Characterization of benign hepatic tumors arising in fatty liver with SonoVue and pulse inversion US.
BACKGROUND
We describe the spectrum of contrast-enhancement patterns of benign hepatic tumors arising in fatty liver on contrast-enhanced ultrasound (US).


METHODS
Sixteen patients (12 women and four men) with 27 benign hepatic tumors (17 hemangiomas, eight focal nodular hyperplasias, and two hepatocellular adenomas) arising in fatty liver underwent baseline and pulse inversion US after administration of SonoVue. Two experienced radiologists evaluated baseline echogenicity and dynamic enhancement pattern of each lesion in comparison with adjacent liver parenchyma.


RESULTS
After administration of SonoVue, in the arterial phase 13 of 17 hemangiomas showed peripheral globular enhancement and one showed a rim of peripheral enhancement, followed by progressive centripetal fill-in, which was complete in 10 of 14 cases and incomplete in four. Three of 18 hemangiomas showed rapid and complete fill-in in the arterial phase. Eight of eight focal nodular hyperplasias became hyperechoic in comparison with adjacent liver parenchyma in the arterial phase and slightly hyperechoic or isoechoic in the portal venous and delayed phases. Both adenomas showed strong arterial contrast enhancement that became less intense in the portal venous and delayed phases.


CONCLUSIONS
Contrast-enhanced US after administration of SonoVue enables depiction of typical contrast-enhancement patterns in most benign hepatic tumors arising in fatty liver, thus providing useful clues for characterization.
Department of Radiology, University of Palermo, Via Del Vespro 127, Palermo 90127, Italy. tv_bartolotta@yahoo.com
T V
TV
Bartolotta
M
M
Midiri
M
M
Galia
G A
GA
Rollandi
F
F
Cademartiri
R
R
Lagalla
A E
AE
Cardinale
D018248:Adenoma, Liver Cell / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage; D005234:Fatty Liver / Q000000981:diagnostic imaging*; D005260:Female; D020518:Focal Nodular Hyperplasia / Q000000981:diagnostic imaging; D006391:Hemangioma / Q000000981:diagnostic imaging; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008099:Liver / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D045423:Microbubbles; D008875:Middle Aged; D010743:Phospholipids / Q000008:administration & dosage; D011446:Prospective Studies; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D013997:Time Factors; D014463:Ultrasonography
D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride