PMID- 30306412 OWN - NLM STAT- MEDLINE DCOM- 20191217 LR - 20200601 IS - 1876-7931 (Electronic) IS - 1971-3495 (Print) IS - 1876-7931 (Linking) VI - 22 IP - 2 DP - 2019 Jun TI - Contrast-enhanced ultrasound patterns of hepatocellular adenoma: an Italian multicenter experience. PG - 157-165 LID - 10.1007/s40477-018-0322-5 [doi] AB - PURPOSE: Hepatocellular adenoma (HCA) is a rare benign monoclonal neoplasm, recently categorized on genetic and histopathological basis into four subtypes with different biological behaviors. Since contrast-enhanced ultrasonography (CEUS) is nowadays a well-established technique for liver nodule characterization, the aim of our study was to assess CEUS features of HCAs to identify criteria that correlate with different HCA subtypes as compared to histopathologic examination and other imaging modalities. METHODS: We retrospectively analyzed data of patients with histology-proven HCA who underwent CEUS, computed tomography or magnetic resonance imaging (MRI) in seven different Italian ultrasound units. RESULTS: The study enrolled 19 patients (16 females; 69% with concomitant/prior use of oral contraceptives): the mean size of all HCAs was 4.2 cm (range 1.6-7.1 cm); 14/19 had inflammatory HCAs (I-HCA), 1/19 beta-catenin-activated HCA, and the others unclassified HCAs. On CEUS, during the arterial phase, all but one HCA displayed a rapid enhancement, with 89% of these showing centripetal and 11% centrifugal filling pattern, whereas during the portal and late venous phase 58% of HCA showed washout and the remaining 42% displayed persistent enhancement. In particular, among I-HCAs 7/14 showed no washout, 3/14 and 4/14 showed washout in the portal or late phase, respectively. CONCLUSIONS: This dataset represents one of the few published experiences on HCAs and CEUS in Italy and shows that HCAs are hypervascularized in the arterial phase usually with a centripetal flow pattern and have a heterogeneous behavior in portal and late phase. In particular, occurrence of delayed washout on CEUS but not on MRI is frequently observed in the subtype of I-HCA. FAU - Garcovich, Matteo AU - Garcovich M AUID- ORCID: 0000-0002-5805-7953 AD - Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Sacred Heart, Largo A. Gemelli 8, 00168, Rome, Italy. matteogarcovich@gmail.com. FAU - Faccia, Mariella AU - Faccia M AD - Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Sacred Heart, Largo A. Gemelli 8, 00168, Rome, Italy. FAU - Meloni, Franca AU - Meloni F AD - Department of Interventional Ultrasound, Casa di Cura Igea, Milan, Italy. AD - Department of Radiology, University of Wisconsin-Madison, Madison, USA. FAU - Bertolini, Emanuela AU - Bertolini E AD - Department of Internal Medicine, Hepatology and Gastroenterology, San Paolo Hospital, Universita degli Studi di Milano, Milan, Italy. FAU - de Sio, Ilario AU - de Sio I AD - Hepatogastroenterology Unit, Universita degli Studi della Campania Luigi Vanvitelli, Naples, Italy. FAU - Calabria, Giosuele AU - Calabria G AD - IX Interventional Ultrasound Unit for Infectious Diseases, AORN dei Colli, Cotugno Hospital, Naples, Italy. FAU - Francica, Giampiero AU - Francica G AD - Interventional Ultrasound Unit, Pineta Grande Hospital, Castel Volturno, Italy. FAU - Vidili, Gianpaolo AU - Vidili G AD - Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy. FAU - Riccardi, Laura AU - Riccardi L AD - Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Sacred Heart, Largo A. Gemelli 8, 00168, Rome, Italy. FAU - Zocco, Maria Assunta AU - Zocco MA AD - Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Sacred Heart, Largo A. Gemelli 8, 00168, Rome, Italy. FAU - Ainora, Maria Elena AU - Ainora ME AD - Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Sacred Heart, Largo A. Gemelli 8, 00168, Rome, Italy. FAU - Ponziani, Francesca Romana AU - Ponziani FR AD - Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Sacred Heart, Largo A. Gemelli 8, 00168, Rome, Italy. FAU - De Gaetano, Anna Maria AU - De Gaetano AM AD - Department of Radiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Sacred Heart, Rome, Italy. FAU - Gasbarrini, Antonio AU - Gasbarrini A AD - Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Sacred Heart, Largo A. Gemelli 8, 00168, Rome, Italy. FAU - Rapaccini, Gian Ludovico AU - Rapaccini GL AD - Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Sacred Heart, Largo A. Gemelli 8, 00168, Rome, Italy. FAU - Pompili, Maurizio AU - Pompili M AD - Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Sacred Heart, Largo A. Gemelli 8, 00168, Rome, Italy. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20181010 PL - Italy TA - J Ultrasound JT - Journal of ultrasound JID - 101315005 RN - 0 (Contraceptives, Oral) RN - 0 (Contrast Media) SB - IM MH - Adenoma, Liver Cell/complications/*diagnostic imaging/epidemiology/pathology MH - Adult MH - Contraceptives, Oral/adverse effects MH - *Contrast Media MH - Female MH - Humans MH - Italy MH - Liver/diagnostic imaging/pathology MH - Liver Neoplasms/complications/*diagnostic imaging/epidemiology/pathology MH - Magnetic Resonance Imaging MH - Male MH - Middle Aged MH - Non-alcoholic Fatty Liver Disease/complications/epidemiology MH - Overweight/complications/epidemiology MH - Retrospective Studies MH - Tomography, X-Ray Computed MH - *Ultrasonography PMC - PMC6531526 OTO - NOTNLM OT - Benign liver lesion OT - Contrast-enhanced ultrasound OT - Hepatocellular adenoma OT - Magnetic resonance imaging OT - Phenotype classification COIS- All authors declare no conflict of interest. EDAT- 2018/10/12 06:00 MHDA- 2019/12/18 06:00 PMCR- 2020/06/01 CRDT- 2018/10/12 06:00 PHST- 2018/07/01 00:00 [received] PHST- 2018/09/14 00:00 [accepted] PHST- 2018/10/12 06:00 [pubmed] PHST- 2019/12/18 06:00 [medline] PHST- 2018/10/12 06:00 [entrez] PHST- 2020/06/01 00:00 [pmc-release] AID - 10.1007/s40477-018-0322-5 [pii] AID - 322 [pii] AID - 10.1007/s40477-018-0322-5 [doi] PST - ppublish SO - J Ultrasound. 2019 Jun;22(2):157-165. doi: 10.1007/s40477-018-0322-5. Epub 2018 Oct 10.