Skip to main content
Erschienen in: European Radiology 4/2004

01.04.2004 | Hepatobiliary–Pancreas

Focal nodular hyperplasia in normal and fatty liver: a qualitative and quantitative evaluation with contrast-enhanced ultrasound

verfasst von: Tommaso Vincenzo Bartolotta, Massimo Midiri, Michele Scialpi, Elio Sciarrino, Massimo Galia, Roberto Lagalla

Erschienen in: European Radiology | Ausgabe 4/2004

Einloggen, um Zugang zu erhalten

Abstract

The aim of this study was to describe gray-scale appearance of liver parenchyma and focal nodular hyperplasia (FNH) by pulse inversion (PI) ultrasound (US) at baseline and after contrast agent administration in patients with normal and fatty liver. Sixteen consecutive patients (12 women, 4 men) with 29 previously diagnosed FNHs (15 of 29 located in normal liver and 14 of 29 in fatty liver) underwent PI US before and after SH U 508A (Levovist) injection. Signal intensity values were measured within the FNHs and the adjacent liver parenchyma in selected images. Baseline echogenicity of fatty liver was higher (15.19±2.90 dB±SD) than normal liver (10.91±3.15 dB±SD; p<0.001). After Levovist administration, normal livers (7 of 16) showed a statistically significant increase of echogenicity (16.59±3.81 dB±SD; p<0.001) in comparison with fatty livers (9 of 16; 15.75±3.12 dB±SD). The FNHs located in normal liver showed baseline echogenicity higher (12.29±3.22 dB±SD) than that of FNHs arising in fatty liver (7.06±2.43 dB±SD; p<0.001). After Levovist administration, FNHs located in normal liver showed a statistically significant increase of echogenicity (25.30±4.62 dB±SD) in comparison with FNHs located in fatty liver (13.58±3.54 dB±SD; p<0.001); the latter always showed mean values of echogenicity lower than surrounding liver parenchyma. In our series decreased contrast-enhancement pattern of both fatty liver and FNHs located in fatty liver was the most prominent finding when Levovist is administered. Contrast washout was a distinctive feature of FNH arising from the fatty liver.
Literatur
1.
Zurück zum Zitat Ros PR, Menu Y, Vilgrain V et al. (2001) Liver neoplasms and tumor-like conditions. Eur Radiol 11 (Suppl 2):S145–S165CrossRef Ros PR, Menu Y, Vilgrain V et al. (2001) Liver neoplasms and tumor-like conditions. Eur Radiol 11 (Suppl 2):S145–S165CrossRef
2.
Zurück zum Zitat Cherqui D, Rahmouni A, Charlotte F et al. (1995) Management of focal nodular hyperplasia and hepatocellular adenoma in young women: a series of 41 patients with clinical, radiological, and pathological correlations. Hepatology 22:1674–1681PubMed Cherqui D, Rahmouni A, Charlotte F et al. (1995) Management of focal nodular hyperplasia and hepatocellular adenoma in young women: a series of 41 patients with clinical, radiological, and pathological correlations. Hepatology 22:1674–1681PubMed
3.
Zurück zum Zitat Vilgrain V, Flejou JF, Arrivé L et al. (1992) Focal nodular hyperplasia of the liver: MR imaging and pathologic correlation in 37 patients. Radiology 184:699–703PubMed Vilgrain V, Flejou JF, Arrivé L et al. (1992) Focal nodular hyperplasia of the liver: MR imaging and pathologic correlation in 37 patients. Radiology 184:699–703PubMed
4.
Zurück zum Zitat Pain JA, Gimson AES, Williams R, Howard ER (1991) Focal nodular hyperplasia of the liver: results of treatment and options in management. Gut 32:524–527PubMed Pain JA, Gimson AES, Williams R, Howard ER (1991) Focal nodular hyperplasia of the liver: results of treatment and options in management. Gut 32:524–527PubMed
5.
Zurück zum Zitat Belghiti J, Pateron D, Panis Y et al. (1993) Resection of presumed benign liver tumours. Br J Surg 80:380–383PubMed Belghiti J, Pateron D, Panis Y et al. (1993) Resection of presumed benign liver tumours. Br J Surg 80:380–383PubMed
6.
