Contrast enhanced ultrasound of hepatocellular carcinoma

Figure 10 A 77-year-old woman with newly developed HCC (maximum diameter 12 mm) in segment VIII. A: Fusion image combining arterial phase contrast-enhanced CT (right side) and conventional US (left side). Arterial phase contrast-enhanced CT shows hypo-attenuation area previously treated by RFA alone (arrow). Conventional US shows two hypo-echoic lesions. One is an HCC lesion which was previously treated by RFA (arrow) and the other is a new HCC lesion which was not detectable by dynamic CT (arrowhead); B: Fusion image combining hepatobiliary phase contrast-enhanced MRI with Gd-EOB-DTPA (right side) and middle phase Sonazoid-enhanced US at a low MI (left side). Hepatobiliary phase contrast-enhanced MRI with Gd-EOB-DTPA shows a small hypo-intense area in segment VIII (arrowhead). Middle phase Sonazoid-enhanced US obtained 1 d after RFA shows the tumor as a perfusion defect. This non-enhanced area is larger than the hypo-echoic lesion seen on the hepatobiliary phase contrast-enhanced MRI with Gd-EOB-DTPA. Normal liver parenchyma is enhanced.