Application of Contrast-Enhanced Ultrasound in Diagnosis of Hepatic Focal Nodular Hyperplasia_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LU Qiang ¹ , HUANG Zixing ² , ZHONG Xiaofei ¹ , GOU Tingkun ¹ , LUO Yan ¹

1.Department of Sonography, West China Hospital, Sichuan University, Chengdu 610041, China;;
2.Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, ChinaCorresponding Author: LUO Yan, E-mail: luoyand@hotmail.com;

Corresponding author：

Keywords：

Contrast-enhanced ultrasound; Diagnosis; Liver; Neoplasm; Focal nodular hyperplasia

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　Objective 　To approach the enhancing patterns of hepatic focal nodular hyperplasia (FNH) under contrast-enhanced ultrasound, and improve the recognition on diagnosis for FNH by contrast-enhanced ultrasound.
　Methods 　The clinical data of 12 patients with histologically proved FNHs having accepted contrast-enhanced ultrasound examination from May 2007 to February 2009 in West China Hospital of Sichuan University were retroptectively analyzed, and related literatures were reviewed.
　Results 　All FNHs were rapidly enhanced in arterial phase and spoke-wheel-like sign was detected in 9/12 lesions. Slightly hyper-enhancement or iso-enhancement were showed in 11/12 lesions, while 1/12 lesions showed hypo-enhancement in late phase.
　Conclusion 　Contrast-enhanced ultrasound can display the dynamic blood perfusion of FNH, especially spoke-wheel-like arterial flow in early arterial phase, which is of great value for the diagnosis of FNH.

Citation： LU Qiang,HUANG Zixing,ZHONG Xiaofei,GOU Tingkun,LUO Yan. Application of Contrast-Enhanced Ultrasound in Diagnosis of Hepatic Focal Nodular Hyperplasia. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(4): 403-407. doi: Copy

