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| Differentiation of Dysplastic Nodule from Hepatocellular Carcinoma on Contrast-Enhanced Power and Pulsed Doppler US |
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| Jung Hee Shin Jung Hee Shin, M.D., Seung Yon Baek, M.D.,Byung Chul Kang, M.D., Hye Kyung Chung, M.D.* |
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| Department of Radiology and Internal Medicine*, Ewha Womans University |
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| PURPOSE : The purpose of this study was to differentiate dysplastic nodule (DN) from hepatocellular carcinoma
(HCC) in patients with liver cirrhosis on contrast-enhanced power and pulsed Doppler US.
MATERIALS and METHODS : Twenty-one patients with liver cirrhosis and a focal lesion were included. They consisted
of biopsy-proven 12 DNs(mean diameter: 1.8 cm, M:F = 5:7, mean age 60) and 9 HCCs(mean diameter: 2.3cm,
M:F = 6:3, mean age 63). All the patients were prospectively examined with Acuson Computed Sonography
128XP/10 and 4MHz vector transducer. Gray-scale US was done to assess the echogenicity of the focal lesion.
Vascular flow signals within the focal lesion were examined with power Doppler US. After the injection of
7ml(300mg/ml) suspension of US contrast agent (LevovistⓇ, Schering, Berlin, Germary), vascular flow signals
were graded to 4 grades on power Doppler US. Arterial and/or venous flow pattern on pulsed Doppler US were
evaluated. Statistical analysis was done using chi-square method.
RESULTS : On gray-scale US, 10 (83%) DNs showed hypoechogenicity and the other two (17%) showed hyperechogenicity.
7 (78%) HCCs were hypoechoic and two (22%) were hyperechoic. On non-enhanced power
Doppler US, all 12 cases (100%) of DNs had no vascular flow signal and four cases of nine HCCs (grade II :
three, grade III : one) revealed vascular flow signals (p=0.429). On contrast-enhanced power Doppler US, 11
cases (92%) of DNs and all cases (100%) of HCCs showed increased vascular flow signals. Three (24%) of
DNs and 7(78%) of HCCs showed grade III and IV . There was a statistical difference in the grade of vascular
flow signals between two groups (p=0.03). On pulsed Doppler US, the arterial flow was present in 2 (17%) DNs
and 8 (89%) HCCs (p=0.002) and venous flow was present in 11 (92%) DNs and 5 (56%) HCCs. Combined
flow appeared in 2 cases (16%) of DNs and 4 cases (44%) of HCCs.
CONCLUSION : In differentiating DN from HCC, the higher probability of HCC can be considered if a focal lesion in
cirrhotic patient has grade III or IV of vascular flow signals on contrast-enhanced power Doppler US and arterial
flow on pulsed Doppler US. |
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| Keyword : Liver neoplasms, Ultrasound(US), contrast media, Ultrasound(US), power Doppler studies |
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pdf파일 : k20200167.pdf 
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> Journal > Journal Search 
Journal of Korean Society of Ultrasound in Medicine 2001 ; 20 (3) : p.167 - 173
