title: Contrast-enhanced ultrasound for the differentiation of small atypical hepatocellular carcinomas from dysplastic nodules in cirrhosis.
abstract: BACKGROUND
  Contrast-enhanced ultrasound is highly accurate in depicting the vascularity of liver nodules. The aim of this study was to evaluate the usefulness of contrast-enhanced ultrasound for the differentiation of hepatocellular carcinomas from dysplastic nodules in cirrhotic patients with small liver nodules showing atypical or not coincidental typical vascular pattern on two dynamic imaging techniques (computed tomography and magnetic resonance imaging).
  
  
  METHODS
  A total of 46 patients with cirrhosis and a liver nodule smaller than 3cm showing an atypical or non-coincident typical vascular pattern on two dynamic imaging techniques, who underwent liver contrast-enhanced ultrasound and ultrasound-guided liver biopsy, were retrospectively reviewed. Contrast-enhanced ultrasound findings were compared with histopathological and clinical data, and with the two dynamic imaging findings.
  
  
  RESULTS
  Significantly different contrast-enhanced ultrasound enhancement patterns were observed among dysplastic nodules, Edmondson grade I and grade II-III hepatocellular carcinomas. Ten out of 11 (90.9%) non-hypervascular hepatocellular carcinomas on two dynamic imaging techniques showed a hypervascular pattern on contrast-enhanced ultrasound, and these made it possible to distinguish hepatocellular carcinomas from dysplastic nodules.
  
  
  CONCLUSIONS
  Contrast-enhanced ultrasound is useful for the differentiation of hepatocellular carcinomas from dysplastic nodules in cirrhotic patients with small liver nodules.
authors.affiliation: Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea.
authors.forename: Seung Kak
authors.initials: SK
authors.lastname: Shin
authors.affiliation: Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea. Electronic address: kimys@gilhospital.com.
authors.forename: Yun Soo
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea.
authors.forename: Seung Joon
authors.initials: SJ
authors.lastname: Choi
authors.affiliation: Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea.
authors.forename: Young Sup
authors.initials: YS
authors.lastname: Shim
authors.affiliation: Department of Pathology, Gachon University Gil Medical Center, Incheon, Republic of Korea.
authors.forename: Dong Hae
authors.initials: DH
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea.
authors.forename: Oh Sang
authors.initials: OS
authors.lastname: Kwon
authors.affiliation: Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea.
authors.forename: Duck Joo
authors.initials: DJ
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea.
authors.forename: Ju Hyun
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000150:complications* / Q000473:pathology*; D008113:Liver Neoplasms / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D003287:Contrast Media
keywords: Contrast-enhanced ultrasound; Dysplastic nodule; Hepatocellular carcinoma