Skip to main content

01.01.2015 | Hepatobiliary-Pancreas | Ausgabe 1/2015

European Radiology 1/2015

Differentiation of focal nodular hyperplasia from hepatocellular adenomas with low-mecanical-index contrast-enhanced sonography (CEUS): effect of size on diagnostic confidence

European Radiology > Ausgabe 1/2015
Vincent Roche, Frederic Pigneur, Lambros Tselikas, Marion Roux, Laurence Baranes, Marjane Djabbari, Charlotte Costentin, Julien Calderaro, Alexis Laurent, Alain Rahmouni, Alain Luciani



The purpose of this study was to assess the diagnostic performance of contrast-enhanced sonography (CEUS) for the differentiation of focal nodular hyperplasia (FNH) from hepatocellular adenoma (HCA) according to lesion size.

Materials and methods

Forty patients with a definite diagnosis of FNH or HCA who underwent CEUS were included in this institutional review board (IRB)-approved study. A total of 43 FNHs and 20 HCAs, including 15 inflammatory HCAs and five unclassified HCAs, were analysed. Two radiologists reviewed the diagnostic CEUS parameters separately and in consensus, including the presence or absence of centrifugal filling and central vessels. The sensitivity (Se), specificity (Sp), and inter-observer confidence (Kappa) of CEUS diagnostic parameters were assessed.


Inter-observer agreement of CEUS for FNH diagnosis was high (kappa = 0.81) with an overall Se of 67.4 % [29/43 (CI 95 %: 51.4–80.1 %)] and an Sp of 100 % [20/20 (CI 95 %: 81–100 %)]. Significantly higher Se figures were found for lesions ≤ 35 mm than for lesions > 35 mm [respectively, 93 % (28/30) (CI 95 %: 77.6–99.2) vs. 7.7 % (1/13) (CI 95 %: 0.2–36 %), p = 0.002] with unchanged specificity.


CEUS is highly specific for the diagnosis of FNH, with very good inter-observer agreement, whatever the size, but its sensitivity is significantly reduced in diagnosing lesions larger than 35 mm.

Key Points

CEUS is highly specific for the diagnosis of FNH, regardless of lesion size
CEUS shows reduced sensitivity in diagnosing FNH lesions larger than 35 mm
The filling patterns of hepatocellular adenomas are not affected by lesion size

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf

Weitere Produktempfehlungen anzeigen
Über diesen Artikel

Weitere Artikel der Ausgabe 1/2015

European Radiology 1/2015 Zur Ausgabe
  1. Sie können e.Med Radiologie 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.

Neu im Fachgebiet Radiologie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Radiologie und bleiben Sie gut informiert – ganz bequem per eMail.