Abstract
Contrast-enhanced ultrasound with sulphur-hexafluoride in diagnosis of early HCC in cirrhosis
Highlights
Today the use of dynamic imaging modalities allows the study of liver vasculature and in particular the study of the blood supply of the focal liver lesions
It is well known that in the case of hepatocellular carcinoma (HCC) arising on cirrhosis the normal vascular support is reversed: while in normal subjects the vascular support of the liver is provided by the portal venous system up to 75%, in HCC the blood supply of the nodule is only arterial
Contrast-enhanced ultrasound (CEUS) plays an essential role in the clinical recognition of small nodules arising de novo or recurrent in cirrhotic livers at risk for HCC
Summary
Today the use of dynamic imaging modalities allows the study of liver vasculature and in particular the study of the blood supply of the focal liver lesions. For what has been said so far, it is evident that HCC diagnosis on CEUS relies on the washout findings (type and time), arterial hyper-enhancement remains the main element for the visualization of the HCC nodule when pure blood stream contrast agents are used. This feature was studied by Giorgio et al.[40] who reported a considerable effectiveness of CEUS in detection of arterial hyperenhancement in small nodules (7-20 mm) discovered in cirrhotic patients during surveillance, so to shorten the diagnostic work-up for the management of HCC. Such detection of further lesions modified the treatment planning and resection was extended if necessary
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