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Contrast-enhanced ultrasonography using levovist: Usefulness of diagnosis of small focal nodular hyperplasia lesions

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Abstract

Differential diagnosis of focal nodular hyperplasia and hepatocellular carcinoma is clinically important because, while both are hypervascular tumors, they have vastly different prognoses. Because the spoke-wheel appearance is the primary characteristic of focal nodular hyperplasia, we attempted to detect this pattern in nodules smaller than 3 cm in diameter with contrast-enhanced ultrasonography using a contrast agent (Levovist). Four patients were examined with contrast-enhanced US: two of the patients were examined with Coded Harmonic Angio; the other two patients were examined with contrast-enhanced color and power Doppler US without harmonic imaging. Although the hepatic arteriogram showed the spoke-wheel appearance in only one tumor (diameter, 3 cm), contrast-enhanced US clearly demonstrated this characteristic in all four tumors, including three tumors that were less than 2 cm in diameter. Because it is noninvasive and can be carried out in an outpatient clinic, contrast-enhanced US is extremely useful for diagnosing small focal noduler hyperplasia lesions at sites that can be observed with US.

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Authors and Affiliations

  1. First Department of Internal Medicine, Iwate Medical University, 19-1 Uchimaru, 020-8505, Morioka, Japan

    Yoshiaki Miura FJSUM, Koryo Kondo, Junko Oikawa, Hidekatsu Kuroda, Kazuhiro Kasai, Michiru Yamada & Kazuyuki Suzuki

  2. Ultrasonic Laboratory Division, Sogo Hanamaki Hospital, 4-18 Kajo, 025-0075, Hanamaki, Japan

    Yoshinori Takahashi RMS

  3. Department of Gastroenterology, Sogo Hanamaki Hospital, 4-18 Kajo, 025-0075, Hanamaki, Japan

    Takahiko Kawata & Yutaka Takeda

  4. First Department of Internal Medicine Hachinohe Red Cross Hospital, 2 Nakaaketo, Tamonoki, 039-1104, Hachinohe, Japan

    Hirohiko Obara

Authors
  1. Yoshiaki Miura FJSUM
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  2. Koryo Kondo
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  3. Junko Oikawa
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  4. Hidekatsu Kuroda
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  5. Kazuhiro Kasai
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  6. Michiru Yamada
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  7. Kazuyuki Suzuki
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  8. Yoshinori Takahashi RMS
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  9. Takahiko Kawata
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  10. Yutaka Takeda
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  11. Hirohiko Obara
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Miura, Y., Kondo, K., Oikawa, J. et al. Contrast-enhanced ultrasonography using levovist: Usefulness of diagnosis of small focal nodular hyperplasia lesions. J Med Ultrasonics 29, 99–104 (2002). https://doi.org/10.1007/BF02481231

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  • DOI: https://doi.org/10.1007/BF02481231

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