Assessment of vascularity in hepatic tumors: comparison of power Doppler sonography and intraarterial CO(2)-enhanced sonography.
OBJECTIVE
The purpose of the study was to compare power Doppler sonography with intraarterial CO(2)-enhanced sonography for revealing vascularity in treated and untreated hepatic tumors.


METHODS
Fifty-five patients with 93 liver tumors were prospectively examined with power Doppler sonography and CO(2)-enhanced sonography. These tumors included 29 hepatocellular carcinomas in patients with no previous treatment, 26 treated hepatocellular carcinomas, and 38 hemangiomas. The vascular depiction of power Doppler sonography was compared with that obtained in the early phase of CO(2)-enhanced sonography. The results of angiography were also recorded for comparison.


RESULTS
In the hepatocellular carcinomas, power Doppler sonography was the same as CO(2)-enhanced sonography in 18 (62%) of 29 tumors, was inferior to CO(2)-enhanced sonography in nine (31%) of 29 tumors, and was superior to CO(2)-enhanced sonography in two (7%) of 29 tumors. In the treated hepatocellular carcinomas, power Doppler sonography was the same as CO(2)-enhanced sonography in 15 (58%) of 26 tumors and was inferior in 11 (42%) of 26 tumors. In hemangiomas, the same vascularity was found in both studies in 15 (39%) of 38 tumors, CO(2)-enhanced sonography was superior in 22 (58%) of 38 tumors, and power Doppler sonography was superior in one (3%) of 38 tumors. As a whole, 45% of the 93 tumors showed better vascular depiction on CO(2)-enhanced sonography. However, 19.4% of tumors were hypovascular using power Doppler sonography but hypervascular using CO(2)-enhanced sonography.


CONCLUSIONS
Power Doppler sonography is a useful technique for screening hepatic tumor vascularity. CO(2)-enhanced sonography is superior to power Doppler sonography in depicting tumor vascularity in treated hepatocellular carcinomas and in hemangiomas, especially small hemangiomas.
Chen
Ran-Chou
RC
Department of Radiology, Taipei Municipal Jen-Ai Hospital, 10, Sec. 4, Jen-Ai Rd., 106, Taipei, Taiwan.
Chen
Wei-Tsung
WT
Tu
Hsing-Yang
HY
Cheng
Nai-Yuan
NY
Wang
Chung-Kwe
CK
Liao
Li-Ying
LY
Wang
Chaur-Shine
CS
Chen
Pao-Huei
PH
D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D002245:Carbon Dioxide; D006528:Carcinoma, Hepatocellular / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000628:therapy; D003287:Contrast Media; D004621:Embolization, Therapeutic; D000431:Ethanol / Q000008:administration & dosage; D005260:Female; D006391:Hemangioma / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D007089:Image Enhancement; D007261:Infusions, Intra-Arterial; D015552:Injections, Intralesional; D008113:Liver Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color; D018617:Ultrasonography, Doppler, Pulsed
D003287:Contrast Media; D002245:Carbon Dioxide; D000431:Ethanol