Detection of focal nodular hyperplasia of the liver with color Doppler ultrasonography

Abstract

A 3-cm lesion indicative of focal nodular hyperplasia (FNH) of the liver was coincidentally detected in a 21-year-old female. Ultrasonography (US), computed tomography (CT), magnetic resonance (MR) imaging and liver scintigraphy all proved nonspecific. However, color Doppler US demonstrated characteristic vascular patterns of FNH of the liver, including (a) hypervascularity of the mass, (b) an enlarged afferent blood vessel in the tumor with blood flow toward the center of the tumor, and (c) arterial pulse waves in all the vessels in the lesion, detected by means of the fast Fourier transformation (FFT). With selective hepatic angiography, a "spoke-wheel" pattern was revealed. The angiographic pattern corresponded well to that shown by color Doppler US. On the basis of the findings from these two modalities, the diagnosis of FNH was made. This report examines the effectiveness of color Doppler US in the differential diagnosis of FNH, compared with other imaging modalities.

Hepatic focal nodular hyperplasia: findings on color Doppler ultrasound

“…In this case, the lesion was a large isoechoic lesion with a central feeding artery branching to supply three small nodules, and color Doppler failed to detect the whole lesion. In addition to pulsatile waveforms described in previous reports [11][12][13], we also detected a continuous waveform from within two lesions, which might represent a draining vein of the lesion.…”

“…Since color Doppler sonography provides information about the vascular pattern of tumors, it is a noninvasive means of obtaining information that is otherwise obtainable only with angiography [11][12][13]. We demonstrated four lesions with a characteristic central stellate vascular appearance from color Doppler sonography, which was correlated with an angiographic spoke-wheel pattern.…”

Contrast-Enhanced Ultrasound in Combination with Color Doppler Ultrasound Can Improve the Diagnostic Performance of Focal Nodular Hyperplasia and Hepatocellular Adenoma

“…Both types of lesions are hypervascular, and the spoke-wheel arterial pattern is considered to be typical sign of FNH (Yamamoto et al 1993;Yen et al 2006). Today, ultrasound contrast agent (UCA) and specific imaging software have provided a technique to visualize the vascularization of organ and lesion in real time.…”