%0 Journal Article
%T Diagnosis and Management of Giant Hepatic Hemangioma: The Usefulness of Contrast-Enhanced Ultrasonography
%A Masaki Maruyama
%A Osamu Isokawa
%A Koki Hoshiyama
%A Ayako Hoshiyama
%A Mari Hoshiyama
%A Yoshihiro Hoshiyama
%J International Journal of Hepatology
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/802180
%X Giant hepatic hemangiomas, though often asymptomatic, may require intervention if rapid growth occurs. The imaging studies including the computed tomography, magnetic resonance imaging, and ultrasonography, and so on are effective for the diagnosis and the management of this tumor; however, due to its size and various patterns of these studies, we need to carefully consider the therapeutic methods. Compared to the cost needed for these modalities, recently developed and approved Perflubutane- (Sonazoid-) based contrast agent enhanced ultrasonography is reasonable and safe. The major advantage is the real-time observation of the vascular structure and function of the Kupffer cells. By this procedure, we can carefully follow the tumor growth or character change in a hemangioma and decide the timing of therapeutic intervention, since abdominal pain, abdominal mass, consumptive coagulopathy, and hemangioma growth are the signs for the therapeutic intervention. We reviewed recent reports about Sonazoid-based enhancement and also showed the representative images collected in our department. This is the first review showing the detailed findings of the giant hemangiomas using Perflubutane (Sonazoid). This review will help the physician in making the decision, and we hope that Sonazoid will gain widespread acceptance in the near future. 1. Introduction Hepatic hemangiomas are the most common benign tumors of the liver and usually do not grow [1]. In cases with giant hepatic hemangiomas, intervention is necessary since clinical symptoms due to rapid growth are present [2, 3]. Detailed follow-up imaging examinations of giant hepatic hemangiomas are essential for relevant medical treatment or surgical intervention. Although computed tomography (CT) or magnetic resonance imaging (MRI) is useful for diagnosing hepatic hemangioma, these modalities are expensive and there are several risks associated with the contrast agents used as well as radiation exposure. There are many recent reports describing contrast-enhanced ultrasonography (US) as being safe, inexpensive, and useful for the diagnosis of focal liver lesions [4, 5]. Perflubutane (Sonazoid) is a new contrast agent for contrast-enhanced US approved only Japan. The only contraindication to its use is an allergy to eggs. Sonazoid contrast-enhanced US is very useful for the diagnosis of hemangioma of the liver, since real-time images can be shown that is unable to be obtained by CT or MRI, and yielding information about Kupffer cell function [6, 7]. However, there have been few reports describing Sonazoid
%U http://www.hindawi.com/journals/ijh/2013/802180/