Evaluation of enhancement patterns of focal nodular hyperplasia in contrast-enhanced, wide-band phase-inversion harmonic power Doppler imaging of the liver.
BACKGROUND
The purpose of the study was to assess the quality of performance of wideband, phase inversion harmonic power Doppler sonography in the diagnosis of focal nodular.


METHODS
During a period of one year, thirty-one patients with FNH previously confirmed by ultrasound-guided biopsy, surgical resection, dynamic helical computed tomography or magnetic resonance imaging were examined. The study protocol consisted of B-mode gray scale sonography, color Doppler, power Doppler examinations, and helical CT scans. Then PI scans were performed after the injection of 2.5 g of Levovist intravenously.


RESULTS
The images obtained by the B-mode gray scale were typical for focal nodular hyperplasia in 13 lesions only (32.5%), and obtained by color, power Doppler sonography in 25 lesions (62%). On the contrary all patients with focal nodular hyperplasia were diagnosed based on the wide-band, phase inversion power Doppler sonography findings. The common enhancement pattern at pulseinversion harmonic US was filling in a central tumor artery with further centrifugal development of contrast. Then during early arterial phase, all typical anatomical features of FNH as 'star sign 'or 'spoke-wheel 'pattern were clearly visible .In 3 cases ,computed tomography and magnetic resonance imaging have failed to disclose pathology while phase inversion sonographic images were completely suggestive which was later confirmed by histologic examination.


CONCLUSIONS
Our data demonstrates the usefulness of wide-band, phase inversion harmonic power Doppler sonography in the differential diagnosis of hepatic focal nodular hyperplasia by visualizing all characteristic anatomical details.
Department of Radiology, Medical University of Bialystok, Bialystok, Poland. jrjanica@wp.pl
Jacek
J
Janica
Wojciech
W
Serwatka
Jerzy
J
Polaków
Andrzej
A
Ustymowicz
Jerzy
J
Walecki
Jerzy Robert
JR
Ladny
Sławomir
S
Dobrzycki
D000328:Adult; D000368:Aged; D003287:Contrast Media; D005260:Female; D020518:Focal Nodular Hyperplasia / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D021621:Imaging, Three-Dimensional; D008099:Liver / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides; D036542:Tomography, Spiral Computed; D018615:Ultrasonography, Doppler, Color; D018617:Ultrasonography, Doppler, Pulsed / Q000379:methods*; D055815:Young Adult
D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508