The Value Of Contrast-Enhanced Power Doppler In The Differential Diagnosis For Focal Nodular Hyperplasia And Atypical Hepatocellular Carcinoma

Objective To explore the value of contrast-enhanced power Doppler (CEPD) in the differential diagnosis for focal nodular hyperplasia(FNH) and atypical hepatocellular carcinoma(HCC).Materials and Methods Review the images of 25 patients with FNH and 25 patients with HCC,including conventional gray-scal imaging,conventional color Doppler flow imaging(CDFI) or power Doppler imaging(PDI),images of contrast-enhanced ultrasound(CEUS) and CEPD from 2010 to 2015.A11 of the nodules were proved by the pathological findings or long-term enhanced radiology.All of the FNHs and HCCs visually exhibited hyper-or isoenhancement during the portal venous phase and late phases.Whether the spoke-wheel arteries could be observed before and after CEUS made a difference.Results Among the 25 patients with FNH,the spoke-wheel arteries could be observed in 10 with conventional CDFI or PDI before CEUS,however 18 with CEPD.Based on the spoke-wheel arteries,the accuracy of conventional CDFI or PDI and CEPD in diagnosis of FNH was 40.0% and 72.0% respectively,and the difference was statistically significant (P<0.05).Among the 25 patients with atypical HCC,no spoke-wheel arteries could be observed with CEPD,however,18 in patients with FNH;the detective rate of spoke-wheel with CEPD for diagnosing FNH and HCC was 72.0% and 0% respectively,and the difference was statistically significant (P<0.05)Conclusions CEPD will increase the diagnostic accuracy of FNH,and contribute to the differentiation of FNH from atypical HCC.