Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1 (5-Year IF – 2.0)
Journal Citation Indicator (JCI) (2023) – 0.4
Scopus CiteScore – 3.7 (CiteScore Tracker 3.8)
Index Copernicus  – 171.00; MNiSW – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2020, vol. 29, nr 9, September, p. 1073–1081

doi: 10.17219/acem/110315

Publication type: original article

Language: English

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

The dynamic enhanced characterization with low mechanical index gray-scale harmonic imaging inflammatory pseudotumor of liver compared with hepatic VX2 tumor and normal liver

Ying Shi1,A,B,C,D,E,F, Xinghua Wang1,A,E, Yingyan Qiao1,B,C, Xueping Bai1,B,C, Qinxiu Wang1,B, Chenggong Lei1,C

1 Department of Ultrasound, Second Hospital of Shanxi Medical University, Taiyuan, China

Abstract

Background. Inflammatory pseudotumor of the liver (IPTL) is misdiagnosed usually as a malignant tumor based on the imaging findings. Differential diagnosis should be established to avoid hepatic resection. At imaging, IPTL has been misdiagnosed usually as hepatocellular carcinoma (HCC). It is usually found firstly using conventional ultrasonic examination, which cannot give a definitive diagnosis. Because of its atypical clinical presentation and radiological appearance, a presumptive diagnosis of malignancy is frequently made. With the development of ultrasound systems and ultrasound contrast agents (UCA), contrast-enhanced ultrasound is widely used in diagnosing focal lesions of the liver.
Objectives. To delineate the hemodynamic features of IPTL compared with hepatic VX2 tumor and normal liver using contrast-enhanced ultrasound.
Material and Methods. Freund’s complete adjuvant (FCA) was injected using a modified method into the desirable portion of the liver in rabbits. Two weeks after the injection, solitary IPTLs were formed (which was proved with pathological examination). Ten rabbits with IPTL, 10 rabbits with VX2 carcinoma and 10 healthy rabbits were studied using contrast-enhanced ultrasound with bolus injection of SonoVueTM through the peripheral vein. Corresponding parameters such as time to enhancement (ET), time to peak intensity (PIT), time to ascent (AT), and time to lighten (LT) were measured with wash-in/wash-out curve.
Results. Contrast-enhanced imaging clearly delineated the dynamic enhancement of the lesions and liver parenchyma during the whole phase. Inflammatory pseudotumor of the liver showed the same enhanced features as the liver parenchyma. In VX2 tumors, hyperechoic enhancement in arterial phase and hypoechoic enhancement was observed in the portal and delayed phase compared with the surrounding hepatic parenchyma. The normal liver showed whole of liver parenchyma enhanced in portal phase.
Conclusion. The study showed that contrast-enhanced ultrasound provided useful information about perfusion in IPTL and VX2 carcinoma. Contrast-enhanced ultrasound is a useful technique in the differential diagnosis of focal liver lesions if combined with time-intensity curve.

Key words

liver, ultrasonography, inflammatory pseudotumor, contrast agent, ultrasonic diagnosis

References (28)