Zurück zum Zitat Harvey CJ, Albrecht T (2001) Ultrasound of focal liver lesions. Eur Radiol 11:1578–1593PubMed Harvey CJ, Albrecht T (2001) Ultrasound of focal liver lesions. Eur Radiol 11:1578–1593PubMed
7.
Zurück zum Zitat Wang LY, Wang JH, Lin ZY et al. (1997) Hepatic focal nodular hyperplasia: findings on color Doppler ultrasound. Abdom Imaging 22:178–181CrossRefPubMed Wang LY, Wang JH, Lin ZY et al. (1997) Hepatic focal nodular hyperplasia: findings on color Doppler ultrasound. Abdom Imaging 22:178–181CrossRefPubMed
8.
Zurück zum Zitat Uggowitzer M, Kugler C, Gröll R et al. (1998) Sonographic evaluation of focal nodular hyperplasias (FNH) of the liver with a transpulmonary galactose-based contrast agent (Levovist). Br J Radiol 71:1026–1032PubMed Uggowitzer M, Kugler C, Gröll R et al. (1998) Sonographic evaluation of focal nodular hyperplasias (FNH) of the liver with a transpulmonary galactose-based contrast agent (Levovist). Br J Radiol 71:1026–1032PubMed
9.
Zurück zum Zitat Hosten N, Puls R, Bechstein WO, Felix R (1999) Focal liver lesions: Doppler ultrasound. Eur Radiol 9:428–435CrossRefPubMed Hosten N, Puls R, Bechstein WO, Felix R (1999) Focal liver lesions: Doppler ultrasound. Eur Radiol 9:428–435CrossRefPubMed
10.
Zurück zum Zitat Uggowitzer MM, Kugler C, Mischinger HJ et al. (1999) Echo-enhanced Doppler sonography of focal nodular hyperplasia of the liver. J Ultrasound Med 18:445–451PubMed Uggowitzer MM, Kugler C, Mischinger HJ et al. (1999) Echo-enhanced Doppler sonography of focal nodular hyperplasia of the liver. J Ultrasound Med 18:445–451PubMed
11.
Zurück zum Zitat Burns PN, Wilson SR, Simpson DH (2000) Pulse inversion imaging of liver blood flow: improved method for characterizing focal masses with microbubble contrast. Invest Radiol 35:58–71PubMed Burns PN, Wilson SR, Simpson DH (2000) Pulse inversion imaging of liver blood flow: improved method for characterizing focal masses with microbubble contrast. Invest Radiol 35:58–71PubMed
12.
Zurück zum Zitat Burns PN, Hope Simpson D, Averkiou M (2000) Nonlinear imaging. Ultrasound Med Biol 26:19–22CrossRef Burns PN, Hope Simpson D, Averkiou M (2000) Nonlinear imaging. Ultrasound Med Biol 26:19–22CrossRef
13.
Zurück zum Zitat Dill-Macky MJ, Burns PN, Khalili K, Wilson SR (2002) Focal hepatic masses: enhancement patterns with SH U 508 A and pulse-inversion US. Radiology 222:95–102PubMed Dill-Macky MJ, Burns PN, Khalili K, Wilson SR (2002) Focal hepatic masses: enhancement patterns with SH U 508 A and pulse-inversion US. Radiology 222:95–102PubMed
14.
Zurück zum Zitat Bertolotto M, Dalla Palma L, Quaia E, Locatelli M (2000) Characterization of unifocal liver lesions with pulse-inversion harmonic imaging after Levovist injection: preliminary results. Eur Radiol 10:1369–1376PubMed Bertolotto M, Dalla Palma L, Quaia E, Locatelli M (2000) Characterization of unifocal liver lesions with pulse-inversion harmonic imaging after Levovist injection: preliminary results. Eur Radiol 10:1369–1376PubMed
15.
Zurück zum Zitat Wilson SR, Burns PN (2001) Liver mass evaluation of ultrasound: the impact of of microbubble contrast agents and pulse-inversion imaging. Semin Liver Dis 21:147–159CrossRefPubMed Wilson SR, Burns PN (2001) Liver mass evaluation of ultrasound: the impact of of microbubble contrast agents and pulse-inversion imaging. Semin Liver Dis 21:147–159CrossRefPubMed
16.
Zurück zum Zitat Konno K, Ishida H, Sato M et al. (2001) Liver tumors in fatty liver: difficulty in ultrasonographic interpretation. Abdom Imaging 26:487–491CrossRefPubMed Konno K, Ishida H, Sato M et al. (2001) Liver tumors in fatty liver: difficulty in ultrasonographic interpretation. Abdom Imaging 26:487–491CrossRefPubMed
17.
