Three-dimensional power Doppler ultrasonography for hepatocellular carcinoma: a comparison with angiography?
Shinpei Sato1, Haruhiko Yoshida, Takuma Teratani
1Department of Gastroenterology University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. sato-sinpei@umin.ac.jp
Background/Aims:
To assess clinical usefulness of three-dimensional power Doppler ultrasonography for the diagnosis of hepatocellular carcinoma.
Methodology:
Fifty-two hepatocellular carcinoma nodules (median 31mm in diameter, range 8 to 94), histologically proven afterwards, in 33 patients were examined by three-dimensional power Doppler ultrasonography (ATL-HDI 5000 with a 5-MHz convex transducer) for tumor vascularity. We classified tumor Doppler signals into four types; Type 1: spotty signals in the tumor, Type 2: signals surrounding the tumor, Type 3: Type 3 with visualized penetrating arteries, Type 4: Type 3 with visualized drainage vein. Types 2-4 were considered specific to hepatocellular carcinoma, and compared with findings on digital subtraction angiography.
Results:
Definite diagnosis of hepatocellular carcinoma was obtained in 29 of 52 nodules (56%) with three-dimensional ultrasonography (5 with Type 2, 19 with Type 3, and 5 with Type 4) while all nodules revealed tumor stain on angiography. 23 nodules showed only Type 1 signals, which were not specific to hepatocellular carcinoma. These nodules included small nodules less than 2cm in diameter, located more than 5cm from body surface, and those in the subphrenic portion of the left lobe.
Conclusions:
Three-dimensional power Doppler ultrasonography provides definite diagnosis of hepatocellular carcinoma in a real-time, non-invasive manner under certain conditions.
