Min Hua Chen MD, Presenter: Nothing to Disclose

Ying Dai MD, Abstract Co-Author: Nothing to Disclose

Wei Wu, Abstract Co-Author: Nothing to Disclose

Kun Yan, Abstract Co-Author: Nothing to Disclose

Shan Shan Yin, Abstract Co-Author: Nothing to Disclose

Xiao Peng Zhang MD, Abstract Co-Author: Nothing to Disclose

Ji You Li, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To investigate the diagnostic value of contrast-enhanced ultrasound (CEUS) enhancement patterns of hepatocellular carcinoma smaller than 2 cm with different histopathological types.

From 408 cases with focal liver lesions underwent CEUS with SonoVue, forty-two cirrhotic patients (with forty-seven HCCs, sized from 0.8cm to 2 cm,) with histopathological diagnosis, were retrospectively analyzed in this study. Surgeries or needle biopsies were performed within fifteen days after CEUS. Twenty-seven tumors were confirmed as moderately differentiated HCC, fourteen as well differentiated HCC, and six as clear cell carcinomas. Based on the study, a 5-point scoring criteria of CEUS was established according to the enhancement patterns.

Forty-seven HCCs enhanced diffusely following contrast administration. Of them, 100% of the moderately differentiated HCCs (27 of 27 lesions), and 35.7% of the well differentiated HCCs (5 of 14 lesions), exhibited typical “fast-in and fast-out” pattern, with fast enhancement in arterial phase and then a quick wash-out in the parenchymal phase. The rest 64.3% of the well differentiated HCCs (9 of14 lesions) exhibited “fast-in and slow-out” pattern. In addition, two of the 6 clear cell carcinomas exhibited “fast-in and fast-out”, one exhibited “fast-in and slow-out” and the other 3 exhibited “slight and slow-in and slight and slow-out” pattern. After CEUS, according to the scoring criteria, 34 lesions (72.3%) exhibiting “fast in and fast out” were given 5 scores and could be considered as malignant, 10 lesions (21.3%) exhibiting “fast in and slow out” were given 4 scores and could be considered as possibly malignant, and 3 lesions (6.4%) exhibiting “slight and slow-in and slight slow-out” were given only 2 scores and could not be considered as malignant by CEUS.

The identification of different enhancement patterns of various histological types of small HCCs could improve the diagnostic value of ultrasound in cirrhotic livers. Thus, CEUS can be a complementary method to enhanced CT and other imaging methods in early diagnosis of HCCs.

Chen, M, Dai, Y, Wu, W, Yan, K, Yin, S, Zhang, X, Li, J, et al, , The Enhancement Patterns of Hepatocellular Carcinoma Smaller than 2cm in Contrast-enhanced Ultrasound and Correlation with Histopathology.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4416035.html