1Department of Radiology, Samsung Seoul Hospital College of Medicine, Sungkyunkwan University, Korea. 2Department of Diagnostic Pathology, Samsung Seoul Hospital College of Medicine, Sungkyunkwan University, Korea. 3Department of Emergency medicine, Samsung Seoul Hospital College of Medicine, Sungkyunkwan University, Korea.
Published online: January 1, 2001.
ABSTRACT
PURPOSE: The purpose of this study was to ascertain the pathologic base of sonographic visibility of regenerative nodules in liver cirrhosis. MATERIALS & METHODS: Thirty-three resected liver specimens from patients with hepatocellualr carcinoma were examined with sonography using 2-4 MHz and 5-10 MHz broad band frequency transducers. The patients had normal liver parenchyma (N=6), chronic hepatitis (N=3), micronodular cirrhosis (N=7), macronodular cirrhosis (N=4), and mixed micro-and macronodular cirrhosis (N=13). Sonographic appearances were analyzed for the presence of identifiable nodules and echotexture, and the results were correlated with gross morpholohy of the specimens and also with preoperative abdominal sonograms using 2-4 MHz transducers. Two radiologists blinded to the gross appearance reviewed sonographic findings jointly at one session and one pathologist blinded to the sonographic findings reviewed the gross specimens. RESULTS: By using 2-4 MHz transducers, regenerative nodules no less than 5 mm surrounded by fibrous septa thicker than 0.5 mm were depicted as hypoechoic focal lesions wheras nodules smaller than 4 mm were not depicted clearly but produce inhomogeneous, increased, and coarse parenchymal echotexture depending on the thickness of fibrous septa. By using 5-10 MHz transducers, majority of regenerative nodules larger than 3 mm were depicted as hypoechoic focal lesions. CONCLUSION: In routine abdominal sonography by using 2-4 MHz transducers, regenerating nodules no less than 5 mm can be depicted as hypoechoic nodules but nodules less than 4 mm produce increased and coarse hepatic echotexture.
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