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01.10.2014 | Ultrasound

Contrast-enhanced ultrasound of focal nodular hyperplasia: a matter of size

verfasst von: Caroline Bertin, Sophie Egels, Mathilde Wagner, Isabelle Huynh-Charlier, Valérie Vilgrain, Olivier Lucidarme

Erschienen in: European Radiology | Ausgabe 10/2014

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Abstract

Objectives

To assess the contrast-enhanced ultrasound (CEUS) frequencies of centrifugal enhancement, spoke-wheel sign and central scar in focal nodular hyperplasia (FNH) as a function of lesion size.

Methods

Ninety-four FNHs were retrospectively reviewed to assess their largest diameter and enhancement pattern, including centrifugal enhancement from one central artery, spoke-wheel sign, diffuse or centripetal enhancement, central scar and late-phase washout.

Results

Mean FNH-lesion size was 3.7 ± 2.1 cm. Only 43.6 % of FNHs had centrifugal enhancement, with a spoke-wheel pattern (23.4 %) or without (20.2 %), while 56.4 % showed diffuse or centripetal enhancement. Centrifugal enhancement was observed in 73.9 % of FNHs ≤3.1 cm and 14.6 % of FNHs >3.1 cm (P < 10^–4). Size and frequency of centrifugal enhancement were negatively correlated (r = –0.57, P < 10^–4). The spoke-wheel pattern was also seen more frequently in smaller (37 %) than in larger FNHs (10.4 %) (P < 10^–3). Late-phase washout was described in 5.3 % of FNHs and was not size-dependent. Lesions with a central scar were larger than those without, respectively, 5.7 ± 1.7 and 3.6 ± 2.0 cm (P = 0.012).

Conclusions

Typical centrifugal enhancement yielding a confident FNH diagnosis is seen significantly more frequently when the lesion is ≤3.1 cm.

Key Points

• CEUS yields confident diagnoses of FNHs ≤3.1 cm

• The larger the FNH, the lower the diagnostic sensitivity of CEUS

• Final diagnosis of FNHs >3.1 cm should be obtained with MRI not CEUS

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Titel: Contrast-enhanced ultrasound of focal nodular hyperplasia: a matter of size
verfasst von: Caroline Bertin
Sophie Egels
Mathilde Wagner
Isabelle Huynh-Charlier
Valérie Vilgrain
Olivier Lucidarme
Publikationsdatum: 01.10.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 10/2014
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3280-0

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Contrast-enhanced ultrasound of focal nodular hyperplasia: a matter of size