Characterization of Hepatic Tumors: Value of Contrast-Enhanced Coded Phase-Inversion Harmonic Angio
Yan Ling Wen1,2,
Masatoshi Kudo1,
Rong Qin Zheng1,3,
Hong Ding1,4,
Pei Zhou1,5,
Yasunori Minami1,
Hobyung Chung1,
Masayuki Kitano1,
Toshihiko Kawasaki1 and
Kiyoshi Maekawa6
1 Department of Gastroenterology and Hepatology, Kinki University School of
Medicine, 377-2, Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan.
2 Present address: Department of Ultrasound, The Second Affiliated Hospital, Sun
Yat-sen University, 107 Yanjiangxi Rd., Guangzhou 510120, China.
3 Present address: Department of Ultrasound, The Third Affiliated Hospital, Sun
Yat-sen University, Shipai, Guangzhou 510630, China.
4 Present address: Department of Ultrasound, Zhongshan Hospital, Shanghai,
China.
5 Present address: Department of Ultrasound, Wuhan General Hospital of Guangzhou
Military Area, Wuhan 430070, China.
6 Abdominal Ultrasound Unit, Kinki University School of Medicine, Osaka-Sayama,
Osaka 589-8511, Japan.
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Fig. 1. —Diagram shows appearance of intranodular hemodynamic patterns
on contrast-enhanced coded harmonic angio images. Tumor is shown as circle
within liver. Tumor vessel is shown as linear or kinking lines in scheme on
real-time scan. Enhancement of nontumoral tissue is shown in light shading,
whereas highly contrast-enhanced tumor is shown in dense shading and
unenhanced tumor is shown as blank space in scheme in interval-delay and sweep
scan. Enhanced vessels, or area in interval-delay scan, are shown as denser
shading than surrounding tumoral tissue.
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Fig. 2A. —Hepatocellular carcinoma in 73-year-old woman. On
contrast-enhanced coded harmonic angio image, intratumoral blood vessels are
shown from periphery infiltrating center of hypoechoic tumor
(arrow).
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Fig. 2B. —Hepatocellular carcinoma in 73-year-old woman. interval-delay
image of contrast-enhanced coded harmonic angio shows tumor parenchymal
staining as heterogeneously hyperechoic on gray-scale background in late
vascular phase (arrow).
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Fig. 2C. —Hepatocellular carcinoma in 73-year-old woman. Tumor is shown
as high-intensity mass (arrow) on T2-weighted MR image.
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Fig. 3A. —Metastasis in 72-year-old man. On contrast-enhanced coded
harmonic angio image, linear tumor vessels are shown in peripheral area
(arrows).
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Fig. 3B. —Metastasis in 72-year-old man. On contrast-enhanced coded
harmonic angio image, rim enhancement is shown between enhanced surrounding
liver parenchyma and unenhanced portion of tumor (arrows).
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Fig. 4A. —Hemangioma in hepatic segment VIII in 43-year-old man.
Contrast-enhanced coded harmonic angio image shows peripheral spotty pooling
pattern (arrowhead) within lesion (arrows) in early arterial
phase.
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Fig. 4B. —Hemangioma in hepatic segment VIII in 43-year-old man.
Interval-delay fast low-angle shot image (10 sec) in late vascular phase shows
typical globular tumor parenchymal staining (arrows) on
contrast-enhanced coded harmonic angio.
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Fig. 4C. —Hemangioma in hepatic segment VIII in 43-year-old man.
T1-weighted MR image shows lesion as low intensity.
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Fig. 4D. —Hemangioma in hepatic segment VIII in 43-year-old man.
T2-weighted MR image shows lesion as high intensity, which confirms diagnosis
of hemangioma.
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Fig. 5A. —Dysplastic nodule in hepatic segment V in 65-year-old man.
Contrast-enhanced coded harmonic angio image shows no blood signal within
hypoechoic nodule (arrows) in early arterial phase.
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Fig. 5B. —Dysplastic nodule in hepatic segment V in 65-year-old man.
Vessellike blood signals (arrowhead) are shown within nodule
(arrows) on real-time scanning of contrast-enhanced coded harmonic
angio image in late vascular phase.
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Fig. 5C. —Dysplastic nodule in hepatic segment V in 65-year-old man.
Hyper- to isoechoic tumor parenchymal staining (arrows) is shown
using interval-delay scanning on contrast-enhanced coded harmonic angio in
late vascular phase.
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Fig. 5D. —Dysplastic nodule in hepatic segment V in 65-year-old man.
Iso- to hypoattenuation nodule (arrow) is shown on arterial phase
dynamic CT scan.
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Fig. 5E. —Dysplastic nodule in hepatic segment V in 65-year-old man.
Iso- to hypoattenuation of nodule (arrow) is shown on portal phase
dynamic CT scan.
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Fig. 6A. —Focal nodular hyperplasia in 37-year-old woman. Central
arterial supply with centrifugal radiation, consisting of spoke-wheel
appearance, is shown within hyperechoic lesion (arrows) on
contrast-enhanced coded harmonic angio image in early arterial phase.
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Fig. 6B. —Focal nodular hyperplasia in 37-year-old woman.
Contrast-enhanced coded harmonic angio image by interval-delay scanning shows
dense tumor parenchymal staining within nodule in late vascular phase
(arrows).
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Fig. 6C. —Focal nodular hyperplasia in 37-year-old woman. Spoke-wheel
pattern of blood vessels, typical for focal nodular hyperplasia, is shown on
digital subtraction angiogram.
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Copyright © 2004 by the American Roentgen Ray Society.
