Yi Dong1,2, Wen-Ping Wang1, Feng Mao1, Mei Fan3, Andre Ignee2, Carla Serra4, Zeno Sparchez5, Ioan Sporea6, Barbara Braden7, Christoph F Dietrich2,3. 1. a Department of Ultrasound , Zhongshan Hospital, Fudan University , Shanghai , China. 2. b Med. Klinik 2, Caritas-Krankenhaus Bad Mergentheim , Bad Mergentheim , Germany. 3. c Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University , Zhengzhou, China. 4. d Diagnostic and Interventional Ultrasound Unit, Department of Organ Failure and Transplantation , S. Orsola-Malpighi Hospital , Bologna , Italy. 5. e 3rd Medical Department, Institute for Gastroenterology and Hepatology, "Iuliu Hatieganu" University of Medicine and Pharmacy , Cluj-Napoca, Romania. 6. f Department of Gastroenterology and Hepatology , University of Medicine and Pharmacy Victor Babes , Timisoara , Romania. 7. g Translational Gastroenterology Unit, Headley Way, Oxford University Hospitals NHS Foundation Trust , Oxford , UK.
Abstract
OBJECTIVE: Hepatic (biliary) cystic tumor (HBCT) is a rare focal cystic liver lesion, which has been rarely described in the literature. In our current multicenter, retrospective study, we aimed to analyze contrast enhanced ultrasound (CEUS) features and its diagnostic performance in histologically proved HBCT. MATERIAL AND METHODS: Twenty-three patients with single HBCT were retrospectively analyzed. Histologically, 17 (73.9%) were benign hepatic (biliary) cystadenoma (HBCA), 6 (26.1%) were hepatic (biliary) cystadenocarcinoma (HBCAC). All CEUS examinations were assessed by two independent radiologists in consensus. Criteria of CEUS imaging evaluation included the contrast enhancement pattern of lesion (hypoenhancing, hyperenhancing, isoenhancing in comparison to the surrounding liver parenchyma) during the arterial, portal venous and late phases. RESULTS: After injection of ultrasound contrast agents, most of the HBCTs (78.3%, 18/23) had typical honeycomb enhancement pattern of the cystic wall, septa or mural nodules. Comparing between HBCA and HBCAC, hyperenhancement of the honeycomb septa during the arterial phase was more common in HBCA (p = .047). However, hypoenhancement during the portal venous and late phases was the characteristic of HBCAC (p = .041). CONCLUSIONS: The EFSUMB algorithm for CEUS for characterization of solid focal liver lesions is also applicable to HBCT. CEUS evaluation can avoid further diagnostic investigations or invasive biopsy procedure.
OBJECTIVE: Hepatic (biliary) cystic tumor (HBCT) is a rare focal cystic liver lesion, which has been rarely described in the literature. In our current multicenter, retrospective study, we aimed to analyze contrast enhanced ultrasound (CEUS) features and its diagnostic performance in histologically proved HBCT. MATERIAL AND METHODS: Twenty-three patients with single HBCT were retrospectively analyzed. Histologically, 17 (73.9%) were benign hepatic (biliary) cystadenoma (HBCA), 6 (26.1%) were hepatic (biliary) cystadenocarcinoma (HBCAC). All CEUS examinations were assessed by two independent radiologists in consensus. Criteria of CEUS imaging evaluation included the contrast enhancement pattern of lesion (hypoenhancing, hyperenhancing, isoenhancing in comparison to the surrounding liver parenchyma) during the arterial, portal venous and late phases. RESULTS: After injection of ultrasound contrast agents, most of the HBCTs (78.3%, 18/23) had typical honeycomb enhancement pattern of the cystic wall, septa or mural nodules. Comparing between HBCA and HBCAC, hyperenhancement of the honeycomb septa during the arterial phase was more common in HBCA (p = .047). However, hypoenhancement during the portal venous and late phases was the characteristic of HBCAC (p = .041). CONCLUSIONS: The EFSUMB algorithm for CEUS for characterization of solid focal liver lesions is also applicable to HBCT. CEUS evaluation can avoid further diagnostic investigations or invasive biopsy procedure.
Authors: Christoph F Dietrich; Yi Dong; Christian Jenssen; Valentina Ciaravino; Michael Hocke; Wen-Ping Wang; Eike Burmester; Kathleen Moeller; Nathan Ss Atkinson; Paola Capelli; Mirko D'Onofrio Journal: World J Gastroenterol Date: 2017-08-14 Impact factor: 5.742