Sonographic appearances of small hepatic nodules without tumor stain on contrast-enhanced computed tomography and angiography.
OBJECTIVE
We report the sonographic appearances and pathologic findings for hepatic nodules 2 cm or smaller that were detected by sonography but that did not produce a tumor stain on constrast-enhanced helical CT or digital subtraction angiography.


METHODS
Sixty-six nodules 2 cm or less were found by sonography in 39 patients. Sonographically guided needle biopsies were done on all lesions.


RESULTS
Twenty-seven nodules were benign nodules, 9 were borderline lesions, and 30 were hepatocellular carcinomas. Benign nodules were significantly smaller than hepatocellular carcinomas (mean size, 1.0 cm versus 1.4 cm, respectively; p <0.00001). Nodules 1 cm or smaller were more likely to be diagnosed as benign nodules (68%) than as either of the other types (32%; p = 0.01). A significantly greater percentage of hepatocellular carcinomas showed a heterogeneous pattern (64%) on sonography compared with benign nodules (25%) and borderline lesions (11%; p = 0.04). In nodules 1 cm or smaller, a homogeneous pattern (68%) was more common than a heterogeneous pattern (32%; p = 0.01).


CONCLUSIONS
The nature of small hepatic nodules cannot be determined with sonography. Thus, biopsy remains the only technique for obtaining a definitive diagnosis.
Iwasaki
M
M
Department of Internal Medicine, National Cancer Center Hospital East, Chiba, Japan.
Furuse
J
J
Yoshino
M
M
Ryu
M
M
Moriyama
N
N
Mukai
K
K
D000368:Aged; D000792:Angiography; D001707:Biopsy, Needle; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging*; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000000981:diagnostic imaging*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D003287:Contrast Media