Application of contrast-enhanced intraoperative ultrasonography in the decision-making about hepatocellular carcinoma operation

Figure 1 IOUS showing typical sonographic appearance of HCC nodules with mosaic pattern (A, arrow) and hyperechoic regenerative nodules (B, arrow); It is hard for IOUS to accurately diagnose a hypoechoic nodule (C, arrow) which could be a regenerative nodule or a small HCC nodule or focal fatty sparing nodule.

Figure 2 CE-IOUS showing an HCC nodule with hyperenhancement in arterial phase (A, arrow) while a regenerative hyperechoic nodule shows isoenhancement on CE-IOUS (B, arrow); Hypoechoic intrahepatic metastatic nodule showing wash out of contrast agent on late phase (C, arrow); Isoechoic nodule missed on IOUS showing a clear margin on CE-IOUS (D, arrow).