1.	Hussain SM, Terkivatan T, Zondervan PE, et al. Focal nodular hyperplasia: findings at state-of-the-art MR imaging, US, CT, and pathologic analysis [J]. Radiographics, 2004; 24(1): 3-17.
2.	张磊, 蔡建强, 赵建军, 等. 肝脏局灶性结节性增生 [J]. 中国普通外科杂志, 2009; 18(7): 749-751.
3.	周玉保, 汪慧, 周华邦, 等. 肝脏局灶性结节性增生46例临床分析 [J]. 临床消化病杂志, 2009; 21(3): 146-149.
4.	张建伟, 王成锋, 刘骞, 等. 肝脏局灶性结节性增生的临床诊治分析 [J]. 中华医学杂志, 2007; 87(36): 2531-2533.
5.	兰明银, 周猛, 胡玲, 等. 肝脏局灶性结节性增生的诊疗分析 [J]. 外科理论与实践, 2007; 12(4): 381-382.
6.	Claudon M, Cosgrove D, Albrecht T, et al. Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS)-update 2008 [J]. Ultraschall Med, 2008; 29(1): 28-44.
7.	Ding H, Wang WP, Huang BJ, et al. Imaging of focal liver lesions: low-mechanical-index real-time ultrasonography with SonoVue [J]. J Ultrasound Med, 2005; 24(3): 285-297.
8.	Li R, Guo Y, Hua X, et al. Characterization of focal liver lesions: comparison of pulse-inversion harmonic contrast-enhanced sonography with contrast-enhanced CT [J]. J Clin Ultrasound, 2007; 35(3): 109-117.
9.	Sidhu PS. The EFSUMB guidelines for contrast-enhanced ultrasound are comprehensive and informative for good clinical practice: will radiologists take the lead? [J]. Br J Radiol, 2008; 81(967): 524-525.
10.	李迎春, 宋彬, 蒋莉莉, 等. 新型MR造影剂钆贝葡胺诊断肝脏局灶性结节样增生的价值(附5例报告) [J]. 中国普外基础与临床杂志, 2007; 15(5): 598-604.
11.	Nguyen BN, Flejou JF, Terris B, et al. Focal nodular hyperplasia of the liver: a comprehensive pathologic study of 305 lesions and recognition of new histologic forms [J]. Am J Surg Pathol, 1999; 23(12): 1441-1445.
12.	纪元, 朱雄增, 谭云山, 等. 肝局灶性结节性增生的临床病理学研究 [J]. 中华病理学杂志, 2000; 29(5): 334-338.
13.	邓晶，胡建群，林红军，等. 肝脏局灶性结节增生的超声造影诊断 [J]. 南京医科大学学报（自然科学版）, 2008; 28(5): 681-684.
14.	程志刚, Weskott H. 肝脏局灶性结节性增生的超声造影表现 [J]. 中国超声医学杂志, 2008; 24(11): 1042-1046.
15.	路小军, 黄道中. 超声造影结合新时相划分在肝脏局灶性结节性增生诊断中的价值 [J]. 中国医学影像技术, 2008; 24(9): 1431-1433.
16.	Ungermann L, Eliás P, Zizka J, et al. Focal nodular hyperplasia: spoke-wheel arterial pattern and other signs on dynamic contrast-enhanced ultrasonography [J]. Eur J Radiol, 2007; 63(2): 290-294.
17.	Bartolotta TV, Midiri M, Quaia E, et al. Benign focal liver lesions: spectrum of findings on SonoVue-enhanced pulse-inversion ultrasonography [J]. Eur Radiol, 2005; 15(8): 1643-1649.
18.	Strobel D, Seitz K, Blank W, et al. Contrast-enhanced ultrasound for the characterization of focal liver lesions-diagnostic accuracy in clinical practice (DEGUM multicenter trial) [J]. Ultraschall Med, 2008; 29(5): 499-505.
19.	Dietrich CF, Schuessler G, Trojan J, et al. Differentiation of focal nodular hyperplasia and hepatocellular adenoma by contrast-enhanced ultrasound [J]. Br J Radiol, 2005; 78(932): 704-707.
20.	潘思波, 叶观瑞, 车斯尧. 肝细胞腺瘤的诊断及治疗 [J]. 中国现代普通外科进展, 2009; 12(5): 414-416.
21.	Celli N, Gaiani S, Piscaglia F, et al. Characterization of liver lesions by real-time contrast-enhanced ultrasonography [J]. Eur J Gastroenterol Hepatol, 2007; 19(1): 3-14.
22.	丁红, 王文平, 黄备建, 等. 超声造影检测和诊断小肝癌的价值 [J]. 中国普外基础与临床杂志, 2007; 15(1): 28-31.
23.	Morin SH, Lim AK, Cobbold JF, et al. Use of second generation contrast-enhanced ultrasound in the assessment of focal liver lesions [J]. World J Gastroenterol, 2007; 13(45): 5963-5670.
24.	Rettenbacher T. Focal liver lesions: role of contrast-enhanced ultrasound [J]. Eur J Radiol, 2007; 64(2): 173-182.
25.	D’Onofrio M, Faccioli N, Zamboni G, et al. Focal liver lesions in cirrhosis: value of contrast-enhanced ultrasonography compared with Doppler ultrasound and alpha-fetoprotein levels [J]. Radiol Med, 2008; 113(7): 978-991.

