Contrast-enhanced ultrasonography findings using a perflubutane-based contrast agent in patients with early hepatocellular carcinoma.

Abstract

OBJECTIVE:

We evaluated the contrast-enhanced ultrasonography (US) imaging features of early hepatocellular carcinomas (HCCs) and compared these findings with those obtained using contrast-enhanced computed tomography (CT).

SUBJECTS AND METHODS:

Forty-three patients with 52 early HCCs with a mean maximal diameter of 15.6mm were enrolled in this retrospective study. After confirming the location of the target lesion using fusion imaging combining conventional US and hepatobiliary phase of contrast-enhanced magnetic resonance (MR) imaging with gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid, we evaluated findings of contrast-enhanced US using a perflubutane-based contrast agent. The contrast-enhanced US detection rates for hyper-vascularity in early HCCs were compared with those obtained for contrast-enhanced CT.

RESULTS:

Transient hypo-vascularity subsequent to iso-vascularity during arterial phase and iso-vascularity during portal and post-vascular phases were the predominant contrast-enhanced US findings seen for 25 (48.1%) of the 52 early HCCs. Nine (17.3%) showed iso-vascularity during all three phases, while 1 (1.9%) showed hypo-vascularity during all three phases. The remaining 17 (32.7%) showed partial or whole hyper-vascularity during arterial phase, iso-vascularity during portal phase, and iso- or hypo-vascularity during post-vascular phase. The detection rate for the hyper-vascularity of early HCCs using contrast-enhanced US (32.7%, 17/52) was significantly higher than that obtained using contrast-enhanced CT (21.2%, 11/52) (P<0.05 by McNemar test).

CONCLUSION:

Hypo-vascularity, iso-vascularity, and hyper-vascularity were observed during the arterial phase of contrast-enhanced US in 50.0%, 17.3%, and 32.7% of the early HCCs, respectively. Contrast-enhanced US was more sensitive than contrast-enhanced CT for the detection of hyper-vascularity in early HCCs. Of note, early HCCs might not exhibit the early arterial enhancement that is generally considered to be a typical finding for HCCs.

• Authors: Kazushi Numata, Hiroyuki Fukuda, Haruo Miwa, Tomohiro Ishii, Satoshi Moriya, Masaaki Kondo, Akito Nozaki, Manabu Morimoto, Masahiro Okada, Shigeo Takebayashi, Shin Maeda, Akinori Nozawa, Masayuki Nakano, Katsuaki Tanaka
• Journal: European journal of radiology (Eur J Radiol) Vol. 83 Issue 1 Pg. 95-102 (Jan 2014) ISSN: 1872-7727 [Electronic] Ireland
• PMID: 24176532 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Contrast Media
• Ferric Compounds
• Oxides
• Sonazoid
• gadolinium ethoxybenzyl DTPA
• Iron
• Gadolinium DTPA

Topics

• Aged
• Aged, 80 and over
• Carcinoma, Hepatocellular (diagnosis)
• Contrast Media
• Early Detection of Cancer (methods)
• Female
• Ferric Compounds
• Gadolinium DTPA
• Humans
• Image Enhancement (methods)
• Iron
• Liver Neoplasms (diagnosis)
• Magnetic Resonance Imaging (methods)
• Male
• Middle Aged
• Multimodal Imaging (methods)
• Neovascularization, Pathologic (diagnosis)
• Oxides
• Reproducibility of Results
• Sensitivity and Specificity
• Tomography, X-Ray Computed (methods)
• Ultrasonography (methods)