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A case of sclerosing angiomatoid nodular transformation of the spleen: correlations between contrast-enhanced ultrasonography and histopathologic findings.

Watanabe M, Shiozawa K, Ikehara T, Kanayama M, Kikuchi Y, Ishii K, Okubo Y, Shibuya K, Sumino Y - J Clin Ultrasound (2013)

Bottom Line: Detection of SANT as an incidentaloma has increased due to improvements in imaging techniques.However, a definitive diagnosis of SANT on CT or MRI remains difficult.We report the use of contrast-enhanced ultrasonography with Sonazoid in a case of SANT in a 50-year-old woman, with gross and microscopic pathologic correlations.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital, 6-11-1, Omorinishi, Ota-ku, Tokyo, 143-8541, Japan.

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Contrast-enhanced ultrasound examination. (A) In the early vascular phase, a spoke-wheel-like enhancement extending radially from the center of the mass appeared at 12 seconds after administration of the contrast agent. (B) A densely enhanced portion then spread through the tumor. (C) Almost the whole tumor was enhanced after 23 seconds (D). In the postvascular phase, 15 minutes after injection, there is residual pooling of contrast agent in the periphery of the mass (E). The contrast-enhanced image is obtained after high acoustic pressure; insonation confirms the pooling of the contrast agent at the periphery of the mass.
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fig02: Contrast-enhanced ultrasound examination. (A) In the early vascular phase, a spoke-wheel-like enhancement extending radially from the center of the mass appeared at 12 seconds after administration of the contrast agent. (B) A densely enhanced portion then spread through the tumor. (C) Almost the whole tumor was enhanced after 23 seconds (D). In the postvascular phase, 15 minutes after injection, there is residual pooling of contrast agent in the periphery of the mass (E). The contrast-enhanced image is obtained after high acoustic pressure; insonation confirms the pooling of the contrast agent at the periphery of the mass.

Mentions: CEUS was performed using an SSA-790A system (Toshiba Medical Systems, Tokyo, Japan) with a convex probe (PVT-375BT, 3.75-MHz center frequency). Sonazoid (Daiichi-Sankyo, Tokyo, Japan) was injected as a bolus through the median cubital vein at 0.5 ml/body followed by a 10-ml normal saline flush, and the mass was observed by placing the focus at the lower margin of the mass and setting the mechanical index level to 0.2. In the early vascular phase, a spoke-wheel-like enhancement extending radially from the center of the mass appeared at 12 seconds after administration of the contrast agent, and almost complete enhancement, which was weaker than the contrast enhancement in the splenic parenchyma, was observed after 23 seconds (Figure 2A–2C). Fifteen minutes after contrast administration in the postvascular phase (so-called Kupffer phase), enhancement persisted in the periphery of the mass (Figure 2D). To examine the distribution of Sonazoid bubbles accumulated in splenic reticuloendothelial cells, the center of the mass was insonated at high acoustic pressure (flash method),6 confirming the pooling of the contrast agent in the periphery of the mass (Figure 2E).


A case of sclerosing angiomatoid nodular transformation of the spleen: correlations between contrast-enhanced ultrasonography and histopathologic findings.

Watanabe M, Shiozawa K, Ikehara T, Kanayama M, Kikuchi Y, Ishii K, Okubo Y, Shibuya K, Sumino Y - J Clin Ultrasound (2013)

Contrast-enhanced ultrasound examination. (A) In the early vascular phase, a spoke-wheel-like enhancement extending radially from the center of the mass appeared at 12 seconds after administration of the contrast agent. (B) A densely enhanced portion then spread through the tumor. (C) Almost the whole tumor was enhanced after 23 seconds (D). In the postvascular phase, 15 minutes after injection, there is residual pooling of contrast agent in the periphery of the mass (E). The contrast-enhanced image is obtained after high acoustic pressure; insonation confirms the pooling of the contrast agent at the periphery of the mass.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4285946&req=5

fig02: Contrast-enhanced ultrasound examination. (A) In the early vascular phase, a spoke-wheel-like enhancement extending radially from the center of the mass appeared at 12 seconds after administration of the contrast agent. (B) A densely enhanced portion then spread through the tumor. (C) Almost the whole tumor was enhanced after 23 seconds (D). In the postvascular phase, 15 minutes after injection, there is residual pooling of contrast agent in the periphery of the mass (E). The contrast-enhanced image is obtained after high acoustic pressure; insonation confirms the pooling of the contrast agent at the periphery of the mass.
Mentions: CEUS was performed using an SSA-790A system (Toshiba Medical Systems, Tokyo, Japan) with a convex probe (PVT-375BT, 3.75-MHz center frequency). Sonazoid (Daiichi-Sankyo, Tokyo, Japan) was injected as a bolus through the median cubital vein at 0.5 ml/body followed by a 10-ml normal saline flush, and the mass was observed by placing the focus at the lower margin of the mass and setting the mechanical index level to 0.2. In the early vascular phase, a spoke-wheel-like enhancement extending radially from the center of the mass appeared at 12 seconds after administration of the contrast agent, and almost complete enhancement, which was weaker than the contrast enhancement in the splenic parenchyma, was observed after 23 seconds (Figure 2A–2C). Fifteen minutes after contrast administration in the postvascular phase (so-called Kupffer phase), enhancement persisted in the periphery of the mass (Figure 2D). To examine the distribution of Sonazoid bubbles accumulated in splenic reticuloendothelial cells, the center of the mass was insonated at high acoustic pressure (flash method),6 confirming the pooling of the contrast agent in the periphery of the mass (Figure 2E).

Bottom Line: Detection of SANT as an incidentaloma has increased due to improvements in imaging techniques.However, a definitive diagnosis of SANT on CT or MRI remains difficult.We report the use of contrast-enhanced ultrasonography with Sonazoid in a case of SANT in a 50-year-old woman, with gross and microscopic pathologic correlations.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital, 6-11-1, Omorinishi, Ota-ku, Tokyo, 143-8541, Japan.

Show MeSH
Related in: MedlinePlus