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

Area of Science:

• Hepatology and Medical Imaging
• Oncology and Diagnostic Ultrasound

Background:

• Hepatocellular cancer (HCC) diagnosis requires reliable imaging techniques.
• Echography is an established method for detecting focal liver lesions.
• Understanding HCC presentation in patients with and without liver cirrhosis is crucial.

Purpose of the Study:

• To evaluate the diagnostic capabilities of echography for hepatocellular cancer (HCC).
• To assess HCC diagnosis in patients with and without liver cirrhosis.
• To identify characteristic echographic features suggestive of HCC.

Main Methods:

• Echographic examination of 45 patients diagnosed with hepatocellular cancer (HCC).
• Classification of echographic images into five types: hyperechogenic, hypoechogenic, mosaic, mixed, and 'bovine eye'.
• Correlation of echographic findings with clinical data, including cirrhosis, HBsAg status, alpha-fetoprotein levels, and guided fine-needle biopsy results.

Main Results:

• Five echographic patterns were identified: hyperechogenic (29%), hypoechogenic (27%), mosaic (24%), mixed (11%), and 'bovine eye' (9%).
• Peripheral low-echogenic zones and non-homogenous mosaic tissue structure were suggestive of HCC.
• HCC presented as multiple lesions in 55.6% of patients; it was more frequently associated with cirrhosis in Bulgarian patients compared to Kuwaiti patients.

Conclusions:

• Echography is a valuable tool for the early diagnosis and systematic follow-up of HCC, particularly in patients with liver cirrhosis.
• Combining echography with guided biopsy and alpha-fetoprotein determination significantly improves diagnostic accuracy for HCC.
• Ultrasound examination plays a key role in establishing the diagnosis of HCC in diverse patient populations.