[Hepatocellular carcinoma--its echographic characteristics and diagnostic potentials]

Echography is an approved method for establishing focal processes in liver. Forty five patients, from Bulgaria and Kuwait, with confirmed hepatocellular cancer (HCC) were studied by echographies aiming at the elucidation of the possibilities of ultrasound examination in making the diagnosis of HCC in patients with and without cirrhosis of the liver. Five types of images have been established--hyperechogenic (29%), hypoechogenic (27%), mosaic (24%) mixed (11%) and type "bovine eye" (9%). The echographic characteristics that could suggest the character of the lesion are low-echogenic zone in the periphery and non-homogenous (mosaic) tissue structure. HCC, in 55.6 per cent of the patients, proved to be with multiple localization in liver. The comparison of the patients from Kuwait and Bulgaria revealed no differences in the mean age, carriership of HBsAg, but in the latter--the HCC was significantly more often combined with cirrhosis of the liver. Serum alpha-fetoprotein was increased in 15 out of 20 patients with HCC. The establishment of the tumour in part of the patients by ultrasound initially, suggests that echography is a useful method for the early diagnosis of HCC and for a systematic follow up of the patients with cirrhosis of the liver. Guided fine-needle biopsy was performed in 15 patients, and in 86.7 per cent of the cases--accurate cytologic diagnosis was obtained. Echography, combined with guided biopsy and determination of alpha-fetoprotein, guarantee in a considerable part of the cases, also the correct diagnosis of HCC in patients with and without cirrhosis of the liver.