Clinical value of contrast-enhanced ultrasound in early diagnosis of small hepatocellular carcinoma (≤ 2 cm)  

作　　者：Qi Mei Mei Yu Qiong Chen 

机构地区：[1]Department of Ultrasound,Shanghai Xuhui Dahua Hospital,Shanghai 200237,China [2]Department of Radiology,Shanghai Xuhui Dahua Hospital,Shanghai 200237,China

出　　处：《World Journal of Clinical Cases》2022年第24期8525-8534,共10页世界临床病例杂志

基　　金：Supported by National Natural Science Foundation of China,No.81571675;Academic Experience and Research Workshop Construction Project of Shanghai Famous TCM Doctors,No.JCZYGZS-008;Clinical Study on Control and Clearance of Hepatitis B Surface Antigen by Traditional Chinese Medicine,No.1340190290A。

摘　　要：BACKGROUND Hepatocellular carcinoma(HCC)is the most common type of primary liver malignancy.Contrast-enhanced ultrasound(CEUS)uses contrast microbubbles during ultrasound,allowing the detection and characterization of malignant focal liver lesions with much higher diagnostic accuracy than conventional ultrasound;however,there are few reports focusing on the pattern of enhancement of CEUS for the diagnosis of HCC smaller than 2 cm.AIM To investigate the clinical value of CEUS in the early detection of small HCC with high risk factors.METHODS A total of 395 patients with 632 nodules at high risk of HCC,who underwent regular follow-up at Xuhui Dahua Hospital from January 2007 to December 2021,were retrospectively examined.Conventional ultrasonography combined with CEUS was adopted to analyze the echo,size,location,and enhancement characteristics of benign and malignant nodules,as well as the enhancement methods for HCC with different diameters.RESULTS The follow-up rate and duration were 92.15%(364/395)and 51.28±45.09 mo,respectively.Conventional ultrasonography combined with CEUS revealed 65(11.80%)nodules with a follow-up diagnosis of HCC,19(3.45%)dysplastic nodules,and 467(84.75%)benign cirrhotic hyperplastic nodules.Among 65 cases of confirmed HCC,40(61.54%)were transformed from hypoechoic nodules,9(13.85%)from hyperechoic nodules,and the remaining 16(24.62%)from isoechoic nodules.Significant differences in CEUS characteristics were found among cirrhotic nodules,dysplastic nodules,and HCC nodules at each phase.Significant differences in the enhancement mode were observed between nodules≤1 cm and those 1–2 cm.The smaller the HCC nodule,the later the contrast agent began to flush and the longer the duration of contrast enhancement.CONCLUSION Conventional ultrasonography combined with CEUS could identify small HCC and help monitor patients with an early diagnosis of HCC.Significant differences in the enhancement mode are noted between nodules≤1 cm and those 1–2 cm.

关 键 词：CARCINOMA HEPATOCELLULAR Contrast-enhanced ultrasonography Diagnostic imaging 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]