BACKGROUND:To determine the utility of contrast-enhanced ultrasonography (CEUS) in assessing hepatic tumors with central feeding arteries found by color/power Doppler ultrasonograophy (CDUS/PDUS). METHODS:We prospectively studied 37 hepatic tumors (34 patients), with a mean size of 2.9cm and each having a central feeding artery, by CDUS/PDUS. The CEUS was performed with a galactose-based microbubble contrast agent. The detection of a spoke-wheel sign was interpreted as evidence of focal nodular hyperplasia (FNH). All patients underwent tumor biopsies or surgical resection. RESULTS:CEUS showed a central feeding artery with a spoke-wheel sign in 36 tumors, including 34 FNHs and 2 hepatocellular carcinomas. The remaining tumor was demonstrated to be FNH despite the absence of a spoke-wheel sign as detected by CEUS. The sensitivity of the spoke-wheel sign or central scar for FNH was 97.1% (34/35), 40% (14/35), 28.6% (10/35), 50% (8/16) and 0% (0/15) for CEUS, CDUS/PDUS, dynamic computed tomography (CT) or magnetic resonance imaging (MRI), hepatic angiography and liver scintigraphy, respectively. The two hepatocellular carcinomas showed scirrhous changes histologically. CONCLUSIONS:CEUS is more sensitive than CDUS/PDUS, dynamic CT, MRI, hepatic angiography and liver scintigraphy in the detection of the spoke-wheel sign or central scar in FNH. Scirrhous hepatocellular carcinoma should be included in the differential diagnosis for liver tumors with spoke-wheel sign detected by CEUS.

译文

背景:为了确定造影增强超声(CEUS)在评估彩色/能量多普勒超声检查(CDUS / PDUS)发现的中央供血动脉肝肿瘤中的效用。
方法:我们通过CDUS / PDUS前瞻性研究了37例肝肿瘤(34例患者),平均大小为2.9cm,每个均具有中央供血动脉。 CEUS用半乳糖基微泡造影剂进行。轮辐迹象的检测被解释为局灶性结节性增生(FNH)的证据。所有患者均进行了肿瘤活检或手术切除。
结果:CEUS显示36个肿瘤(包括34个FNHs和2个肝细胞癌)中有一条带有轮辐迹象的中央进食动脉。尽管CEUS检测到没有轮辐迹象,但其余肿瘤仍被证明是FNH。轮辐迹象或中央疤痕对FNH的敏感度分别为97.1%(34/35),40%(14/35),28.6%(10/35),50%(8/16)和0%(0 / 15)分别用于CEUS,CDUS / PDUS,动态计算机断层扫描(CT)或磁共振成像(MRI),肝血管造影和肝闪烁显像。两种肝细胞癌在组织学上均显示出硬化性改变。
结论:CEUS在检测FNH的轮辐征象或中央疤痕方面比CDUS / PDUS,动态CT,MRI,肝血管造影和肝闪烁显像术更为敏感。 CEUS检测到轮辐征兆的肝肿瘤的鉴别诊断中应包括肝硬化性肝癌。

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