Objective: To investigate the ultrasonographic features of hepatic epithelioid hemangioendothelioma (HEHE) on B-mode and contrast-enhanced ultrasound (CEUS).
Methods: From January 2012 to September 2016, 17 patients with surgery or biopsy confirmed HEHE were retrospectively analyzed for their clinical history, ultrasonographic data of B-mode ultrasound and CEUS characteristics.
Results: The mean age of the 17 patients was (42.88±13.95) yr. (range 23-69 yr.). On B-mode ultrasound, 6 case (6/17, 35.3%) were single lesion, while 11 case (11/17, 64.7%) had multiple lesions, of which 10 cases involved the global liver. There were 88.2% of lesions (15/17) located underneath the liver capsule, and 94.1% of lesions (16/17) with regular shape. The mean diameter of the lesions was (3.93±2.23) cm. The lesions appeared as hypoechoic (13/17, 76.5%), hyperechoic (1/17, 5.9%) and mixed-echoic (3/17, 17.6%). 7 patients underwent CEUS, 5 of them (5/7, 71.4%) showed a rim-like hyperenhancement in arterial phase while the other 2 presented overall hyperenhancement of the lesions with uneven perfusion inside. All cases demonstrated hypoenhancement in portal and delay phases.
Conclusion: Multiple subcapsular hypoechoic focal liver lesions with regular shape remind of the possibility of HEHE. CEUS could provide considerable value in its diagnosis.
Keywords: Contrast-enhanced ultrasound; Epithelioid hemangioendothelioma; Liver.