Contrast-Enhanced Ultrasound Findings and Differential Diagnosis of Hepatic Epithelioid Angiomyolipoma Compared with Hepatocellular Carcinoma

Huang, Zhewei; Wu, Xiaobei; S, Li; Li, Kaiyan

doi:10.1016/j.ultrasmedbio.2020.02.001

Cited by 6 publications

(7 citation statements)

References 19 publications

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“…HEAML mainly presents with hypoechoic nodules on gray-scale ultrasonography similar to HCC; this is consistent with our previous research [ 6 ]. The hyperechoic zone surrounding the HEAML lesion on gray-scale ultrasonography in this case may be a manifestation of the fibrosis of the liver parenchyma caused by long-term compression by the tumor.…”

Section: Discussionsupporting

confidence: 92%

“…CEUS of HEAML showed rapid wash-out that is consistent with the performance of enhanced CT. Tumor cells have reduced interstitium, a rich vascular network, relatively thin tube walls, and increased blood flow, resulting in faster diffusion of the contrast agent, while the portal venous phase and late vascular phase are relatively lower than the liver parenchymal signal. The case study also used quantitative analysis software to assess the utility of Sonazoid in imaging HEAML and found that its performance was consistent with that of SonoVue in our previous study on HEAML [ 6 ]. The majority of the clinical evidence for the diagnosis of focal liver lesions with CEUS was obtained with SonoVue, while little is known about Sonazoid.…”

Section: Discussionmentioning

confidence: 64%

“…Contrast-enhanced ultrasonography (CEUS) performed using a blood-pool contrast agent has demonstrated high sensitivity and specificity for characterizing focal liver lesions [ 5 ]. Sonazoid® (Daiichi-Sankyo, Tokyo, Japan; GE Healthcare, Milwaukee, WI, USA), a new contrast agent that permits hepatic parenchyma-specific Kupffer phase imaging on CEUS, leads to the observation of a persistent enhancement during the postvascular phase (Kupffer phase) for > 10 min after injection [ 6 ]. It is very useful for the detection and characterization of focal liver lesions and is now available in Japan, South Korea, Norway, and Taiwan [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound contrast agent Sonazoid for the diagnosis of hepatic epithelioid angiomyolipoma: a case report

Huang

Xin

2021

BMC Gastroenterol

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Background An angiomyolipoma usually occurs in the kidneys and rarely in the liver. Hepatic epithelioid angiomyolipoma (HEAML), a rare variant of angiomyolipoma, possesses malignant potential and mimics the imaging features of hepatocellular carcinoma. Sonazoid® (perfluorobutane microbubbles), a new contrast agent that facilitates hepatic parenchyma-specific Kupffer phase imaging on contrast-enhanced ultrasonography (CEUS), is useful for the detection and characterization of focal liver lesions. Case presentation A 30-year-old man with HEAML underwent CEUS using Sonazoid®, in which new concepts for ultrasonography-based differentiation between HEAML and hepatocellular carcinoma were applied. Conclusions This case report provides clinicians and radiologists with a reference for distinguishing HEAML from hepatocellular carcinoma based on CEUS using Sonazoid®.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 99%

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Ultrasound contrast agent Sonazoid for the diagnosis of hepatic epithelioid angiomyolipoma: a case report

Huang

Xin

2021

BMC Gastroenterol

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“…Nine patients (75%) were asymptomatic, and HBV infection was identified in three patients. All tumours were solitary and presented regularly in morphology (quasi‐circular or oval), which is consistent with previous studies 17,18 . The tumours were located in the left and right lobe in six cases, respectively, and their maximum diameter was 2.3–16 cm.…”

Section: Discussionsupporting

confidence: 90%

“…All tumours were solitary and presented regularly in morphology (quasi-circular or oval), which is consistent with previous studies. 17,18 The tumours were located in the left and right lobe in six cases, respectively, and their maximum diameter was 2.3-16 cm. The variable imaging appearances of HEAML are associated with various proportions of the intratumoral tissue components.…”

Section: Discussionmentioning

confidence: 99%

Primary hepatic epithelioid angiomyolipoma: a small case series

Zhu

Wang

Sun

et al. 2022

ANZ Journal of Surgery

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Background Hepatic epithelioid angiomyolipomas (HEAMLs) are rare and usually arise in case reports, and thus, we aimed to study the clinicopathological features, treatment and prognosis of these lesions. Methods We identified patients from institutional database with HEAMLs and retrospectively collected clinical data. Results Of 12 patients, 10 were females, and the median age was 49 years. A liver mass was found on chance upon routine health screening in nine patients. Imaging features included clear border (9/12), internal heterogeneity (8/12), arterial enhancement (12/12), fat (5/12), intra‐tumour vessel (3/12), draining hepatic vein (2/12) and pseudocapsule (1/12). The preoperative diagnoses contained HEAML (n = 5), hepatocellular carcinoma (n = 6), and hepatic cystadenocarcinoma (n = 1). All cases had received surgery and obtained a negative margin. All specimens showed positive findings for HMB‐45 and Melan A. No tumour recurrence or mortality was described with a mean follow‐up time of 23.5 months. Conclusions HEAML is a low potential malignancy tumour that frequently appears in middle‐aged females. It has nonspecific symptoms and may present special imaging features including intra‐tumour vessel, early draining hepatic vein and lack of a pseudo capsule. The lesion is confirmed by pathological and immunohistochemical findings. Surgery and subsequent long‐term follow‐up are the most appropriate management approaches.

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