Arrival time parametric imaging using Sonazoid-enhanced ultrasonography is useful for the detection of spoke-wheel patterns of focal nodular hyperplasia smaller than 3 cm

Wakui,Noritaka; Takayama,Ryuji; Kamiyama,Naohisa; Kobayashi,Kojiro; Matsui,Daigo; Matsukiyo,Yasushi; Kanekawa,Takenori; Ikehara,Takashi; Ishii,Koji; Sumino,Yasukiyo

doi:10.3892/etm.2013.1048

Arrival time parametric imaging using Sonazoid-enhanced ultrasonography is useful for the detection of spoke-wheel patterns of focal nodular hyperplasia smaller than 3 cm

Authors:
- Noritaka Wakui
- Ryuji Takayama
- Naohisa Kamiyama
- Kojiro Kobayashi
- Daigo Matsui
- Yasushi Matsukiyo
- Takenori Kanekawa
- Takashi Ikehara
- Koji Ishii
- Yasukiyo Sumino
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Affiliations: Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, Tokyo 143-8541, Japan, Ultrasound General Imaging, GE Healthcare, Tokyo 191-8503, Japan
Published online on: April 4, 2013 https://doi.org/10.3892/etm.2013.1048
Pages: 1551-1554

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Abstract

It is considered difficult to make a definitive diagnosis of focal nodular hyperplasia (FNH) of <3 cm when using conventional diagnostic imaging modalities. Typical FNH imaging findings are: i) central scar formation, ii) nutrient vessels extending radially from the center and iii) the presence of Kupffer cells. In a clinical setting, identification of a spoke-wheel pattern formed by nutrient vessels extending radially is a key feature in the diagnosis of FNH. In this study, we investigated the detection rate of spoke-wheel patterns of FNH <3 cm using arrival time parametric imaging (At-PI) technology with Sonazoid-enhanced ultrasonography (US). Five patients with FNH <3 cm who had undergone Sonazoid‑enhanced US at the Toho University Omori Medical Center between February 2008 and March 2009 were included in the study. The mean tumor diameter was 20.2±7.2 mm. Lesions were enhanced with 0.5 ml Sonazoid US contrast agent and a video of the procedure was saved and used for At-PI analysis of contrast agent dynamics in FNH. Three ultrasonographic specialists examined the images and made a diagnosis of FNH based on the findings of spoke-wheel patterns. Similarly, micro-flow imaging (MFI) was performed to evaluate the contrast agent dynamics in FNH. Using MFI, FNH was diagnosed in 3 of the 5 cases by the three specialists, whereas At-PI enabled the identification of spoke-wheel patterns in all 5 cases. At-PI using Sonazoid-enhanced US is superior for detecting spoke-wheel patterns of FNH <3 cm.

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