title: Three-dimensional power Doppler ultrasonography for hepatocellular carcinoma: a comparison with angiography?
abstract: OBJECTIVE
  To assess clinical usefulness of three-dimensional power Doppler ultrasonography for the diagnosis of hepatocellular carcinoma.
  
  
  METHODS
  Fifty-two hepatocellular carcinoma nodules (median 31mm in diameter, range 8 to 94), histologically proven afterwards, in 33 patients were examined by three-dimensional power Doppler ultrasonography (ATL-HDI 5000 with a 5-MHz convex transducer) for tumor vascularity. We classified tumor Doppler signals into four types; Type 1: spotty signals in the tumor, Type 2: signals surrounding the tumor, Type 3: Type 3 with visualized penetrating arteries, Type 4: Type 3 with visualized drainage vein. Types 2-4 were considered specific to hepatocellular carcinoma, and compared with findings on digital subtraction angiography.
  
  
  RESULTS
  Definite diagnosis of hepatocellular carcinoma was obtained in 29 of 52 nodules (56%) with three-dimensional ultrasonography (5 with Type 2, 19 with Type 3, and 5 with Type 4) while all nodules revealed tumor stain on angiography. 23 nodules showed only Type 1 signals, which were not specific to hepatocellular carcinoma. These nodules included small nodules less than 2cm in diameter, located more than 5cm from body surface, and those in the subphrenic portion of the left lobe.
  
  
  CONCLUSIONS
  Three-dimensional power Doppler ultrasonography provides definite diagnosis of hepatocellular carcinoma in a real-time, non-invasive manner under certain conditions.
authors.affiliation: Department of Gastroenterology University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. sato-sinpei@umin.ac.jp
authors.forename: Shinpei
authors.initials: S
authors.lastname: Sato
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Yoshida
authors.forename: Takuma
authors.initials: T
authors.lastname: Teratani
authors.forename: Shuntaro
authors.initials: S
authors.lastname: Obi
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Koike
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Shiina
authors.forename: Masao
authors.initials: M
authors.lastname: Omata
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000175:diagnosis*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008113:Liver Neoplasms / Q000098:blood supply / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler / Q000379:methods*