Evaluation on the diagnosis of hepatic hemangioma with fatty liver by contrast-enhanced ultrasound

Objective To evaluate the value of differential diagnosis of hepatic hemangioma with fatty liver by observing the echoes of the small blood vessels of hemangioma via the harmonic angiographic ultrasounography. Methods Ultrasound contrast agent SonoVue and real time contrast tuned imaging (CnTI)were used for twenty-seven lesions from twenty-five typical fatty liver patients with unconfirmed hepatic hemangioma by conventional methods of ultrasound or misdiagnosed by CT.The resuIts were compared with CT or MRI method.Results The contrast enhancement patterns were obtained at mean (17.0±4.4)s after the administration of the contrast agents.Twelve of 17 foci(diameter≤2 cm) demonstrated even or uneven integral echo enhancement with well-defined margins,which were obviouslv stronger than their surrounding fatty liver tissues or even showed so strong echoes that we called submerged image.The other 8 of 10 foci(diameter＞2.0cm)showed patchy or ring irregular enhancement from the periphery to the central lesions.One case with a diameter of 1.3cm showing atypical image by the CT method began to show a hyper echoic focal lesion at the 12th second after the injection of the uhrasound agents and lasted 6 minutes before the echo disappeared(liver parenchyma phase).However,the mean duration of contrast enhancement in the foci with the diameter of less than 2 cm was not significantlv different from that of the foci with the diameter more than 2 cm. Conclusions Contrast-enhanced ultrasound may be a better technique for the quantitative diagnosis of hepatic hemangioma accompanied with fatty liver. Key words: Ultrasonography; Microbubbles; Fatty liver; Hemangioma