enhancement pattern (acoustic emission imaging). Each imaging pattern was categorized and analyzed by consensus of 2 experienced radiologists.


RESULTS
In 12 (92%) of 13 lesions, vascular imaging during the arterial phase showed central arteries of a spoked wheel pattern, whereas the remaining lesion had stippled vascularity. On acoustic emission imaging, 11 (85%) of 13 lesions were hyperechoic during the early phase, and the remaining 2 (15%) were isoechoic compared with surrounding parenchyma. Ten (77%) of 13 lesions remained either hyperechoic (5 of 13) or isoechoic (5 of 13) during the delay phase, whereas the remaining 3 lesions (23%) were hypoechoic.


CONCLUSIONS
Contrast-enhanced gray scale harmonic sonography showed the typical vascularity of a spoked wheel pattern during the vascular phase and persistent enhancement on serial acoustic emission imaging in most cases of hepatic focal nodular hyperplasia, and thereby it can be a promising technique in noninvasive diagnosis of this entity.
Department of Radiology, Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Min Ju
MJ
Kim
Hyo K
HK
Lim
Seong Hyun
SH
Kim
Dongil
D
Choi
Won Jae
WJ
Lee
Soon Jin
SJ
Lee
Jae Hoon
JH
Lim
D000293:Adolescent; D000328:Adult; D003287:Contrast Media; D005260:Female; D020518:Focal Nodular Hyperplasia / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides; D012189:Retrospective Studies; D014463:Ultrasonography
D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508