  1. Pack GT, Baker HW. Total right hepatic lobectomy: Report of a case. Ann Surg. 1953;138(2):253–258.
  2. Nitta T, Kataoka J, Inoue Y, et al. A case of multiple inflammatory hepatic pseudotumor protruding from the liver surface after colonic cancer. Int J Surg Case Rep. 2017;37:261–264.
  3. Al-Jabri T, Sanjay P, Shaikh I, Woodward A. Inflammatory myofibroblastic pseudotumor of the liver in association with gall stones: A rare case report and brief review. Diagn Pathol. 2010;5:53.
  4. Yafei Z, Hongwei L, Hong J, Yiming L. Inflammatory pseudotumor of the liver: A case report and literature review. Intractable Rare Dis Res. 2015;4(3):155–158.
  5. Fukuya T, Honda H, Matsumata T, et al. Diagnosis of inflammatory pseudotumor of the liver: Value of CT. AJR Am J Roentgenol. 1994;163(5):1087–1091.
  6. Honmyoa N, Kobayashia T, Tashiroa H, et al. Inflammatory pseudotumor of the liver occurring during the course of hepatitis C virus-related hepatocellular carcinoma treatment: A case report. Int J Surg Case Rep. 2016;20:96–100.
  7. Gesualdo A, Tamburrano R, Gentile A, Giannini A, Palasciano G, Palmieri VO. A diagnosis of inflammatory pseudotumor of the liver by contrast-enhaced ultrasound and fine-needle biopsy: A case report. Eur J Case Rep Intern Med. 2017;4(2):000495.
  8. Kawaguchi T, Mochizuki K, Kizu T, et al. Inflammatory pseudotumor of the liver and spleen diagnosed by percutaneous needle biopsy. World J Gastroenterol. 2012;18(1):90–95.
  9. Yamaguchi J, Sakamoto Y, Sano T, Shimada K, Kosuge T. Spontaneous regression of inflammatory pseudotumor of the liver: Report of three cases. Surg Today. 2007;37(6):525–529.
  10. Matsuo Y, Sato M, Shibata T, et al. Inflammatory pseudotumor of the liver diagnosed as metastatic liver tumor in a patient with a gastrointestinal stromal tumor of the rectum: Report of a case. World J Surg Oncol. 2014;12:140.
  11. Leoni S, Serio I, Pecorelli A, Marinelli S, Bolondi L. Contrast-enhanced ultrasound in liver cancer. Hepatic Oncol. 2015;2(1):51–62.
  12. Durot I, Wilson SR, Willmann JK. Contrast-enhanced ultrasound of malignant liver lesions. Abdom Radiol (NY). 2018;43(4):819–847.
  13. Derchi LE, Martinoli C, Pretolesi F, Crespi G, Buccicardi D. Quantitative analysis of contrast enhancement. Eur Radiol. 1999;9(Suppl 3):S372–376.
  14. Marret H, Sauget S, Giraudeau B, et al. Contrast-enhanced sonography helps in discrimination of benign from malignant adnexal masses. J Ultrasound Med. 2004;23(12):1629–1639.
  15. Kljucevsek D, Vidmar D, Urlep D, Dezman R. Dynamic contrast-enhanced ultrasound of the bowel wall with quantitative assessment of Crohn’s disease activity in childhood. Radiol Oncol. 2016:50(4):347–354.
  16. Li J, Dong BW, Yu XL, Li C. Ultrasonographic portography with low mechanical index gray-scale imaging in hepatic VX2 tumor. Ultrasound Med Biol. 2006;32(5):641–647.
  17. Yang W, Mou S, Xu Y, Du J. Contrast-enhanced ultrasonography for assessment of tubular atrophy/interstitial fibrosis in immunoglobulin A nephropathy: A preliminary clinical study. Abdom Radiol (NY). 2018;43(6):1423–1431.
  18. Xu YK, Liu XY, Zhang JN, et al. Experiment study of intravenous hepatosplenography with a new iodized oily emulsion for detection of small liver foci: Preliminary results. MMI Bimonthly. 1998;7:272–273.
  19. Caramella T, Novellas S, Fournol M, et al. Imaging of inflammatory pseudotumors of the liver [in French]. J Radiol. 2007;88(6):882–888.
  20. Lee J, Jeong WK, Lim HK, Kim AY. Focal nodular hyperplasia of the liver: Contrast‐enhanced ultrasonographic features with sonazoid. J Ultrasound Med. 2018;37(6):1473–1480.
  21. Soye JA, Mullan CP, Porter S, Beattie H, Barltrop AH, Nelson WM. The use of contrast-enhanced ultrasound in the characterisation of focal liver lesions. Ulster Med J. 2007;76(1):22–25.
  22. Bagley JE, Paul DE, Halferty S, DiGiacinto D. The use of contrast‐enhan­ced ultrasonography for the characterisation of focal liver lesions. Sonography. 2018;5(3):120–134.
  23. Vjjanic GM, Milovanovic D, Aleksandrovic S. Aggressive inflammatory pseudotumor of the abdomen 9 years after therapy for Wilms tumor: A complication, coincidence, or association. Cancer. 1992;70(9):2362–2366.
  24. Toda K, Yasuda I, Nishigaki Y, et al. Inflammatory pseudotumor of the liver with primary sclerosing cholangitis. J Gastoenterol. 2000;35(4): 304–309.
  25. Milias K, Madhavan KK, Bellamy C, Garden OJ, Parks RW. Inflammatory pseudotumors of the liver: Experience of a specialist surgical unit. J Gastroenterol Hepatol. 2009;24(9):1562–1566.
  26. Oto T, Akata D, Besim A. Peritoneal inflammatory myofibroblastic pseudotumor metastatic to the liver: CT findings. Eur Radiol. 2000;10(9):1501.
  27. Mastuda H, Sugimachi K, Kuwano H, Mori M. Hyperthermia, tissue microcirculation, and temporarily increased thermosensitivity in VX2 carcinoma in rabbit liver. Cancer Res. 1989;49(10):2777–2782.
  28. Wang Y, Yu XL, Cheng ZG. Contrast-enhanced ultrasonographic features of inflammatory pseudotumor of the liver. Chin J Med Ultrasound. 2006;3:31–33.
© Wroclaw Medical University