Ultrasonic Doppler studies of hepatocellular carcinoma and comparison with other hepatic focal lesions.
One hundred fifty-four liver lesions, including 63 hepatocellular carcinomas, were studied to determine the value of duplex ultrasound in the diagnosis of small hepatocellular carcinomas. Arterial Doppler signals were obtained either within the body of the tumor, at its periphery, or in both locations, from 28 to 37 hepatocellular carcinomas less than or equal to 3 cm in diameter and from all 26 hepatocellular carcinomas with a diameter greater than 3 cm. Arterial Doppler signals were obtained at the periphery of 5 of 7 cholangiocarcinomas, 4 of 11 liver metastatic tumors, and 5 of 23 hemangiomas. No such signals were obtained from 29 regenerative nodules, 10 hepatic pseudotumors, and 11 liver cysts. The mean peak systolic frequency seen in hepatocellular carcinoma (1.2 kHz) was significantly greater than in cholangiocarcinoma (0.6 kHz), metastatic tumors (0.5 kHz), or hemangiomas (0.3 kHz). A peak systolic frequency of greater than 3 kHz was found in 6 of 8 hepatocellular carcinomas greater than or equal to 4 cm in diameter with angiographically proven arterioportal shunting, whereas the value in other hepatocellular carcinomas or other hepatic focal lesions was less than 2.6 kHz. This study showed that the peak systolic shift was related to the degree of arterioportal shunting. Because shunting is either minor or nonexistent in small hepatocellular carcinomas, the value of duplex Doppler ultrasound in the diagnosis of these lesions appears to be limited.
Ohnishi
K
K
First Department of Medicine, Chiba University School of Medicine, Japan.
Nomura
F
F
D002759:Adenoma, Bile Duct / Q000098:blood supply / Q000175:diagnosis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000098:blood supply / Q000175:diagnosis; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000175:diagnosis*; D005260:Female; D006391:Hemangioma / Q000098:blood supply / Q000175:diagnosis; D006499:Hepatic Artery / Q000473:pathology; D006503:Hepatic Veins / Q000473:pathology; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000175:diagnosis* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000473:pathology; D014463:Ultrasonography