Zurück zum Zitat Dalla Palma L, Bertolotto M (1999) Introduction to ultrasound contrast agents: physics overview. Eur Radiol 9 (Suppl 3):S338–S342PubMed Dalla Palma L, Bertolotto M (1999) Introduction to ultrasound contrast agents: physics overview. Eur Radiol 9 (Suppl 3):S338–S342PubMed
18.
Zurück zum Zitat Foley D, Jochem RJ (1991) Computed tomography: focal and diffuse liver disease. Radiol Clin North Am 29:1213–1222PubMed Foley D, Jochem RJ (1991) Computed tomography: focal and diffuse liver disease. Radiol Clin North Am 29:1213–1222PubMed
19.
Zurück zum Zitat Blomley MKJ, Albrecth T, Cosgrove DO et al. (1999) Improved imaging of the liver metastases with stimulated acustic emission in the late phase of enhancement with the US contrast agent SH U 508A: early experience. Radiology 210:409–416PubMed Blomley MKJ, Albrecth T, Cosgrove DO et al. (1999) Improved imaging of the liver metastases with stimulated acustic emission in the late phase of enhancement with the US contrast agent SH U 508A: early experience. Radiology 210:409–416PubMed
20.
Zurück zum Zitat Herbay A von, Vogt C, Haussinger D (2002) Late-phase pulse-inversion sonography using the contrast agent Levovist: differentiation between benign and malignant focal lesions of the liver. Am J Roentgenol 179:1273–1279PubMed Herbay A von, Vogt C, Haussinger D (2002) Late-phase pulse-inversion sonography using the contrast agent Levovist: differentiation between benign and malignant focal lesions of the liver. Am J Roentgenol 179:1273–1279PubMed
21.
Zurück zum Zitat Bartolozzi C, Lencioni R, Paolicchi A et al. (1997) Differentiation of hepatocellular adenoma and focal nodular hyperplasia of the liver: comparison of power Doppler imaging and conventional color Doppler sonography. Eur Radiol 7:1410–1415PubMed Bartolozzi C, Lencioni R, Paolicchi A et al. (1997) Differentiation of hepatocellular adenoma and focal nodular hyperplasia of the liver: comparison of power Doppler imaging and conventional color Doppler sonography. Eur Radiol 7:1410–1415PubMed
22.
Zurück zum Zitat Strobel D, Krodel U, Martus P et al. (2000) Clinical evaluation of contrast-enhanced color Doppler sonography in the differential diagnosis of liver tumors. J Clin Ultrasound 28:1–13PubMed Strobel D, Krodel U, Martus P et al. (2000) Clinical evaluation of contrast-enhanced color Doppler sonography in the differential diagnosis of liver tumors. J Clin Ultrasound 28:1–13PubMed
23.
Zurück zum Zitat Leen E (2001) The role of contrast-enhanced ultrasound in the characterisation of focal liver lesions. Eur Radiol 11 (Suppl 3):S27–S34 Leen E (2001) The role of contrast-enhanced ultrasound in the characterisation of focal liver lesions. Eur Radiol 11 (Suppl 3):S27–S34
24.
Zurück zum Zitat Wilson SR, Burns PN, Muradali D et al. (2000) Harmonic hepatic US with microbubble contrast agent: initial experience showing improved characterization of hemangioma, hepatocellular carcinoma, and metastasis. Radiology 215:153–161 Wilson SR, Burns PN, Muradali D et al. (2000) Harmonic hepatic US with microbubble contrast agent: initial experience showing improved characterization of hemangioma, hepatocellular carcinoma, and metastasis. Radiology 215:153–161
25.
Zurück zum Zitat Kim TK, Choi BI, Han JK et al. (2000) Hepatic tumors: contrast agent-enhancement patterns with pulse-inversion harmonic US. Radiology 216:411–417PubMed Kim TK, Choi BI, Han JK et al. (2000) Hepatic tumors: contrast agent-enhancement patterns with pulse-inversion harmonic US. Radiology 216:411–417PubMed
26.
Zurück zum Zitat Tanaka S, Ioka T, Oshikawa O et al. (2001) Dynamic sonography of hepatic tumors. Am J Roentgenol 177:799–805 Tanaka S, Ioka T, Oshikawa O et al. (2001) Dynamic sonography of hepatic tumors. Am J Roentgenol 177:799–805
27.