1. Hussain SM, Terkivatan T, Zondervan PE, et al. Focal nodular hyperplasia: findings at state-of-the-art MR imaging, US, CT, and pathologic analysis [J]. Radiographics, 2004; 24(1): 3-17.
2. 　张磊, 蔡建强, 赵建军, 等. 肝脏局灶性结节性增生 [J]. 中国普通外科杂志, 2009; 18(7): 749-751.
3. 　周玉保, 汪慧, 周华邦, 等. 肝脏局灶性结节性增生46例临床分析 [J]. 临床消化病杂志, 2009; 21(3): 146-149.
4. 　张建伟, 王成锋, 刘骞, 等. 肝脏局灶性结节性增生的临床诊治分析 [J]. 中华医学杂志, 2007; 87(36): 2531-2533.
5. 　兰明银, 周猛, 胡玲, 等. 肝脏局灶性结节性增生的诊疗分析 [J]. 外科理论与实践, 2007; 12(4): 381-382.
6. 　Claudon M, Cosgrove D, Albrecht T, et al. Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS)-update 2008 [J]. Ultraschall Med, 2008; 29(1): 28-44.
7. 　Ding H, Wang WP, Huang BJ, et al. Imaging of focal liver lesions: low-mechanical-index real-time ultrasonography with SonoVue [J]. J Ultrasound Med, 2005; 24(3): 285-297.
8. 　Li R, Guo Y, Hua X, et al. Characterization of focal liver lesions: comparison of pulse-inversion harmonic contrast-enhanced sonography with contrast-enhanced CT [J]. J Clin Ultrasound, 2007; 35(3): 109-117.
9. 　Sidhu PS. The EFSUMB guidelines for contrast-enhanced ultrasound are comprehensive and informative for good clinical practice: will radiologists take the lead? [J]. Br J Radiol, 2008; 81(967): 524-525.
10. 　李迎春, 宋彬, 蒋莉莉, 等. 新型MR造影剂钆贝葡胺诊断肝脏局灶性结节样增生的价值(附5例报告) [J]. 中国普外基础与临床杂志, 2007; 15(5): 598-604.
11. 　Nguyen BN, Flejou JF, Terris B, et al. Focal nodular hyperplasia of the liver: a comprehensive pathologic study of 305 lesions and recognition of new histologic forms [J]. Am J Surg Pathol, 1999; 23(12): 1441-1445.
12. 　纪元, 朱雄增, 谭云山, 等. 肝局灶性结节性增生的临床病理学研究 [J]. 中华病理学杂志, 2000; 29(5): 334-338.
13. 　邓晶，胡建群，林红军，等. 肝脏局灶性结节增生的超声造影诊断 [J]. 南京医科大学学报（自然科学版）, 2008; 28(5): 681-684.
14. 　程志刚, Weskott H. 肝脏局灶性结节性增生的超声造影表现 [J]. 中国超声医学杂志, 2008; 24(11): 1042-1046.
15. 　路小军, 黄道中. 超声造影结合新时相划分在肝脏局灶性结节性增生诊断中的价值 [J]. 中国医学影像技术, 2008; 24(9): 1431-1433.
16. 　Ungermann L, Eliás P, Zizka J, et al. Focal nodular hyperplasia: spoke-wheel arterial pattern and other signs on dynamic contrast-enhanced ultrasonography [J]. Eur J Radiol, 2007; 63(2): 290-294.
17. 　Bartolotta TV, Midiri M, Quaia E, et al. Benign focal liver lesions: spectrum of findings on SonoVue-enhanced pulse-inversion ultrasonography [J]. Eur Radiol, 2005; 15(8): 1643-1649.
18. 　Strobel D, Seitz K, Blank W, et al. Contrast-enhanced ultrasound for the characterization of focal liver lesions-diagnostic accuracy in clinical practice (DEGUM multicenter trial) [J]. Ultraschall Med, 2008; 29(5): 499-505.
19. 　Dietrich CF, Schuessler G, Trojan J, et al. Differentiation of focal nodular hyperplasia and hepatocellular adenoma by contrast-enhanced ultrasound [J]. Br J Radiol, 2005; 78(932): 704-707.
20. 　潘思波, 叶观瑞, 车斯尧. 肝细胞腺瘤的诊断及治疗 [J]. 中国现代普通外科进展, 2009; 12(5): 414-416.
21. 　Celli N, Gaiani S, Piscaglia F, et al. Characterization of liver lesions by real-time contrast-enhanced ultrasonography [J]. Eur J Gastroenterol Hepatol, 2007; 19(1): 3-14.
22. 　丁红, 王文平, 黄备建, 等. 超声造影检测和诊断小肝癌的价值 [J]. 中国普外基础与临床杂志, 2007; 15(1): 28-31.
23. 　Morin SH, Lim AK, Cobbold JF, et al. Use of second generation contrast-enhanced ultrasound in the assessment of focal liver lesions [J]. World J Gastroenterol, 2007; 13(45): 5963-5670.
24. 　Rettenbacher T. Focal liver lesions: role of contrast-enhanced ultrasound [J]. Eur J Radiol, 2007; 64(2): 173-182.
25. 　D’Onofrio M, Faccioli N, Zamboni G, et al. Focal liver lesions in cirrhosis: value of contrast-enhanced ultrasonography compared with Doppler ultrasound and alpha-fetoprotein levels [J]. Radiol Med, 2008; 113(7): 978-991.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of Contrast-Enhanced Ultrasound in Diagnosis of Hepatic Focal Nodular Hyperplasia

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