Use of accumulation images obtained by arterial-phase contrast-enhanced harmonic grayscale ultrasonography to evaluate tumor vessels in focal nodular hyperplasia and other hepatic tumors.
OBJECTIVE
To evaluate the usefulness of accumulation images obtained by arterial-phase contrast-enhanced harmonic grayscale ultrasonography for examining tumor vessels in focal nodular hyperplasia and other hepatic lesions.


METHODS
After injecting a galactose-palmitic acid contrast agent, we used conventional contrast-enhanced harmonic grayscale ultrasonography to scan 8 focal nodular hyperplasia lesions, 21 hepatocellular carcinomas, 2 cholangiocellular carcinomas, 12 hepatic metastases, 17 hemangiomas, and 2 angiomyolipomas. We then accumulated and superimposed consecutive conventional images (accumulation images) and compared them with corresponding conventional images to evaluate serial images of hepatic tumor vessels.


RESULTS
Serial tumor vessel findings obtained from accumulation images were superior to those obtained from conventional images in 51 (77%) of the 66 various hepatic lesions examined. Evidence of the spoke-wheel artery pattern in 2 of the 8 focal nodular hyperplasia lesions was equivocal in the conventional images, but accumulation images clearly depicted serial images of spoke-wheel arteries, clearly indicating a diagnosis of focal nodular hyperplasia. Accumulation images allowed the diagnosis of two additional focal nodular hyperplasia lesions that had not been correctly diagnosed as focal nodular hyperplasia from conventional images.


CONCLUSIONS
Accumulation images obtained by arterial-phase contrast-enhanced harmonic grayscale ultrasonography are useful in evaluating hepatic tumor vessels, especially spoke-wheel arteries, which specifically indicate focal nodular hyperplasia.
Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune, Minami, Yokohama, Kanagawa, 232-0024, Japan. kz-numa@zero.ad.jp.
Kazushi
K
Numata
Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune, Minami, Yokohama, Kanagawa, 232-0024, Japan.
Manabu
M
Morimoto
Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune, Minami, Yokohama, Kanagawa, 232-0024, Japan.
Tetsuo
T
Isozaki
Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune, Minami, Yokohama, Kanagawa, 232-0024, Japan.
Kazuya
K
Sugimori
Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune, Minami, Yokohama, Kanagawa, 232-0024, Japan.
Hiroyuki
H
Oka
Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune, Minami, Yokohama, Kanagawa, 232-0024, Japan.
Kenichi
K
Matsuo
Second Department of Surgery, Yokohama City University School of Medicine, Kanagawa, Japan.
Hiroshi
H
Shimada
Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune, Minami, Yokohama, Kanagawa, 232-0024, Japan.
Toshio
T
Imada
Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune, Minami, Yokohama, Kanagawa, 232-0024, Japan.
Katsuaki
K
Tanaka
accumulation image; central scar; contrast-enhanced harmonic grayscale ultrasonography; focal nodular hyperplasia (FNH); spoke-wheel artery