title: Comparison of imaging characteristics between hepatic benign regenerative nodules and hepatocellular carcinomas associated with Budd-Chiari syndrome by contrast enhanced ultrasound.
abstract: OBJECTIVE
  To compare different imaging characteristics between hepatic benign regenerative nodules and hepatocellular carcinomas (HCCs) associated with Budd-Chiari syndrome (BCS) by contrast enhanced ultrasound (CEUS).
  
  
  METHODS
  A total of 32 chronic BCS patients (mean age, 42 years; age range, 18-59 years) with hepatic nodules who underwent CEUS were retrospectively studied. All patients had no the history of viral hepatitis. There were 23 patients with benign regenerative nodules (22±9 mm; range, 8-42 mm) and 9 patients with HCCs (63±21 mm; range, 26-90 mm). Lesion characteristics, including number, size, vascularization on color Doppler flow imaging, echogenicity, peripheral hypoechoic rim, and enhancement patterns in arterial, portal, and late phases on CEUS, were analyzed.
  
  
  RESULTS
  There were significant differences in number and size of the lesions between two groups. No significant differences were observed in vascularity, echogenicity, and peripheral hypoechoic rim. Overall, there were significant differences in enhancement patterns in arterial, portal, and late phases between them on CEUS. Of 23 patients with benign regenerative nodules, 16 (70%) were center-to-periphery hyperenhanced and 7 patients (30%) were homogeneously hyperenhanced in arterial phase; the majority were homogeneously hyperenhanced in portal and late phases. Of 9 patients with HCCs, 8 (89%) were heterogeneously hyperenhanced in arterial phase and most of them were hypoenhanced in portal and late phases.
  
  
  CONCLUSIONS
  CEUS imaging characteristics of benign regenerative nodules radically differ from that of HCCs in BCS patients.
authors.affiliation: Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, 1 Eastern Jianshe Road, Zhengzhou, Henan Province 450052, China. zhangruifang999@hotmail.com
authors.forename: Ruifang
authors.initials: R
authors.lastname: Zhang
authors.forename: Shicheng
authors.initials: S
authors.lastname: Qin
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Zhou
authors.forename: Yi
authors.initials: Y
authors.lastname: Song
authors.forename: Lulu
authors.initials: L
authors.lastname: Sun
mesh_terms: D000293:Adolescent; D000328:Adult; D006502:Budd-Chiari Syndrome / Q000150:complications* / Q000000981:diagnostic imaging*; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult