title: Characterization of dysplastic nodules, early hepatocellular carcinoma and progressed hepatocellular carcinoma in cirrhosis with contrast-enhanced ultrasound.
abstract: BACKGROUND
  During the progression from low-grade dysplastic nodule (DN) to progressed hepatocellular carcinoma (HCC), intranodular portal tracts gradually disappear, while unpaired arteries develop increasingly. Contrast-enhanced ultrasound (CEUS) is highly accurate in depicting intranodular vascularity. This study evaluates the usefulness of CEUS in the characterization of DN, early HCC and progressed HCC in cirrhotic livers.
  
  
  METHODS
  Forty consecutive patients with cirrhosis and a single hepatic nodule ≤2 cm underwent CEUS and subsequent ultrasound-guided biopsy of the nodule. Imaging and pathological findings of DN and HCC were compared.
  
  
  RESULTS
  The homogeneous pattern of hypervascularization during the arterial phase identified progressed HCC with a sensitivity of 90.9% and a specificity of 100%, whereas the inhomogeneous and reticular pattern identified early HCC with a sensitivity of 85.7% and a specificity of 96.1%.
  
  
  CONCLUSIONS
  DN, early HCC and progressed HCC can be accurately differentiated with CEUS on the basis of the vascularization pattern during the arterial phase.
authors: IX Infectious Diseases and Interventional Ultrasound Unit, D. Cotugno Hospital, Via G. Quagliarello 54, 80131 Naples, Italy. assanui1@virgilio.it
authors: Antonio
authors: A
authors: Giorgio
authors: Giorgio
authors: G
authors: Calisti
authors: Antonella
authors: A
authors: di Sarno
authors: Nunzia
authors: N
authors: Farella
authors: Giorgio
authors: G
authors: de Stefano
authors: Umberto
authors: U
authors: Scognamiglio
authors: Valentina
authors: V
authors: Giorgio
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000209:etiology*; D003287:Contrast Media; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000000981:diagnostic imaging* / Q000473:pathology; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic; D011379:Prognosis; D011446:Prospective Studies; D014465:Ultrasonics; D014463:Ultrasonography
chemical_list: D003287:Contrast Media