Zurück zum Zitat Wilson SR, Burns PN (2001) Liver mass evaluation of ultrasound: the impact of of microbubble contrast agents and pulse-inversion imaging. Semin Liver Dis 21:147–159CrossRefPubMed Wilson SR, Burns PN (2001) Liver mass evaluation of ultrasound: the impact of of microbubble contrast agents and pulse-inversion imaging. Semin Liver Dis 21:147–159CrossRefPubMed
28.
Zurück zum Zitat Quaia E, Bertolotto M, Dalla Palma L (2002) Characterization of liver hemangiomas with pulse-inversion harmonic imaging. Eur Radiol 12:537–544PubMed Quaia E, Bertolotto M, Dalla Palma L (2002) Characterization of liver hemangiomas with pulse-inversion harmonic imaging. Eur Radiol 12:537–544PubMed
29.
Zurück zum Zitat Herbay A von, Vogt C, Haussinger D (2002) Pulse-inversion sonography in the early phase of the sonographic contrast agent Levovist: differentiation between benign and malignant focal liver lesions. J Ultrasound Med 21:1191–2000PubMed Herbay A von, Vogt C, Haussinger D (2002) Pulse-inversion sonography in the early phase of the sonographic contrast agent Levovist: differentiation between benign and malignant focal liver lesions. J Ultrasound Med 21:1191–2000PubMed
30.
Zurück zum Zitat Lencioni R, Cioni D, Bartolozzi C (2002) Tissue harmonic and contrast agent and contrast-specific imaging: back to gray scale in ultrasound. Eur Radiol 12:151–165CrossRefPubMed Lencioni R, Cioni D, Bartolozzi C (2002) Tissue harmonic and contrast agent and contrast-specific imaging: back to gray scale in ultrasound. Eur Radiol 12:151–165CrossRefPubMed
31.
Zurück zum Zitat Mattrey RF, Kono Y (1999) Parenchymal enhancement on gray-scale in normal and pathologic tissues. Eur Radiol 9 (Suppl 3):S359–S363PubMed Mattrey RF, Kono Y (1999) Parenchymal enhancement on gray-scale in normal and pathologic tissues. Eur Radiol 9 (Suppl 3):S359–S363PubMed
32.
Zurück zum Zitat Buetow PC, Pantongrag-Brown L, Buck JL, Ros P, Goodman ZD (1999) Focal nodular hyperplasia of the liver: radiologic–pathologic correlation. Radiographics 16:369–388 Buetow PC, Pantongrag-Brown L, Buck JL, Ros P, Goodman ZD (1999) Focal nodular hyperplasia of the liver: radiologic–pathologic correlation. Radiographics 16:369–388
33.
Zurück zum Zitat Horton KM, Bluemke DA, Hruban RH, Soyer P, Fishman EK (1999) CT and MR imaging of benign hepatic and biliary tumors. Radiographics 19:431–451PubMed Horton KM, Bluemke DA, Hruban RH, Soyer P, Fishman EK (1999) CT and MR imaging of benign hepatic and biliary tumors. Radiographics 19:431–451PubMed
34.
Zurück zum Zitat Nino-Murcia M, Olcott EW, Jeffrey RB, Lamm RL, Beaulieu CF, Jain KA (2000) Focal liver lesions: pattern-based classification scheme for enhancement at arterial phase CT. Radiology 215:746–751PubMed Nino-Murcia M, Olcott EW, Jeffrey RB, Lamm RL, Beaulieu CF, Jain KA (2000) Focal liver lesions: pattern-based classification scheme for enhancement at arterial phase CT. Radiology 215:746–751PubMed
35.
Zurück zum Zitat Bartolotta TV, Midiri M, Galia M, Carcione A, De Maria M, Lagalla R (2001) Benign hepatic tumors: MRI features before and after superparamagnetic iron oxide administration. Radiol Med 101:219–229 Bartolotta TV, Midiri M, Galia M, Carcione A, De Maria M, Lagalla R (2001) Benign hepatic tumors: MRI features before and after superparamagnetic iron oxide administration. Radiol Med 101:219–229
Metadaten
Titel
Focal nodular hyperplasia in normal and fatty liver: a qualitative and quantitative evaluation with contrast-enhanced ultrasound
verfasst von
Tommaso Vincenzo Bartolotta
Massimo Midiri
Michele Scialpi
Elio Sciarrino
Massimo Galia
Roberto Lagalla
Publikationsdatum
01.04.2004
Verlag
Springer-Verlag
Erschienen in
European Radiology / Ausgabe 4/2004
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-003-2089-z

Weitere Artikel der Ausgabe 4/2004

European Radiology 4/2004 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.