title: Contrast-enhanced ultrasound features of histologically proven focal nodular hyperplasia: diagnostic performance compared with contrast-enhanced CT.
abstract: OBJECTIVE
  To investigate and compare contrast-enhanced ultrasound (CEUS) in the characterisation of histologically proven focal nodular hyperplasia (FNH) with contrast-enhanced computed tomography (CECT).
  
  
  METHODS
  CEUS was performed in 85 patients with 85 histologically proven FNHs. Enhancement, centrifugal filling, spoke-wheel arteries, feeding artery and central scarring were reviewed and correlated with lesion size or liver background. Independent factors for predicting FNH from other focal liver lesions (FLLs) were evaluated. Forty-seven FLLs with CECT were randomly selected for comparison of diagnostic performance with CEUS.
  
  
  RESULTS
  Centrifugal filling was more common (P = 0.002) and the significant predictor (P = 0.003) in FNHs ≤3 cm. Lesion size or liver background has no significant influence on the detection rate of the spoke-wheel arteries and feeding artery (P > 0.05). Central scarring was found in 42.6 % of FNHs ≥3 cm (P = 0.000). The area under the ROC curve, sensitivity and specificity showed no significant differences between CEUS and CECT (P > 0.05), except that the sensitivity of CEUS was better for reader 1 (P = 0.041).
  
  
  CONCLUSIONS
  CEUS is valuable in characterising centrifugal filling signs or spoke wheels in small FNHs and should be employed as the first-line imaging technique for diagnosis of FNH.
  
  
  CONCLUSIONS
  • The confident diagnosis of focal nodular hyperplasia is important in liver imaging. • The centrifugal filling sign is useful for diagnosis of FNHs ≤3 cm. • Contrast-enhanced ultrasound and contrast-enhanced CT have similar diagnostic performance for FNH. • CEUS should be the first-line imaging technique for the diagnosis of FNH.
authors.affiliation: Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, NO.58 Zhongshan Road 2, Guangzhou, 510080, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Li-Da
authors.initials: LD
authors.lastname: Chen
authors.forename: Ming-De
authors.initials: MD
authors.lastname: Lu
authors.forename: Guang-Jian
authors.initials: GJ
authors.lastname: Liu
authors.forename: Shun-Li
authors.initials: SL
authors.lastname: Shen
authors.forename: Zuo-Feng
authors.initials: ZF
authors.lastname: Xu
authors.forename: Xiao-Yan
authors.initials: XY
authors.lastname: Xie
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.forename: Lu-Yao
authors.initials: LY
authors.lastname: Zhou
mesh_terms: D000328:Adult; D003287:Contrast Media; D003362:Cost-Benefit Analysis; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D020518:Focal Nodular Hyperplasia / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008099:Liver / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D012372:ROC Curve; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult
chemical_list: D003287:Contrast Media