The study on hepatic epithelioid hemangioendothelioma by contrast-enhanced ultrasound

Abstract

Objective To investigate the value of contrast enhanced ultrasonography(CEUS) in the diagnosis of hepatic epithelioid hemangioendothelioma(HEHE). Methods The images of CEUS had been retrospectively evaluated in 21 lesions of HEHE which were confirmed by pathology. The perfusion patterns and time of enhancement were observed,including time to begin enhancement,time to peak enhancement,the washout time and the appearance of internal structures. Results The mean time of begin enhancement,time to peak,time to isoechogenity and hypoechogenity were (17.4±5.2)s,(22.0±7.2) s,(23.9±4.6)s and (42.2±13.7)s,respectively. During the arterial phase,8 lesions showed diffuse enhancement,7 lesions showed rim-like enhancement and 6 lesions showed branch enhancement. The inner margin in 6 lesions showed speculate enhancement. The central portion of the tumors was not enhanced in part lesions of 8 cases. As to time of peak enhancement,compared to the normal hepatic parenchyma,hypoenhancement,isoenhancement and hyperenhancement were observed in 10 lesions,6 lesions and 5 lesions respectively. Synchronous enhancement was observed in 11 lesions on CEUS,rapid enhancement was observed in 8 lesions and slow enhancement was observed in 2 lesions. Twenty-one lesions manifested hypoechoic mass in portal phase and delayed phase. The boundary of lesions was unclear on conventional ultrasound and became distinct after contrast injection in 21 lesions. Conclusions CEUS is useful for the diagnosis of HEHE. Key words: Contrast-enhanced ultrasound; Liver neoplasms; Hemangioendothelioma,epithelioid