Utility of contrast-enhanced ultrasound with perflubutane for diagnosing the macroscopic type of small nodular hepatocellular carcinomas

作者:Tada Toshifumi*; Kumada Takashi; Toyoda Hidenori; Ito Takanori; Sone Yasuhiro; Kaneoka Yuji; Maeda Atsuyuki; Okuda Seiji; Otobe Katsuhiko; Takahashi Kenichi
来源:European Radiology, 2014, 24(9): 2157-2166.
DOI:10.1007/s00330-014-3254-2

摘要

To clarify the diagnostic value of contrast-enhanced ultrasound (CEUS) with perflubutane in the macroscopic classification of small nodular hepatocellular carcinomas (HCCs). A total of 99 surgically resected nodular HCCs with a maximum diameter of 3 cm or less were analysed. HCCs were macroscopically categorized as simple nodular (SN) and non-SN. CEUS findings were evaluated during the arterial phase (vascularity, level and shape of enhancement), portal phase (presence or absence of washout) and post-vascular phase (echo intensity and shape). Sixty-eight HCCs were categorized as SN and the remaining 31 were categorized as non-SN. For diagnosis of non-SN HCC, the areas under the receiver operating characteristic curve (A (z)) value for the shape of enhancement in the late arterial phase and the shape of the post-vascular image were 0.824 (95 % confidence interval [CI] 0.721-0.895) and 0.878 (95 % CI 0.788-0.933), respectively. The A (z) value for the combination of the shape of enhancement in the late arterial phase and the shape of the post-vascular image for the diagnosis of non-SN HCC was 0.907 (95 % CI 0.815-0.956), corresponding to a high diagnostic value. CEUS can provide high-quality imaging assessment for determining the macroscopic classification of small nodular HCCs. aEuro cent Non-SN is one of the poor prognostic factors in patients with HCC aEuro cent Assessment of macroscopic type provides valuable information for the management of HCC aEuro cent CEUS can provide high-quality imaging assessment for macroscopic classification of HCC aEuro cent For non-SN HCC diagnosed using CEUS, hepatectomy is preferred as curative treatment.

  • 出版日期2014-9