Affiliations: [a] Department of Radiology, Interdisciplinary Ultrasound-Center Ludwig-Maximilians-University of Munich – Grosshadern Campus, Munich, Germany
| [b] Division of Health Care Sciences, Center for Clinical Research and Management Education, Dresden International University, Dresden, Germany
| [c] Division of Health Care Sciences, Center for Clinical Research and Management Education, Dresden International University, Dresden, Germany
| [d] Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| [e] Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
Correspondence:
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Corresponding author: Dr. Med. Giovanna Negrão de Figueiredo, M.D, M.Sc., Department of Radiology, Interdisciplinary Ultrasound Center, Ludwig-Maximilians-University of Munich – Grosshadern Campus, Marchioninistr. 15, 81377 Munich, Germany. Tel.: +49 89 44007 3620; E-mail: Giovanna.Negrao_de_Figueiredo@med.uni-muenchen.de.
Note: [1] These authors contributed equally to this work.
Abstract: BACKGROUND:Focal nodular hyperplasia (FNH) is a hyperplastic mass of vascular abnormality and the second most common benign liver lesion. It can be discovered incidentally or during a surveillance examination in patients at risk for hepatic malignancy, mostly by conventional ultrasound. CEUS has been used as an additional alternative method for the rapid diagnosis of FNH. However, none of the previous studies compared the diagnostic performance of CEUS to MRI retrospectively in a 10-year observation. OBJECTIVE:The aim of this long-term retrospective study is to assess the diagnostic performance of CEUS in the imaging of FNH and compare the results to MRI. MATERIAL AND METHODS:A single experienced physician performed CEUS examinations in 244 patients between 2009 and 2019 with suspected focal nodular hyperplasia after conventional ultrasound. A second-generation blood pool agent (SonoVue®, Bracco, Milan, Italy) was administered. Additional dynamic MRI with contrast agent was performed in a subgroup of 95 patients. RESULTS:Out of 244 patients, FNH could be displayed in 221 patients on CEUS. A subgroup of 95 patients had CEUS examinations and CEMRI for diagnosis comparison. In comparison with CEMRI, CEUS presented a sensitivity of 97%, a specificity of 76%, a positive predictive value of 93% and a negative predictive value of 89%. CONCLUSION:CEUS is a safe and feasible approach that assess the diagnosis of focal nodular hyperplasia equally to MRI. The focal lesion enhancement can be depicted in real-time in the arterial, venous and late phase facilitating the prompt diagnosis.
Keywords: CEUS, focal nodular hyperplasia, MRI, long-term study
