Case Report: Microbubble Contrast-Enhanced Ultrasound Characteristics of Multiple Biliary Hamartomas (von Meyenberg Complexes)

Berry, Jonathan; Boxer, M E; Rashid, Hisham; Sidhu, Paul S.

doi:10.1179/174227104225019490

Cited by 10 publications

(9 citation statements)

References 14 publications

(19 reference statements)

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“…Sonographic appearances of VMC are varied, being described as multiple hypoechoic lesions,[24] hyperechoic lesions[5] and also a mixture of both hypo- and hyper-echoic lesions. [3] It has been postulated that lesional reflectivity may be dependent on the size and number of the dilated bile ducts and degree of fibrosis.…”

Section: Discussionmentioning

confidence: 99%

“…CEUS of two cases of VMC have been described. Berry et al .,[4] reported a case of multiple VMCs that did not demonstrate contrast enhancement in all phases; exclusion of hypovascular metastases was not possible. Hohmann et al .,[7] highlighted the presence of enhancement in a biliary hamartoma on CEUS with ‘washout’ in the delayed phase.…”

Section: Discussionmentioning

confidence: 99%

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Appearances of von Meyenburg Complex on Cross Sectional Imaging

Lung

Jaffer

Akbar

et al. 2013

Journal of Clinical Imaging Science

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The von Meyenburg complex (VMC) is an uncommon congenital malformation and is characterized by benign bile duct hamartomas. These are usually discovered incidentally and may represent a diagnostic dilemma when liver metastases are suspected. MRI of VMC shows distinct imaging characteristics, but reporting of lesional contrast enhancement has been inconsistent, whilst microbubble contrast enhanced ultrasound provides ‘real-time’ evaluation of soft tissue vascularity. Given the diagnostic uncertainty over imaging in VMC, biopsy is often recommended as the definitive diagnosis. We report a biopsy proven case of VMC on a background of primary colonic malignancy investigated with ultrasound, contrast enhanced ultrasound, computed tomography CT, and magnetic resonance imaging MRI, and review the key imaging features.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Appearances of von Meyenburg Complex on Cross Sectional Imaging

Lung

Jaffer

Akbar

et al. 2013

Journal of Clinical Imaging Science

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“…Multiple biliary hamartomas (von Meyenberg complexes) are an uncommon benign biliary neoplasm often detected incidentally on imaging [19]. Typically, multiple biliary hamartomas can mimic metastatic disease.…”

Section: Biliary Hamartomasmentioning

confidence: 99%

Evaluation of gallbladder and biliary duct disease using microbubble contrast-enhanced ultrasound

Meacock

Sellars²,

Sidhu³

2010

BJR

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ABSTRACT. Ultrasound examination of the gallbladder is accepted as the primary imaging modality in the assessment of gallbladder disease, with inherent superiority in comparison to other imaging modalities. Contrast-enhanced ultrasound is established as a reliable tool in the detection and characterisation of focal liver lesions. It is less well recognised in gallbladder and biliary disease but can be a valuable complement to baseline ultrasound examination. Contrast-enhanced ultrasound provides the advantages of real-time, repeatable, multiplanar imaging without compromising patient safety or exposing patients to radiation. It can provide specific information as pathology often becomes more conspicuous following the administration of contrast, allowing detailed assessment of benign and malignant conditions arising in the gallbladder and biliary tree. This review illustrates the application of contrast-enhanced ultrasound in the evaluation of a variety of gallbladder and biliary duct diseases. The examination allows clearer delineation of the disease process and more confident diagnosis.

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“…5. Few case studies exist regarding the CEUS characteristics of biliary hamartoma, and there seem to be contradictory reports regarding the portal and late venous phases [17,22,23]. The diagnostic values of CEUS in our study were calculated on a lesion by lesion basis and therefore cannot be directly transferred to a patientby-patient basis in clinical practice.…”

mentioning

confidence: 83%

“…The interpretation method of CEUS, which is often performed at the bedside, makes fast and accurate diagnoses possible, so that patients with benign FLLs can be excluded, avoiding unnecessary and demanding ionizing radiological follow-up, biopsy, and consequent complications. Previous studies have shown that CEUS may have a high diagnostic value in differentiating FLLs [7,9,10,[17][18][19]. In a recently published study, CEUS showed a high diagnostic accuracy in CTundetermined FLLs [20].…”

mentioning

confidence: 91%

Contrast Enhanced Ultrasound in CT-undetermined Focal Liver Lesions

Sandrose

Karstrup

Gerke

et al. 2017

Ultrasound International Open

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Purpose: The purpose of this study was to examine the diagnostic accuracy of CEUS in the diagnosis of focal liver lesions, which were undetermined at CT scan. Materials and Methods: From January 2010 to December 2010, patients with CT-undetermined focal liver lesions were included in this study. A total of 78 patients were evaluated: 41 men and 37 women, mean age 61.8 years; age range 30?91 years. All patients were examined with GE LOGIQ 9E ultrasound scanners with contrast-specific software, and SonoVue intravenous bolus. The standard of reference was composite consisting of: percutaneous biopsy, surgical resection, PET/CT and clinical follow-up. Results: The 78 included patients had 163 undetermined focal liver lesions, mean size 1.1?cm, range 0.1?5.3?cm. There were 18 malignant and 145 benign liver lesions, as defined by the standard of reference. In differentiating between benign vs. malignant CEUS demonstrated sensitivity, specificity, PPV, NPV and accuracy of 94.4% (95% CI: 56.3?99.5%), 99.3% (95% CI: 94.9??99.9%), 94.4% (95% CI: 56.3?99.5%), 99.3% (95% CI: 94.9?99.9%) and 98.7% (95% CI: 94.9?99.7%), respectively. If the CEUS-inconclusive results were assumed to indicate malignancy, then sensitivity, specificity, PPV, NPV and accuracy would be 95.8% (95% CI: 66.4?99.6%), 98.6% (95% CI: 94.4?99.7%), 92.0% (95CI: 65.1?98.6%), 99.3% (95% CI: 95.0?99.9%), 98.2% (95% CI: 94.4?99.5%). Conclusion: The results of this study showed a high diagnostic accuracy for CEUS in undetermined focal liver lesions found by CT. Due to a high diagnostic accuracy of CEUS in this study, it was cautiously concluded that CEUS is useful in differentiating between malignant and benign focal liver lesions in clinical practice.

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Case Report: Microbubble Contrast-Enhanced Ultrasound Characteristics of Multiple Biliary Hamartomas (von Meyenberg Complexes)

Cited by 10 publications

References 14 publications

Appearances of von Meyenburg Complex on Cross Sectional Imaging

Appearances of von Meyenburg Complex on Cross Sectional Imaging

Evaluation of gallbladder and biliary duct disease using microbubble contrast-enhanced ultrasound

Contrast Enhanced Ultrasound in CT-undetermined Focal Liver Lesions

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