title: Evaluation of hepatocellular carcinoma by contrast-enhanced sonography: correlation with pathologic differentiation.
abstract: OBJECTIVE
  The purpose of this study was to determine whether contrast-enhanced sonography can be used to differentiate histopathologic grades of hepatocellular carcinoma.
  
  
  METHODS
  This study included 54 patients with hepatocellular carcinomas. All patients underwent fundamental and contrast-enhanced sonographic examinations. Auto-tracking contrast quantification software was used to determine the contrast arrival time, time to peak, peak intensity, contrast-enhanced time, wash-out time, enhancement slope, and clearance slope of the lesions. All lesions were confirmed by surgery. The hepatocellular carcinoma lesions were divided into 2 groups according to the World Health Organization grading system: group 1 (well-differentiated hepatocellular carcinomas) and group 2 (moderately to poorly differentiated carcinomas). The enhancement parameters between the groups were compared using a Student t test.
  
  
  RESULTS
  Fourteen of 20 well-differentiated lesions showed a "fast-in, slow-out" enhancement pattern, whereas 6 showed a "fast-in, fast-out" pattern. Thirty-three of 34 moderately to poorly differentiated lesions showed a fast-in, fast-out pattern, whereas only 1 showed a fast-in, slow-out pattern. The differences in the time to peak, contrast-enhanced time, wash-out time, enhancement slope, and clearance slope between the groups were statistically significant (P < .05), whereas the differences in the arrival time and peak intensity were not significant (P > .05).
  
  
  CONCLUSIONS
  The contrast patterns of well-differentiated and moderately to poorly differentiated hepatocellular carcinomas were quite different on contrast-enhanced sonography. The time to peak, contrast-enhanced time, and wash-out time of the well-differentiated hepatocellular carcinomas were longer than those of the moderately to poorly differentiated carcinomas, whereas the enhancement slope and clearance slope of the well-differentiated lesions were lower those that of the moderately to poorly differentiated lesions.
authors.affiliation: Department of Ultrasonography, Second Clinical College of Jinan University, Shenzhen People's Hospital, 518020 Shenzhen, China. xu.jinfeng@yahoo.com.cn
authors.forename: Jin Feng
authors.initials: JF
authors.lastname: Xu
authors.forename: Hui Yu
authors.initials: HY
authors.lastname: Liu
authors.forename: Yang
authors.initials: Y
authors.lastname: Shi
authors.forename: Zhang Hong
authors.initials: ZH
authors.lastname: Wei
authors.forename: Ying
authors.initials: Y
authors.lastname: Wu
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010743:Phospholipids; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D013459:Sulfur Hexafluoride; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride