Value of new contrast harmonic technique for detecting tumor vascularity in hepatocellular carcinoma: Preliminary results.
OBJECTIVE
To investigate the value of a new wide-band contrast harmonic imaging method in depicting intratumoral vascularity in hepatocellular carcinoma.


METHODS
Twenty-two patients with 28 hepatocellular carcinoma nodules evaluated with Contrast Harmonic Echo, a new wide-band harmonic imaging method, using Levovist(®) as a contrast-enhancing agent. Intermittent imaging was carried out in the early arterial phase for 10 to 40 seconds, in the late vascular phase for 1 to 2 minutes, and in the postvascular phase for 5 to 7 minutes. Subtraction images were obtained using the multishot method during the late vascular phase. The ability of Contrast Harmonic Echo imaging to detect vascularity in hepatocellular carcinoma was compared to that of unenhanced color Doppler imaging by analzing results obtained using dynamic CT as a gold standard.


RESULTS
Contrast harmonic Echo imaging detected intratumoral vessels, tumor parenchymal stain, and perfusion defect in the early arterial phase, the late vascular phase, and the postvascular phase, respectively. In the late vascular phase, the subtraction image clearly delineated the tumor parenchymal strain. Intratumoral vascularity was detected in 25 (89%) of the hepatocellular carcinoma nodules by Contrast Harmonic Echo, compared with 15 (54%) when color Doppler imaging was used (p<0.05). The diagnostic sensitivity, specificity, and accuracy of Contrast Harmonic Echo were 96.1%, 100% and 96.4%, respectively, corresponding to results obtained using dynamic CT.


CONCLUSIONS
Contrast Harmonic Echo imaging is superior to unenhanced color Doppler imaging in depicting intratumoral vessels and parenchymal stain, and agrees closely with results obtained with three-phase dynamic CT.
Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2, Ohno-Higashi, Osaka-Sayama, Osaka-Sayama, Japan.|Department of Ultrasound, Sun Yut-Sen University of Medical Science Memorial Hospital, 107 Yanjiangxi Rd, 510120, Guangzhou, China.
Yan Ling
YL
Wen
Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2, Ohno-Higashi, Osaka-Sayama, Osaka-Sayama, Japan.
Masatoshi
M
Kudo
Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2, Ohno-Higashi, Osaka-Sayama, Osaka-Sayama, Japan.
Yasunori
Y
Minami
Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2, Ohno-Higashi, Osaka-Sayama, Osaka-Sayama, Japan.
Hobyung
H
Chung
Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2, Ohno-Higashi, Osaka-Sayama, Osaka-Sayama, Japan.
Yoichiro
Y
Suetomi
Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2, Ohno-Higashi, Osaka-Sayama, Osaka-Sayama, Japan.
Hirokazu
H
Onda
Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2, Ohno-Higashi, Osaka-Sayama, Osaka-Sayama, Japan.
Masayuki
M
Kitano
Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2, Ohno-Higashi, Osaka-Sayama, Osaka-Sayama, Japan.
Toshihiko
T
Kawasaki
Abdominal Ultrasound Unit, Kinki University School of Medicine, 377-2, Ohno-Higashi, Osaka-Sayama, Osaka-Sayama, Japan.
Kiyoshi
K
Maekawa
contrast medium; hepatocellular carcinoma; ultrasound; wide-band harmonic imaging