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Real-time contrast-enhanced ultrasonography of resected and immunohistochemically proven hepatic angiomyolipomas

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Abstract

Purpose

The purpose of this study was to assess real-time contrast-enhanced ultrasound in patients with hepatic angiomyolipomas with respect to contrast-enhancing kinetics and enhancement patterns.

Materials and methods

Nonlinear, low mechanical index (mechanical index less than 0.2), real-time contrast-enhanced ultrasonography was performed in 18 patients with 19 tumors after 2.4 mL bolus injection of contrast agent SonoVue. All the 19 tumors were surgically resected and immunohistochemically proven sporadic hepatic angiomyolipomas.

Results

Inhomogeneous hyperenhancing pattern was detected 16 tumors (84.2%) and homogeneous hyperenhancing pattern in 1 tumor (0.5%) in arterial phase and portal phase, 16 lesions remained hyperenhancement but one lesion became isoenhancement in late phase. Two lesions (10.5%) were detected inhomogeneously hypoenhancement compared to liver parenchyma during arterial, portal, and late phases, with only punctiform internal enhancement. The margin of all the lesions were smooth and well defined on contrast-enhanced ultrasonography, whereas no peripheral nodular arterial enhancement, centripetal filling, or spoke-wheel like enhancement pattern were depicted. Early strong enhancement in arterial phase, rapid washout of contrast agent, and appear hypoechoic to surrounding liver tissue during portal or late phase was not at all observed.

Conclusion

Real-time contrast-enhanced ultrasonography can demonstrate typical imaging characteristics of hepatic angiomyolipomas in most cases, that is, inhomogeneous hyperenhancing pattern in arterial phase, prolonged hyperenhancement during portal and late phase with smooth and well-defined margin. This real-time dynamic imaging technique may therefore improve noninvasive characterization and differentiation of this rare, benign, hepatic mesenchymal neoplasm.

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References

  1. Petrolla Amber A, Xin W (2008) Hepatic angiomyolipoma. Arch Pathol Lab Med 132:1679–1682

    CAS  PubMed  Google Scholar 

  2. Zhou YM, Li B, Xu F, et al. (2008) Clinical features of hepatic angiomyolipoma. Hepatobiliary Pancreat Dis Int 7(3):284–287

    PubMed  Google Scholar 

  3. Yoshimura H, Murakami T, Kim T, et al. (2002) Angiomyolipoma of the liver with least amount of fat component: imaging features of CT, MR, and angiography. Abdom Imaging 27:184–187

    Article  CAS  PubMed  Google Scholar 

  4. Högemann D, Flemming P, Kreipe H, Galanski M (2001) Correlation of MRI and CT findings with histopathology in hepatic angiomyolipoma. Eur Radiol 11(8):1389–1395

    Article  PubMed  Google Scholar 

  5. Li R, Guo Y, Hua X, et al. (2007) Characterization of focal liver lesions: comparison of pulse-inversion harmonic contrast-enhanced sonography with contrast-enhanced CT. J Clinical Ultrasound 35(3):109–117

    Article  Google Scholar 

  6. Celli N, Gaiani S, Piscaglia F, et al. (2007) Characterization of focal liver lesions by real-time contrast-enhanced ultrasonography. Eur J Gastroenterol Hepatol 19:3–14

    Article  PubMed  Google Scholar 

  7. Takayama Y, Moriura S, Nagata J, et al. (2002) Hepatic angiomyolipoma: radiologic and histopathologic correlation. Abdom Imaging 27:180–183

    Article  CAS  PubMed  Google Scholar 

  8. Yan F, Zeng M, Zhou K, et al. (2002) Hepatic angiomyolipoma: various appearances on two-phase contrast scanning of spiral CT. Eur J Radiol 41:12–18

    Article  PubMed  Google Scholar 

  9. Prasad SR, Wang H, Rosas H, et al. (2005) Fat-containing lesions of the liver: radiologic-pathologic correlation. Radiographics 25:321–331

    Article  PubMed  Google Scholar 

  10. Xiao W, Zhou M, Lou H, Wang Z, Zhang M (2009) Hemodynamic characterization of hepatic angiomyolipoma with least amount of fat evaluated by contrast-enhanced magnetic resonance angiography. Abdom Imaging [Epub ahead of print]

  11. Yoshikawa J, Matsui O, Takashima T, et al. (1988) Fatty metamorphosis in hepatocellular carcinoma: radiologic features in 10 cases. AJR 151:717–720

