Contrast-enhanced ultrasound of focal nodular hyperplasia: a matter of size |
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Authors: | Caroline Bertin Sophie Egels Mathilde Wagner Isabelle Huynh-Charlier Valérie Vilgrain Olivier Lucidarme |
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Institution: | 1. Radiology Department, H?pital Beaujon APHP, 92118, Clichy, Cedex, France 2. Radiology Department, H?pital Pitié–Salpêtrière APHP, 75651, Paris, Cedex, France 3. INSERM, UMR 1149, Laboratoire IPMA, Centre de Recherche sur l’Inflammation, Faculté de Médecine X Bichat, Université Paris Diderot, 75877, Paris, Cedex, France 4. UPMC Univ Paris 06, CNRS UMR 7371, INSERM UMR_S 1146, Laboratoire d’Imagerie Biomédicale, Sorbonne Universités, 75005, Paris, France 5. Service de Radiologie Polyvalente et Oncologique, Groupe Hospitalier Pitié-Salpêtrière – Charles Foix, 47-83, boulevard de l’H?pital, 75651, Paris, Cedex, France
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Abstract: | Objectives To assess the contrast-enhanced ultrasound (CEUS) frequencies of centrifugal enhancement, spoke-wheel sign and central scar in focal nodular hyperplasia (FNH) as a function of lesion size. Methods Ninety-four FNHs were retrospectively reviewed to assess their largest diameter and enhancement pattern, including centrifugal enhancement from one central artery, spoke-wheel sign, diffuse or centripetal enhancement, central scar and late-phase washout. Results Mean FNH-lesion size was 3.7?±?2.1 cm. Only 43.6 % of FNHs had centrifugal enhancement, with a spoke-wheel pattern (23.4 %) or without (20.2 %), while 56.4 % showed diffuse or centripetal enhancement. Centrifugal enhancement was observed in 73.9 % of FNHs ≤3.1 cm and 14.6 % of FNHs >3.1 cm (P?10–4). Size and frequency of centrifugal enhancement were negatively correlated (r?=?–0.57, P?10–4). The spoke-wheel pattern was also seen more frequently in smaller (37 %) than in larger FNHs (10.4 %) (P?10–3). Late-phase washout was described in 5.3 % of FNHs and was not size-dependent. Lesions with a central scar were larger than those without, respectively, 5.7?±?1.7 and 3.6?±?2.0 cm (P?=?0.012). Conclusions Typical centrifugal enhancement yielding a confident FNH diagnosis is seen significantly more frequently when the lesion is ≤3.1 cm. Key Points ? CEUS yields confident diagnoses of FNHs ≤3.1 cm ? The larger the FNH, the lower the diagnostic sensitivity of CEUS ? Final diagnosis of FNHs >3.1 cm should be obtained with MRI not CEUS |
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