Department of Radiology, Inha University College of Medicine.
Published online: June 1, 2001.
ABSTRACT
PURPOSE: To evaluate the ultrasonographic findings of diffuse hepatocelluar carcinoma(HCC) and to assess the feasibility of initial ultrasonography (US) as the diagnostic modality in the diagnosis of diffuse HCC. MATERIALS and METHODS: Among the patients with underlying liver cirrhosis(LC), ultrasonographic findings of thirty six cases with pathologically confirmed diffuse HCC were retrospectively reviewed. The ultrasonographic examinations was done using gray-scale US with duplex color Doppler imaging. Ultrasonographic findings were evaluated with special emphasis on echogenicity, echotexture, hepatomegaly, potal venous thrombosis and signal on color Doppler imaging if portal venous thrombosis was present. RESULTS: Changes in echogenicity was observed in thirty two cases (89%), and the echogenicity was increased in all thirty two cases when compared to the underlying cirrhotic liver parenchyma. Twenty nine cases(81%) showed different levels of coarseness from the neighboring liver parenchyma: twenty three cases(64%) with increased coarseness and six cases(17%) with decreased coarseness. Hepatomegaly was observed in twenty eight cases(78%), especially in the involving lobes or segments of the liver. Portal venous thrombosis was detected in thirty cases(83%), and eighteen (50% ) of them had color Doppler signal in their thrombi. CONCLUSION: When there are areas with a high echogenicity in contrast to the normal parenchyma, areas with different echotexture, hepatomegaly in spite of underlying LC, and the presence of portal venous thrombosis with color Doppler signals, a possibility of diffuse HCC should be taken into consideration on the initial ultrasonography of patients with LC.
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