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How often hepatocellular carcinoma has a typical pattern in contrast enhanced ultrasound?

OBJECTIVES
Contrast Enhanced Ultrasound is an imaging method that can evaluate imediatelly focal liver lesions discovered by ultrasound.The aim of this study is to demonstrate if Contrast Enhanced Ultrasound can be reliable as a diagnostic method for hepatocellular carcinoma.


MATERIAL AND METHODS
We included in our retrospective monocentric study all patients evaluated in our Department during 2 years, which had hepatocellular carcinoma as final diagnosis (using Contrast Enhanced Ultrasound, Contrast Enhanced Computed Tomography, Magnetic Resonance Imaging or biopsy). 91 patients with chronic liver diseases were evaluated, with a total of 114 liver nodules. The enhancement pattern of the nodules was evaluated according to the 2008 guidelines of the European Federation of Societies for Ultrasound in Medicine and Biology. The lesions with arterial enhancement and washout in the portal or late phase were considered hepatocellular carcinoma. The nodules were classified according to their size in ≤3 cm and >3 cm.


OUTCOMES
Of all nodules, 103 had hyperenhancing arterial pattern and washout was observed in 79 cases. In our study, this method established the diagnosis of hepatocellular carcinoma in 45 of 55 cases with liver nodules larger than 3 cm (81.8%) vs. 34 of 59 cases with nodules smaller than 3 cm (57.6%) (p<0.001).


CONCLUSIONS
69.3% of all hepatocellular carcinoma had a typical enhancement pattern on Contrast Enhanced Ultrasound, performing better in nodules larger than 3 cm, than in smaller nodules (p<0.001).