Quaia E, Bartolotta T V, Midiri M, Cernic S, Belgrano M, Cova M
Department of Radiology, Cattinara Hospital, University of Trieste, Strada di Fiume 447, Trieste, 34149, Italy.
Abdom Imaging. 2006 Jan-Feb;31(1):59-64. doi: 10.1007/s00261-005-0358-9. Epub 2005 Dec 7.
We describe different possible enhancement patterns in liver hemangiomas with atypical appearance on baseline ultrasound after microbubble-based contrast agent injection.
From a series of 253 consecutive lesions that were indeterminate on baseline ultrasound and then scanned after injection of air-filled microbubble contrast agent, 65 focal liver lesions were retrospectively selected on the basis of a diagnosis of liver hemangioma on multiphase contrast-enhanced computed tomography (n = 23), magnetic resonance imaging (n = 27), or histology (n = 15). Each lesion was scanned during arterial phase (30 s after microbubble injection) and late phase (5 min after injection). On-site sonologists performed retrospective assessment of contrast-enhancement patterns by consensus.
Centripetal fill-in preceded (n = 50) or not preceded (n = 3) by peripheral nodular/rim-like enhancement was the prevalently observed contrast-enhancement pattern, equivalent to the typical enhancement pattern of liver hemangiomas on contrast-enhanced computed tomography or magnetic resonance imaging. In the remaining lesions, additional enhancement patterns (diffuse contrast enhancement with rapid fill-in and a late hyper-isoechoic appearance, n = 6; peripheral nodular enhancement with a late hypoechoic appearance, n = 3; or persistent heterogeneous and hyperechoic appearance, n = 3) were observed.
Different contrast-enhancement patterns are possible in atypical liver hemangiomas after microbubble injection. Typical centripetal fill-in is the prevalent pattern and its evidence allows diagnosis.
我们描述了在基于微泡的造影剂注射后，肝脏血管瘤在基线超声检查中呈现非典型表现时不同的可能增强模式。
在一系列253个连续病变中，这些病变在基线超声检查时不确定，然后在注射充气微泡造影剂后进行扫描，根据多期对比增强计算机断层扫描（n = 23）、磁共振成像（n = 27）或组织学（n = 15）诊断为肝脏血管瘤，回顾性选择了65个肝脏局灶性病变。在动脉期（微泡注射后30秒）和延迟期（注射后5分钟）对每个病变进行扫描。现场超声科医生通过共识对造影剂增强模式进行回顾性评估。
周围结节状/边缘样增强之前（n = 50）或之后（n = 3）出现向心性填充是普遍观察到的造影剂增强模式，等同于肝脏血管瘤在对比增强计算机断层扫描或磁共振成像上的典型增强模式。在其余病变中，观察到其他增强模式（快速填充的弥漫性造影剂增强和延迟期高回声等表现，n = 6；延迟期低回声的周围结节状增强，n = 3；或持续的不均匀高回声表现，n = 3）。
微泡注射后，非典型肝脏血管瘤可能出现不同的造影剂增强模式。典型的向心性填充是普遍模式，其出现有助于诊断。
