Hemangiomas and focal nodular hyperplasia images in contrast-enhanced, wide-band phase-inversion harmonic power Doppler imaging.

Background: Contrast-enhanced, wide-band, phase inversion power Doppler sonography in the depiction of vasculature in hemangioma and focal nodular hyperplasia.

Material/methods: Fifty-one patients with liver lesions (40 FNHs,37 hemangiomas) were prospectively evaluated with conventional, color, power Doppler sonography, tissue harmonic, phase-inversion sonography and helical CT. Levovist was the standard contrast agent used and all examinations were performed on Siemens SONOLINE Elegra equipped with Ensemble Contrast Imaging (ECI) software.

Results: Color and power Doppler scans were frequently not specific for these highly vasularized lesions. Images were not suggestive in 15 out of 40 FNHs and not positive in all of 37 hemangiomas). If peripheral enhancement in form of puddle enhancement, 'bloo pools' or rimlike followed by a slow centripetal fill-in is regarded as a positive finding for hemangiomas all lesions were depicted confidently with wide-band, phase inversion, contrast enhanced power Doppler scans. Moreover, all typical vascularity features of FNHs confluence firstly the feeding artery then centrifugal spread of contrast later forming wheel like pattern was obvious in all cases of diagnosed FNHs.

Conclusions: Contrast-enhanced, wide-band, PI ,power Doppler imaging is useful method for diagnosing the vascularity of FNHs and hemangiomas. Not only it overcomes the low prediction rate which was the main obstacle for routine use of sonography but it is cheap, portable, and free also from contrast media and radiation.