Early diagnosis of small hepatocellular carcinoma in patients with liver cirrhosis using contrast-enhanced ultrasound and contrast-enhanced magnetic resonance

Abstract

Objective To evaluate retrospectively the difference and complementary of contrastenhanced ultrasound (CEUS) and contrast-enhanced magnetic resonance (CEMR) in early diagnosis and differential diagnosis of small hepatocellular carcinoma (SHCC)(≤2.0 cm) in patients with liver cirrhosis.Methods Forty-five patients with space-occupying lesions in cirrhotic livers were included, who were referred to CEUS and CEMR before operations. Numbers as well as diagnosis results were recorded respectively,and all cases were confirmed by pathological examination. Results Seventy-five lesions were found after CEUS and CEMR,with 69 and 58 respectively. Forty-one lesions were diagnosed pathologically as SHCC by surgery or needle biopsy. Overlapping exited in enhanced mode between CEUS and CEMR.Most SHCC displayed as mode Ⅰ fast-in and fast-out and mode Ⅱ fast-in and slow-out in both examination,which can be considered as a reliable criterion. The diagnostic accuracy of CEUS and CEMR was 77. 3% (58/75) and 62. 7% (44/75) respectively (0. 50＜ P ＜0. 75). Differences of the diagnostic accuracy of SHCC with atypical enhanced mode between CEMR and CEUS were statistically significant.Conclusions There is no significant difference of diagnostic accuracy of SHCC between CEMR and CEUS.Both of these two examing procedure have its own advantages for atypical lesions, which accounts for its diagnostic difference of small SHCC and benign lesions. Key words: Ultrasonography; Microbubbles; Liver neoplasms; Liver cirrhosis; Magnetic resonance imaging