A New Ultrasonographic "Fluttering Sign" for Hepatic Hemangioma

Area of Science:

• Radiology
• Medical Imaging
• Hepatology

Background:

• Hepatic hemangiomas are common benign liver tumors.
• Accurate diagnosis is crucial for appropriate patient management.
• Gray-scale ultrasonography (US) is a primary imaging modality.

Purpose of the Study:

• To evaluate the diagnostic value of the "fluttering sign" in gray-scale ultrasonography for hepatic hemangiomas.
• To compare the prevalence of the fluttering sign with other established US signs.

Main Methods:

• Retrospective analysis of 172 hepatic hemangiomas diagnosed with contrast-enhanced US.
• Evaluation for the presence of the "fluttering sign" characterized by continuously changing speckled echogenicity.
• Comparison of fluttering sign prevalence with marginal strong echo, posterior acoustic enhancement, and chameleon sign.

Main Results:

• The fluttering sign was identified in 123 out of 172 hemangiomas (71.5%).
• Its prevalence was significantly higher than other evaluated signs (p < 0.001 for marginal strong echo).
• The sign was more frequent in mixed/hypo-echoic, larger, and superficially located tumors (p < 0.001).

Conclusions:

• The "fluttering sign" is a prevalent finding in hepatic hemangiomas on gray-scale US.
• It demonstrates significant diagnostic potential as a complementary imaging biomarker.
• This sign may improve the accuracy of non-invasive hepatic hemangioma diagnosis.