    CAS  PubMed  Google Scholar 

  12. Goodman ZD, Ishak KG (1984) Angiomyolipoma of the liver. Am J Surg Pathol 8:745–750

    Article  CAS  PubMed  Google Scholar 

  13. Tsui WM, Colombari R, Portmann BC, et al. (1999) Hepatic angiomyolipoma: a clinicopathologic study of 30 cases and delineation of unusual morphologic variants. Am J Surg Pathol 23:34–48

    Article  CAS  PubMed  Google Scholar 

  14. Jiang TA, Zhao QY, Chen MY, Wang LJ, Ao JY (2005) Diagnostic analysis of hepatic angiomyolipoma. Hepatobiliary Pancreat Dis Int 4:152–155

    PubMed  Google Scholar 

  15. Ascenti G, Gaeta M, Zimbaro G, et al. (2000) US power Doppler of hepatic angiomyolipoma with low fat content. Eur Radiol 10:935–937

    Article  CAS  PubMed  Google Scholar 

  16. Nicolau C, Vilana R, Catalá V, et al. (2006) Importance of evaluating all vascular phases on contrast-enhanced sonography in the differentiation of benign from malignant focal liver lesions. Am J Roentgenol 186:158–167

    Article  Google Scholar 

  17. Dietrich CF, Schuessler G, Trojan J, Fellbaum C, Ignee A (2005) Differentiation of focal nodular hyperplasia and hepatocellular adenoma by contrast-enhanced ultrasound. Br J Radiol 78:704–707

    Article  CAS  PubMed  Google Scholar 

  18. Ricci P, Laghi A, Cantisani V, et al. (2005) Contrast-enhanced sonography with SonoVue: enhancement patterns of benign focal liver lesions and correlation with dynamic gadobenate dimeglumine-enhanced MRI. Am J Roentgenol 184:821–827

    Google Scholar 

  19. Leen E, Ceccotti P, Kalogeropoulou C, et al. (2006) Prospective multicenter trial evaluating a novel method of characterizing focal liver lesions using contrast-enhanced sonography. Am J Roentgenol 186:1551–1559

    Article  Google Scholar 

  20. Martin K, Fabian K, Marco E, et al. (2004) Low mechanical index contrast enhanced ultrasound better reflects high arterial perfusion oh liver metastases than arterial phase computed tomography. Invest Radiol 39:222–261

    Google Scholar 

  21. Burns P, Wilson S (2007) Focal liver masses: enhancement patterns on contrast enhanced images-concordance of US scans with CT scans and MR images. Radiology 242:162–174

    Article  PubMed  Google Scholar 

  22. Catalá V, Nicolau C, Vilana R, et al. (2007) Characterization of focal liver lesions: comparative study of contrast-enhanced ultrasound versus spiral computed tomography. Eur Radiol 17:1066–1073

    Article  PubMed  Google Scholar 

  23. Von Herbay A, Vogt C, Willers R, Häussinger D (2004) Real-time imaging with the sonographic contrast agent SonoVue: differentiation between benign and malignant hepatic lesions. J Ultrasound Med 23:1557–1568

    Google Scholar 

  24. Wilson SR, Burns PN (2006) An algorithm for the diagnosis of focal liver masses using microbubble contrast enhanced pulse inversion sonography. Am J Roentgenol 186:1401–1412

    Article  Google Scholar 

  25. Nanomura A, Mizukami Y, Kadoya M (1994) Angiomyolipoma of the liver: a collective review. J Gastroenterol 29:95–105

    Article  Google Scholar 

  26. Xu AM, Zhang SH, Zheng JM, Zheng WQ, Wu MC (2006) Pathological and molecular analysis of sporadic hepatic angiomyolipoma. Hum Pathol 37(6):735–741

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Ultrasound, SouthWest Hospital, Chongqing, People’s Republic of China

    Rui Li, Xiaohang Zhang, Xing Hua, Hua Zhong & Yanli Guo

  2. Department of Radiology, SouthWest Hospital, Chongqing, People’s Republic of China

    Ping Cai & Shiyi Ding

  3. Department of Pathology, SouthWest Hospital, Chongqing, People’s Republic of China

    XiaoChu Yan

Authors
  1. Rui Li
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  2. Xiaohang Zhang
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  3. Xing Hua
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  4. Ping Cai
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  5. Hua Zhong
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  6. Yanli Guo
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  7. Shiyi Ding
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  8. XiaoChu Yan
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Correspondence to Rui Li.

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Li, R., Zhang, X., Hua, X. et al. Real-time contrast-enhanced ultrasonography of resected and immunohistochemically proven hepatic angiomyolipomas. Abdom Imaging 35, 676–682 (2010). https://doi.org/10.1007/s00261-009-9592-x

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  • DOI: https://doi.org/10.1007/s00261-009-9592-x

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