title: Contrast-enhanced ultrasound study of primary hepatic angiosarcoma: a pitfall of non-enhancement.
abstract: OBJECTIVE
  To investigate the contrast-enhanced ultrasound (CEUS) characteristics of primary hepatic angiosarcoma (PHA).
  
  
  METHODS
  The sonographic findings and CEUS images of PHA in three patients were retrospectively analyzed.
  
  
  RESULTS
  In our study, 3 cases of PHA (2 multiple nodules and 1 solitary mass) showed similar enhancement pattern on CEUS, characterized by remarkable central non-enhancement and peripheral irregular enhancement in the arterial and portal phase, and complete wash-out in the late phase. Furthermore, we unexpectedly found that abundant neoplastic tissues were present in the central area of non-enhancement on pathological evaluation. Based on literature review, we supposed that the unusual finding may be associated with the very low velocity of blood flow in the central region of tumors.
  
  
  CONCLUSIONS
  CEUS could well depict PHA with some common features, which may provide valuable clues in diagnosis of this rare disease. And non-necrotic tumor tissue of PHA could also demonstrate non-enhancement on CEUS, which warrant further investigations.
authors: Department of Ultrasound, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, 1 Shuaifuyuan Wangfujing, Beijing 100730, China. liangw 1983@yahoo.com.cn
authors: Liang
authors: L
authors: Wang
authors: Ke
authors: K
authors: Lv
authors: Xiao-Yan
authors: XY
authors: Chang
authors: Yu
authors: Y
authors: Xia
authors: Zhi-Ying
authors: ZY
authors: Yang
authors: Yu-Xin
authors: YX
authors: Jiang
authors: Qing
authors: Q
authors: Dai
authors: Li
authors: L
authors: Tan
authors: Jian-Chu
authors: JC
authors: Li
mesh_terms: D000328:Adult; D000368:Aged; D016477:Artifacts; D003287:Contrast Media; D005188:False Negative Reactions; D005260:Female; D006394:Hemangiosarcoma / Q000000981:diagnostic imaging*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010743:Phospholipids; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride