Interest of contrast-enhanced sonography to identify focal nodular hyperplasia with sinusoidal dilatation - 14/01/14
, N. Frulio a, P. Bioulac-Sage b, c, H. Laumonier a, C. Balabaud b, J.-T. Perez a, F.R. Teixeira d, N. Harbonnier e, H. Trillaud a
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Abstract |
Background and aims |
Focal nodular hyperplasia with major sinusoidal dilatation (FNH-sd) is a misleading entity, with some features resembling inflammatory hepatocellular adenoma (HCA). We aimed to assess the performance of contrast-enhanced ultrasound (CEUS) for the diagnosis of FNH-sd.
Methods |
Four histologically proven FNH-sd nodules in four patients were investigated with both MRI and CEUS imaging. Sinusoidal dilatation was focally visible in all cases in histology.
Results |
In MRI, in all the four cases, lesions were hypervascular in arterial phase, with high intensity in T2-weighted sequence imaging and persistent enhancement in the delayed gadolinium-enhanced phase. These MRI features were more indicative of HCA than FNH. On the other hand, CEUS showed a very specific centrifugal filling followed by a strong, homogeneous enhancement of the whole lesion.
Conclusion |
CEUS seems to be an essential step for the diagnosis of non-typical FNH, such as FNH-sd. This small series highlights the interest of performing both CEUS and MRI for the diagnosis of atypical focal liver lesions, such as FNH-sd.
Le texte complet de cet article est disponible en PDF.Keywords : Focal nodular hyperplasia, Sinusoidal dilatation, Inflammatory hepatocellular adenoma, Contrast-enhanced ultrasound, Glutamine synthetase
Plan
Vol 95 - N° 1
P. 77-83 - janvier 2014 Retour au numéro
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