Contrast-enhanced ultrasound in the diagnosis of nodules in liver cirrhosis.
Contrast-enhanced ultrasound (CEUS) using microbubble contrast agents are useful for the diagnosis of the nodules in liver cirrhosis. CEUS can be used as a problem-solving method for indeterminate nodules on computed tomography (CT) or magnetic resonance imaging (MRI) or as an initial diagnostic test for small newly detected liver nodules. CEUS has unique advantages over CT and MRI including no renal excretion of contrast, real-time imaging capability, and purely intravascular contrast. Hepatocellular carcinoma (HCC) is characterized by arterial-phase hypervascularity and later washout (negative enhancement). Benign nodules such as regenerative nodules or dysplastic nodules are usually isoechoic or slightly hypoechoic in the arterial phase and isoechoic in the late phase. However, there are occasional HCC lesions with atypical enhancement including hypovascular HCC and hypervascular HCC without washout. Cholangiocarcinomas are infrequently detected during HCC surveillance and mostly show rim-like or diffuse hypervascularity followed by rapid washout. Hemangiomas are often found at HCC surveillance and are easily diagnosed by CEUS. CEUS can be effectively used in the diagnostic work-up of small nodules detected at HCC surveillance. CEUS is also useful to differentiate malignant and benign venous thrombosis and to guide and monitor the local ablation therapy for HCC.
Tae Kyoung Kim, Hyun-Jung Jang, Department of Medical Imaging, Toronto General Hospital, University of Toronto, Toronto ON M5G 2N2, Canada.
Tae Kyoung
TK
Kim
Tae Kyoung Kim, Hyun-Jung Jang, Department of Medical Imaging, Toronto General Hospital, University of Toronto, Toronto ON M5G 2N2, Canada.
Hyun-Jung
HJ
Jang
D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging; D003287:Contrast Media / Q000737:chemistry*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging; D045423:Microbubbles; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000000981:diagnostic imaging
D003287:Contrast Media
Contrast ultrasound; Dysplastic nodule; Hepatocellular carcinoma; Imaging; Liver cirrhosis