PMID- 32361381
OWN - NLM
STAT- MEDLINE
DCOM- 20210107
LR  - 20210107
IS  - 1872-7727 (Electronic)
IS  - 0720-048X (Linking)
VI  - 128
DP  - 2020 Jul
TI  - Limited added value of contrast-enhanced ultrasound over B-mode for the subtyping 
      of hepatocellular adenomas.
PG  - 109027
LID - S0720-048X(20)30216-3 [pii]
LID - 10.1016/j.ejrad.2020.109027 [doi]
AB  - PURPOSE: To compare the features of hepatocellular adenoma subtypes (HCAs) in 
      B-mode and contrast-enhanced ultrasound (CEUS). METHOD: Thirty-three patients (31 
      women [94 %] and two men [6%], median age [Q1-Q3] 43.5 years old [35-51]) with 44 
      pathologically proven and subtyped HCAs (including 29 inflammatory HCAs [I-HCA] 
      and 15 HNF1-alpha inactivated HCAs [H-HCA]) who underwent CEUS were included. The 
      features of HCA on B-mode and CEUS were independently reviewed by two 
      radiologists and compared between HCA subtypes. RESULTS: I-HCAs were mostly 
      hypoechoic (23/29, 79 %) or isoechoic (4/29, 14 %) with B-mode. Twelve of them 
      (41 %) were heterogeneous. All H-HCAs except one demonstrated homogeneous 
      hyperechogenicity (93 %) (p = 0.001). Moderate or marked liver steatosis was only 
      observed in I-HCAs (12/29, 41 %) (p = 0.001). Arterial hyperenhancement was 
      observed on CEUS in 27/29 (93 %) I-HCAs and in 14/15 (93 %) H-HCAs (p=0.98). 
      Washout was present in 6/29 (21 %) I-HCAs and 1/15 (7%) H-HCAs (p=0.27). A total 
      of 23/29 (79 %) I-HCAs and 15/15 (100 %) HCAs were homogeneous on portal and 
      delayed phase acquisitions (p=0.04). The specificity for identifying an H-HCA was 
      100 % when the lesion was homogeneous and hyperechoic on B-mode, and the 
      sensibility to rule out an H-HCA was 100 % if neither of these two features was 
      present in a liver with obvious steatosis. CONCLUSIONS: Most CEUS features, 
      especially enhancement patterns, do not significantly differ between HCA 
      subtypes. When HCA is suspected on CEUS, B-mode features should be considered, 
      and a combination of lesion hyperechogenicity, homogeneity and the absence of 
      obvious liver steatosis may be useful to distinguish H-HCAs from I-HCAs.
CI  - Copyright (c) 2020 Elsevier B.V. All rights reserved.
FAU - Gregory, Jules
AU  - Gregory J
AD  - Assistance Publique - Hopitaux de Paris, Hopitaux Universitaires Paris Nord Val 
      de Seine, Hopital Beaujon, Clichy, France; Universite de Paris, Faculte de 
      Medecine, Paris, France.
FAU - Paisant, Anita
AU  - Paisant A
AD  - Assistance Publique - Hopitaux de Paris, Hopitaux Universitaires Paris Nord Val 
      de Seine, Hopital Beaujon, Clichy, France.
FAU - Paulatto, Luisa
AU  - Paulatto L
AD  - Assistance Publique - Hopitaux de Paris, Hopitaux Universitaires Paris Nord Val 
      de Seine, Hopital Beaujon, Clichy, France.
FAU - Raynaud, Lucas
AU  - Raynaud L
AD  - Assistance Publique - Hopitaux de Paris, Hopitaux Universitaires Paris Nord Val 
      de Seine, Hopital Beaujon, Clichy, France.
FAU - Bertin, Caroline
AU  - Bertin C
AD  - Assistance Publique - Hopitaux de Paris, Hopitaux Universitaires Paris Nord Val 
      de Seine, Hopital Beaujon, Clichy, France.
FAU - Kerbaol, Anne
AU  - Kerbaol A
AD  - Assistance Publique - Hopitaux de Paris, Hopitaux Universitaires Paris Nord Val 
      de Seine, Hopital Beaujon, Clichy, France.
FAU - Vullierme, Marie-Pierre
AU  - Vullierme MP
AD  - Assistance Publique - Hopitaux de Paris, Hopitaux Universitaires Paris Nord Val 
      de Seine, Hopital Beaujon, Clichy, France; Universite de Paris, Faculte de 
      Medecine, Paris, France.
FAU - Paradis, Valerie
AU  - Paradis V
AD  - Assistance Publique - Hopitaux de Paris, Hopitaux Universitaires Paris Nord Val 
      de Seine, Hopital Beaujon, Clichy, France; Universite de Paris, Faculte de 
      Medecine, Paris, France; INSERM U1149, Centre de Recherche de l'Inflammation 
      (CRI), Paris, France.
FAU - Vilgrain, Valerie
AU  - Vilgrain V
AD  - Assistance Publique - Hopitaux de Paris, Hopitaux Universitaires Paris Nord Val 
      de Seine, Hopital Beaujon, Clichy, France; Universite de Paris, Faculte de 
      Medecine, Paris, France; INSERM U1149, Centre de Recherche de l'Inflammation 
      (CRI), Paris, France.
FAU - Ronot, Maxime
AU  - Ronot M
AD  - Assistance Publique - Hopitaux de Paris, Hopitaux Universitaires Paris Nord Val 
      de Seine, Hopital Beaujon, Clichy, France; Universite de Paris, Faculte de 
      Medecine, Paris, France; INSERM U1149, Centre de Recherche de l'Inflammation 
      (CRI), Paris, France. Electronic address: maxime.ronot@aphp.fr.
LA  - eng
PT  - Journal Article
DEP - 20200425
PL  - Ireland
TA  - Eur J Radiol
JT  - European journal of radiology
JID - 8106411
RN  - 0 (Contrast Media)
SB  - IM
MH  - Adenoma, Liver Cell/*diagnostic imaging/pathology
MH  - Adult
MH  - *Contrast Media
MH  - Female
MH  - Humans
MH  - Image Enhancement/*methods
MH  - Liver Neoplasms/*diagnostic imaging/pathology
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Sensitivity and Specificity
MH  - Ultrasonography/*methods
OTO - NOTNLM
OT  - Adenoma, liver cell
OT  - Contrast media
OT  - Liver neoplasms
OT  - Ultrasonography
COIS- Declaration of Competing Interest None.
EDAT- 2020/05/04 06:00
MHDA- 2021/01/08 06:00
CRDT- 2020/05/04 06:00
PHST- 2019/12/14 00:00 [received]
PHST- 2020/03/30 00:00 [revised]
PHST- 2020/04/15 00:00 [accepted]
PHST- 2020/05/04 06:00 [pubmed]
PHST- 2021/01/08 06:00 [medline]
PHST- 2020/05/04 06:00 [entrez]
AID - S0720-048X(20)30216-3 [pii]
AID - 10.1016/j.ejrad.2020.109027 [doi]
PST - ppublish
SO  - Eur J Radiol. 2020 Jul;128:109027. doi: 10.1016/j.ejrad.2020.109027. Epub 2020 
      Apr 25.