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Contrast-enhanced ultrasound features of histologically proven focal nodular hyperplasia: diagnostic performance compared with contrast-enhanced CT

  • Hepatobiliary-Pancreas
  • Published:
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Abstract

Objectives

To investigate and compare contrast-enhanced ultrasound (CEUS) in the characterisation of histologically proven focal nodular hyperplasia (FNH) with contrast-enhanced computed tomography (CECT).

Methods

CEUS was performed in 85 patients with 85 histologically proven FNHs. Enhancement, centrifugal filling, spoke-wheel arteries, feeding artery and central scarring were reviewed and correlated with lesion size or liver background. Independent factors for predicting FNH from other focal liver lesions (FLLs) were evaluated. Forty-seven FLLs with CECT were randomly selected for comparison of diagnostic performance with CEUS.

Results

Centrifugal filling was more common (P = 0.002) and the significant predictor (P = 0.003) in FNHs ≤3 cm. Lesion size or liver background has no significant influence on the detection rate of the spoke-wheel arteries and feeding artery (P > 0.05). Central scarring was found in 42.6 % of FNHs ≥3 cm (P = 0.000). The area under the ROC curve, sensitivity and specificity showed no significant differences between CEUS and CECT (P > 0.05), except that the sensitivity of CEUS was better for reader 1 (P = 0.041).

Conclusion

CEUS is valuable in characterising centrifugal filling signs or spoke wheels in small FNHs and should be employed as the first-line imaging technique for diagnosis of FNH.

Key Points

• The confident diagnosis of focal nodular hyperplasia is important in liver imaging.

• The centrifugal filling sign is useful for diagnosis of FNHs ≤3 cm.

• Contrast-enhanced ultrasound and contrast-enhanced CT have similar diagnostic performance for FNH.

• CEUS should be the first-line imaging technique for the diagnosis of FNH.

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Abbreviations

FNH:

Focal nodular hyperplasia

FLLs:

Focal liver lesions

CECT:

Contrast-enhanced computed tomography

CEMRI:

Contrast-enhanced magnetic resonance imaging

CEUS:

Contrast-enhanced ultrasound

HCC:

Hepatocellular carcinoma

ROC:

Receiver-operating characteristic

Az:

Area under the ROC curve

PPV:

Positive predictive value

NPV:

Negative predictive value

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Acknowledgements

Our work is supported by the National Natural Science Foundation of China (no. 30901384, 81271576).

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Authors and Affiliations

  1. Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, NO.58 Zhongshan Road 2, Guangzhou, 510080, People’s Republic of China

    Wei Wang, Li-Da Chen, Ming-De Lu, Guang-Jian Liu, Zuo-Feng Xu, Xiao-Yan Xie, Yan Wang & Lu-Yao Zhou

  2. Department of Hepatobiliary Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China

    Ming-De Lu & Shun-Li Shen

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  1. Wei Wang
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  2. Li-Da Chen
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  3. Ming-De Lu
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  6. Zuo-Feng Xu
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  7. Xiao-Yan Xie
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  8. Yan Wang
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Correspondence to Guang-Jian Liu.

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Wang, W., Chen, LD., Lu, MD. et al. Contrast-enhanced ultrasound features of histologically proven focal nodular hyperplasia: diagnostic performance compared with contrast-enhanced CT. Eur Radiol 23, 2546–2554 (2013). https://doi.org/10.1007/s00330-013-2849-3

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  • DOI: https://doi.org/10.1007/s00330-013-2849-3

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