title: Ring-shaped appearance in liver-specific image with Levovist: a characteristic enhancement pattern for hypervascular benign nodule in the liver of heavy drinkers.
abstract: OBJECTIVE
  The aim was to clarify the features of contrast-enhanced ultrasound (CEUS) with Levovist for diagnosis of hypervascular benign nodules in the liver of heavy drinkers.
  
  
  METHODS
  Seven heavy drinkers with hypervascular nodules in the liver were studied. Findings of CEUS with Levovist (wide-band Doppler, 7/7), contrast-enhanced computed tomography (CECT, 7/7) and magnetic resonance imaging (MRI, 5/7) were compared for one nodule in each patient.
  
  
  RESULTS
  Diagnosis of all seven nodules on CECT was HCC, whereas pathological results were HCC for four nodules and benign lesion for three nodules. The former four showed compatible findings for HCC on CEUS (4/4) and MRI (2/4). However, the latter three showed characteristic liver-specific sonograms with a ring-shaped appearance--peripheral enhancement with a central non-enhanced area. Two of the three nodules showed decreased signal-intensity in the periphery on SPIO-enhanced MRI.
  
  
  CONCLUSIONS
  The ring-shaped appearance on liver-specific sonograms with Levovist may be a useful sign for the differential diagnosis of hypervascular benign nodule from HCC in heavy drinkers.
authors.affiliation: Department of Medicine and Clinical Oncology, Chiba University Graduate School of Medicine, Chiba, Japan. maru-cib@umin.ac.jp
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Maruyama
authors.forename: Shoichi
authors.initials: S
authors.lastname: Matsutani
authors.forename: Fukuo
authors.initials: F
authors.lastname: Kondo
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Yoshizumi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Okugawa
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ebara
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Saisho
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000473:pathology* / Q000503:physiopathology; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D008104:Liver Cirrhosis, Alcoholic / Q000000981:diagnostic imaging* / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D003287:Contrast Media; D011134:Polysaccharides; D000509:alpha-Fetoproteins; C059891:SHU 508