Ultrasound findings in peliosis hepatis
Yi Dong1 , Wen-Ping Wang2 , Adrian Lim3 , Won Jae Lee4 , Dirk-Andre Clevert5 , Michael Höpfner7 , Andrea Tannapfel6 , Christoph F. Dietrich1
1Kliniken Hirslanden Bern, Bern, Switzerland
2Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
3Department of Imaging, Imperial College London and Healthcare NHS Trust, Charing Cross Hospital Campus, London, United Kingdom
4Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Health Science and Technology and Medical Device Management and Research, Samsung Advanced Institute for Health Scien
5Interdisciplinary Ultrasound-Center, Department of Radiology, University of Munich-Grosshadern Campus, Munich, Germany
6Institut für Pathologie, Ruhr-Universität, Bochum, Germany
7Department Gastroenterologie, Klinik für Innere Medizin; Agaplesion Diakonie Kliniken Kassel, Kassel, Germany
Corresponding Author: Christoph F. Dietrich ,Tel: +41313353333, Fax: 41313353333, Email: c.f.dietrich@googlemail.com
Received: October 10, 2020;  Accepted: February 22, 2021.  Published online: February 22, 2021.
ABSTRACT
Purpose:
To retrospectively evaluate the contrast enhanced ultrasound (CEUS) findings in patients with peliosis hepatis (PH). Patients &
Methods:
Retrospective analysis of CEUS features in 24 patients with histopathological confirmed PH (male 11, female 13, mean age, 32.4 ± 7.1 years; range 28 - 41 years) was performed. All lesions were histologically proven, either by core needle biopsy (n = 10) or by hepatic surgery (n = 14).
Results:
The mean size was 36. 8 ± 12.4 mm (10 - 80 mm). On B-Mode US (BMUS), all PH were heterogeneous hypoechoic with well-defined margins but irregular shapes. No mass effect was observed. During the arterial phase of CEUS, all lesions displayed mild heterogeneously hyperenhancement (83.3 %, 20/24) or isoenhancement (16.7 %, 4/24). 87.5 % PH lesions showed mild washout after 1 min in the portal venous phase (30 – 120 sec) and mild washout in the late phase (> 120 sec).
Conclusions:
The lack of mass effect on BMUS, mild heterogeneous arterial hyperenhancement and washout in the very late portal venous phase (after 1 min) are characteristic of PH. Although a histological diagnosis, PH should be considered in the differential diagnosis when the clinical settings do not favor a malignancy or infection.
Keywords: Focal peliosis hepatis; Contrast-enhanced ultrasound; Focal liver lesions
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