Abstract
Objective
The aim of this study was to assess the role of contrast-enhanced ultrasound (CEUS) in the characterization of hepatic inflammatory pseudotumor (IPT).
Methods
We retrospectively reviewed 36 cases of histopathologically diagnosed IPT. Nodule enhancement appearances during the arterial, portal, and delayed phases were defined as hyperenhancement, isoenhancement, hypoenhancement, and non-enhancement compared with the surrounding liver parenchyma. Statistical analysis was performed by the one-way ANOVA and χ 2 tests.
Results
Among total 36 cases, 7 nodules were absent of contrast enhancement during all three phrases on CEUS. Twenty-nine nodules appeared different forms of enhancement in arterial phase. Diffuse homogeneous hyperenhancement, diffuse heterogeneous hyperenhancement, peripheral rim-like enhancement, and diffuse iso-enhancement were found in 10, 12, 5, and 2 of the nodules, respectively. Twenty-five nodules showed hypoenhancement in portal and delayed phases. Four nodules showed contrast washed out synchronously with normal liver parenchyma. The median time to enhancement, median time to peak, and median time to wash out of the nodules were 17 s (range 11–28 s), 23 s (range 14–42 s), and 45 s (range 23–100 s), respectively. No statistical significant differences were found in the above parameters of nodule enhancement and proportion of enhancement patterns when dividing the nodules into subgroups by nodule size.
Conclusion
IPT displays a variety of enhancement patterns due to pathological changes in the course of disease progression. Some characteristics on CEUS may be helpful in the differential diagnosis of IPT.
Similar content being viewed by others
Reference
Pack GT, Baker HW (1953) Total right hepatic lobectomy: report of a case. Ann Surg 138(2):253–258
Torzilli G, Inoue K, Midorikawa Y, et al. (2001) Inflammatory pseudotumors of the liver: prevalence and clinical impact in surgical patients. Hepatogastroenterology 48(40):1118–1123
Calomeni GD, Ataíde EB, Machado RR, et al. (2013) Hepatic inflammatory pseudotumor: a case series. Int J Surg Case Rep 4(3):308–311
Kim YW, Lee JG, Kim KS, et al. (2006) Inflammatory pseudotumor of the liver treated by hepatic resection: a case report. Yonsei Med J 47(1):140–143
Yoon KH, Ha HK, Lee JS, et al. (1999) Inflammatory pseudotumor of the liver in patients with recurrent pyogenic cholangitis: CT-histopathologic correlation. Radiology 211(2):373–379
Balabaud C, Bioulac-Sage P, Goodman ZD, Makhlouf HR (2012) Inflammatory pseudotumor of the liver: a rare but distinct tumor-like lesion. Gastroenterol Hepatol 8(9):633–634
Someren A (1978) Inflammatory pseudotumour of liver with occlusive phlebitis: report of a case in child and review of the literature. Am J Clin Pathol 69(2):176–181
Schnelldorfer T, Chavin KD, Lin A, Lewin DN, Baliga PK (2007) Inflammatory myofibroblastic tumor of the liver. J Hepatobiliary Pancreat Surg 14(4):421–423
Claudon M, Dietrich CF, Choi BI, et al. (2013) Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS) in the liver—update 2012: a WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS. Ultrasound Med Biol 39(2):187–210
Standiford SB, Sobel H, Dasmahapatra KS (1989) Inflammatory pseudotumor of the liver. J Surg Oncol 40(4):283–287
Saito M, Seo Y, Yano Y, et al. (2012) Sonazoid-enhanced ultrasonography and Ga-EOB-DTPA-enhanced MRI of hepatic inflammatory pseudotumor: a case report. Intern Med 51(7):723–726
Chen Y, Jiang TA, Ao JY, et al. (2010) Contrast-enhanced ultrasonography in diagnosis of inflammatory pseudotumor of liver. Zhejiang Da Xue Xue Bao Yi Xue Ban 39(6):634–637
Koea JB, Broadhurst GW, Rodgers MS, McCall JL (2003) Inflammatory pseudotumor of the liver: demographics, diagnosis, and the case for nonoperative management. J Am Coll Surg 196(2):226–235
Giorgio A, De Stefano G, Coppola C, et al. (2007) Contrast-enhanced sonography in the characterization of small hepatocellular carcinomas in cirrhotic patients: comparison with contrast-enhanced ultrafast magnetic resonance imaging. Anticancer Res 27(6C):4263–4269
Bhayana D, Kim TK, Jang HJ, Burns PN, Wilson SR (2010) Hypervascular liver masses on contrast-enhanced ultrasound: the importance of washout. AJR 194(4):977–983
Ganesan K, Viamonte B, Peterson M, et al. (2009) Capsular retraction: an uncommon imaging finding in hepatic inflammatory pseudotumour. Br J Radiol 82(984):256–260
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kong, WT., Wang, WP., Cai, H. et al. The analysis of enhancement pattern of hepatic inflammatory pseudotumor on contrast-enhanced ultrasound. Abdom Imaging 39, 168–174 (2014). https://doi.org/10.1007/s00261-013-0051-3
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00261-013-0051-3