Ultrasonography.  2021 Oct;40(4):546-554. 10.14366/usg.20162.

Ultrasound findings in peliosis hepatis

• Dong Y
• Wang WP
• Lim A
• Lee WJ
• Clevert DA
• Höpfner M
• Tannapfel A
• Dietrich CF

• KMID: 2520314
• DOI: http://doi.org/10.14366/usg.20162

Abstract

Purpose
The aim of this study was to retrospectively evaluate contrast-enhanced ultrasound (CEUS) findings in patients with peliosis hepatis (PH).
Methods
A retrospective analysis was conducted of CEUS features in 24 patients with histopathologically confirmed PH (11 men and 13 women; mean age, 32.4±7.1 years; range, 28 to 41 years). 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 (range, 10 to 80 mm). On B-mode ultrasonography (BMUS), all PH lesions were heterogeneously hypoechoic, with well-defined margins but irregular shapes. No mass effect was observed. During the arterial phase of CEUS, all lesions displayed mild heterogeneous hyperenhancement (83.3%, 20/24) or isoenhancement (16.7%, 4/24). Furthermore, 87.5% of the PH lesions showed mild washout after 1 minute in the portal venous phase (30-120 seconds) and mild washout in the late phase (>120 seconds).
Conclusion
The lack of a mass effect on BMUS, mild heterogeneous arterial hyperenhancement, and washout in the very late portal venous phase (after 1 minute) on CEUS are characteristic of PH. Although it is a histological diagnosis, PH should be considered in the differential diagnosis when the clinical context does not favor a malignancy or infection.

Keyword

Focal peliosis hepatis; Contrast-enhanced ultrasound; Focal liver lesions