Hemangiomas and focal nodular hyperplasia in contrast-enhanced, wide-band phase-inversion harmonic power Doppler imaging
Jacek Janica, Wojciech Serwatka, Jerzy Polaków, Andrzej Ustymowicz, Urszula Łebkowska, Kazimierz Kordecki, Jerzy Walecki, Piotr Polaków, Sławomir Dobrzycki
Med Sci Monit 2004; 10(3): 26-31
Background: Contrast-enhanced, wide-band, phase inversion power Doppler sonography in the depiction of vasculature in hemangioma and focal nodular hyperplasia.
Material and Methods: Fifty-one patients with liver lesions (40 FNHs, 37 hemangiomas) were prospectively evaluated with conventional, color, power Doppler sonography, tissue harmonic, phase-inversion sonography, and helical CT. Levovist was the standard contrast agent used and all examinations were performed on Siemens SONOLINE Elegra equipped with Ensemble Contrast Imaging
Results: Color and power Doppler scans were frequently not specific for these highly vasularized lesions. Images were not suggestive in 15 out of 40 FNHs and not positive in all of 37 hemangiomas. If peripheral enhancement in form of puddle enhancement, ‘blood pools’ or rimlike followed by a slow centripetal fill-in is regarded as a positive finding for hemangiomas all lesions were depicted confidently
with wide-band, phase inversion, contrast enhanced power Doppler scans. It was typ[[ical for all FNHs cases that filling of the feeding artery was primarily visualized and then centrifugal spread of contrast formed wheel like pattern.
Conclusions: Contrast-enhanced, wide-band, PI, power Doppler imaging is useful method for diagnosing the vascularity of FNHs and hemangiomas. Not only it overcomes the low prediction rate which was the main obstacle for routine use of sonography but it is cheap, portable, and free also from contrast media and radiation.
Keywords: Focal nodular hyperplasia, echo-enhanced wide band, power Doppler sonography, Levovist contrast agent, Adult, Aged, 80 and over, Contrast Media - diagnostic use, Focal Nodular Hyperplasia - ultrasonography, Hemangioma - ultrasonography, Liver Neoplasms - ultrasonography, Prospective Studies, Tomography, Spiral Computed, Ultrasonography, Doppler, Color - methods, young adult