Wong GLH, Xu HX, Xie XY. Detection Of Focal Liver Lesions In Cirrhotic Liver Using Contrast-Enhanced Ultrasound. World J Radiol 2009; 1(1): 25-36 [PMID: 21160718 DOI: 10.4329/wjr.v1.i1.25]
Corresponding Author of This Article
Hui-Xiong Xu, MD, PhD, Department of Medical Ultrasonics, The First Affiliated Hospital, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China. xuhuixiong@hotmail.com
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World J Radiol. Dec 31, 2009; 1(1): 25-36 Published online Dec 31, 2009. doi: 10.4329/wjr.v1.i1.25
Detection Of Focal Liver Lesions In Cirrhotic Liver Using Contrast-Enhanced Ultrasound
Grace Lai-Hung Wong, Hui-Xiong Xu, Xiao-Yan Xie
Grace Lai-Hung Wong, Institute of Digestive Disease, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
Grace Lai-Hung Wong, Hui-Xiong Xu, Xiao-Yan Xie, Department of Medical Ultrasonics, The First Affiliated Hospital, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China
Author contributions: All authors participated in the preparation of the manuscript; Xu HX provided the ultrasonographic images used in the manuscript.
Supported by (in part) Grant No. NCET-06-0723 from Chinese Ministry of Education and grant 2008-2-10 of Public Welfare Research Special Project from Chinese Ministry of Health
Correspondence to: Hui-Xiong Xu, MD, PhD, Department of Medical Ultrasonics, The First Affiliated Hospital, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China. xuhuixiong@hotmail.com
Telephone: +86-20-28823388 Fax: +86-20-87332908
Received: November 11, 2009 Revised: December 17, 2009 Accepted: December 21, 2009 Published online: December 31, 2009
Abstract
Patients with liver cirrhosis are at increased risk of hepatocellular carcinoma (HCC). Conventional or baseline ultrasound (BUS) is often used as the first-line tool for HCC surveillance or detection, but the accuracy of BUS in HCC detection or differentiation from other focal liver lesions (FLLs) is limited. Contrast-enhanced ultrasound (CEUS) represents a recent revolution in the field of ultrasonography and it has become increasingly important in the detection and evaluation of FLLs. In CEUS, HCC typically exhibits arterial hyper-enhancement and portal-venous washout represented by hypo-enhanced lesions in the portal venous and late phases. The detection rate of HCC was significantly higher with CEUS compared with BUS. Even regenerative or some dysplastic nodules may exhibit arterial hyper-enhancement as they are differentiated from HCC by its iso-enhancing pattern in portal and late phases. The contrast-enhancement patterns of other different types of benign and malignant FLLs, as well as their detection rates with CEUS, were also discussed.
