Contrast-enhanced ultrasound in the diagnosis of malignant mesenchymal liver tumors.
ABSTRACT Contrast-enhanced ultrasound can differentiate malignant from benign hepatic tumors, but has not been studied in malignant mesenchymal liver tumors.
We describe the findings of contrast-enhanced ultrasound in a cohort of five patients with histological-proven malignant hepatic mesenchymal tumors.
The presence of imaging features such as peripheral (nodular) enhancement, chaotic central vascularization, and absence of contrast enhancement in the late phase allowed differentiation from hemangiomas.
If these findings are demonstrated in large hepatic tumors, then the diagnosis of hemangioma is unlikely and further workup is necessary.
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ABSTRACT: Non-invasive differentiation of focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA) is difficult. The aim of this study was to assess the accuracy of contrast-enhanced phase inversion ultrasound to differentiate between histologically proven FNH and HCA, analysing the arterial and (early) portal venous phase. 32 patients with histological proven FNH (n=24) or HCA (n=8) have been included in this prospective study. Examination technique: Siemens Elegra, phase inversion harmonic imaging (PIHI) with low mechanical index (MI)<0.2-0.3 using SonoVue (BR 1). The contrast enhancing tumour characteristics were evaluated during the hepatic arterial (starting 8-22 s) and early portal venous phase (starting 12-30 s). The image analysis was performed by three examiners. In 23 of 24 patients with FNH the contrast pattern revealed pronounced arterial and (early) portal venous enhancement. Homogeneous enhancement was detected during the hepatic arterial phase in all eight patients with HCA. In contrast to patients with FNH, no enhancement was seen during the portal venous phase. In conclusion, contrast-enhanced phase inversion ultrasound demonstrated pronounced arterial and portal venous enhancement in patients with focal nodular hyperplasia. In contrast, after homogeneous enhancement during hepatic arterial phase, no enhancement during hepatic portal venous phase was detected in patients with hepatocellular adenoma. Therefore, this technique might improve the functional characterization of benign hypervascular focal liver lesions.British Journal of Radiology 08/2005; 78(932):704-7. · 1.22 Impact Factor
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ABSTRACT: Primary hepatic angiosarcoma is a rare mesenchymal tumor of the liver that usually presents with nonspecific symptoms in elderly men. We present four cases of hepatic hemangiosarcoma and discuss the imaging characteristics of this entity. Our series shows that this tumor is not uncommon in younger patients with no associated risk factors such as previous exposure to thorotrast or vinyl chloride. Our experiences on a limited number of patients suggests that the combined use of angiography and dual-phase helical CT provides a better identification of the tumor and its complications. Analysis of imaging studies in patients with hepatic hemangiosarcoma reveals hypervascular lesions. Common complications were portal vein thrombosis, Budd-Chiari syndrome, as well as arterio-venous or arterio-portal shunts. Due to the vascularity of the tumor, percutaneous liver biopsy is hazardous.European Radiology 02/2000; 10(1):129-33. · 3.55 Impact Factor
- Ultraschall in der Medizin 03/2008; 29(1):28-44. · 4.12 Impact Factor