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09-08-2023 | Ultrasound | Image–Gastroenterology

Sonazoid-enhanced ultrasound images of multiacinar cirrhotic nodules showing a “donut-like” hyperintense appearance on Gd-EOB-MRI: a case report

Authors: Ryuichi Kubota, Nobuyuki Toshikuni, Mikihiro Tsutsumi, Mutsumi Tsuchishima

Published in: Journal of Medical Ultrasonics | Issue 4/2023

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Excerpt

A 70 year-old man with alcohol-related cirrhosis was referred to our hospital for a detailed examination of approximately 20 liver nodules 7–38 mm in size, detected with gadolinium-ethoxybenzyl-diethylenetriaminepentaacetic acid-enhanced magnetic resonance imaging (Gd-EOB-MRI). All the nodules had the following findings: the nodules were depicted as hyperintense lesions in the portal venous and transitional phases. In the hepatobiliary phase, they appeared hyperintense with a central hypointense area, a so-called “donut-like” hyperintense appearance (Fig. 1a). Several of the liver nodules were detectable on unenhanced ultrasound; they were depicted as poorly demarcated, slightly hypoechoic liver nodules. Sonazoid-enhanced ultrasound (SEUS) was performed for detectable nodules. In the arterial phase, the nodules were poorly enhanced; in the portal venous phase, they were gradually enhanced from their central to peripheral portions (wheel-spoke-like spread of portal branches from the nodules’ centers to their peripheral portions); and in the Kupffer phase, the echo levels of the nodules were similar to those of the surrounding liver parenchyma (Fig. 1b). The pathological findings of an ultrasound-guided biopsy specimen were compatible with multiacinar cirrhotic nodule, a subtype of cirrhotic nodule defined by an International Working Party (Fig. 1c) [1].
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Metadata
Title
Sonazoid-enhanced ultrasound images of multiacinar cirrhotic nodules showing a “donut-like” hyperintense appearance on Gd-EOB-MRI: a case report
Authors
Ryuichi Kubota
Nobuyuki Toshikuni
Mikihiro Tsutsumi
Mutsumi Tsuchishima
Publication date
09-08-2023
Publisher
Springer Nature Singapore
Published in
Journal of Medical Ultrasonics / Issue 4/2023
Print ISSN: 1346-4523
Electronic ISSN: 1613-2254
DOI
https://doi.org/10.1007/s10396-023-01353-4

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