title: Focal nodular hyperplasia: our experience of 53 Japanese cases.
abstract: OBJECTIVE
  Contrast-enhanced ultrasound (CEUS) is a very sensitive diagnostic tool in characterizing liver tumors. It is especially useful in the diagnosis of focal nodular hyperplasia (FNH) of the liver. According to the previous reports, FNH is common in young women, and it is usually diagnosed by MRI. The majority of the previous reports come from European countries, and a very few studies of large series designed to describe the clinical features in Japanese patients have been reported. The aim of this study was to (a) describe the clinical features in 53 patients (59 lesions) diagnosed with CEUS and (b) compare the data with those from the previous reports.
  
  
  METHODS
  The medical data from 53 patients diagnosed on the basis of typical CEUS findings at our institution and affiliated hospitals were reviewed, and their clinical data were analyzed.
  
  
  RESULTS
  (1) The medical data from 53 cases showed a slight male predilection, with 30 male cases (57 %) and 23 female cases (43 %), although the occurrence in both sexes was equal. FNH cases were distributed throughout all generations in both sexes, mostly concentrated in the age of 30-60 years old, and metabolic cases were more common in men than in women (4 vs 0). (2) The lesions were small (mean: 23 mm) and distributed throughout the whole liver. (3) Lesion size was not influenced by age in either sex. (4) A rapid draining to the hepatic vein was recognized in five out of 59 lesions (8 %).
  
  
  CONCLUSIONS
  Our data indicate that FNH occurs slightly more frequently in men than in women in Japan. It occurs also at any age in both sexes, but the mean lesion size was smaller in our series than in the previous reports. Metabolic disease was seen only in male FNH patients. A direct communication between the FNH lesion and the hepatic vein is diagnostically worth noting.
authors.affiliation: Department of Gastroenterology, Yokote Municipal Hospital, Yokote, Japan. hiron@vesta.ocn.ne.jp.
authors.forename: Hiroko
authors.identifier: http://orcid.org/0000-0001-5175-568X
authors.initials: H
authors.lastname: Naganuma
authors.affiliation: Center of Diagnostic Ultrasound, Akita Red Cross Hospital, Akita, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Ishida
authors.affiliation: Department of Gastroenterology and Hepatology, Nihon University Hospital, Tokyo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ogawa
authors.affiliation: Department of Gastroenterology and Hepatology, Nihon University Hospital, Tokyo, Japan.
authors.forename: Yukinobu
authors.initials: Y
authors.lastname: Watanabe
authors.affiliation: Department of Gastroenterology, Noshiro Ishikai Hospital, Noshiro, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Watanabe
authors.affiliation: Department of Medical Laboratory, Akita Kousei Medical Center, Akita, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Ohyama
authors.affiliation: Center of Diagnostic Ultrasound, Akita Red Cross Hospital, Akita, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D000367:Age Factors; D003287:Contrast Media; D005260:Female; D020518:Focal Nodular Hyperplasia / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D006391:Hemangioma / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology; D006503:Hepatic Veins / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008659:Metabolic Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media
keywords: Contrast-enhanced ultrasound; Focal nodular hyperplasia (FNH); Hemangioma; Hepatic vein; Liver; Metabolic disease