| Objective:To discuss the clinical value of real-time gray scale contrast enhanced ultrasound in diagnosis and differential diagnosis of small hepatocellular carcinoma (SHCC).Methods:One hundred and forty three patients with one hundred and eighty eight focal hepatic lesions (FHLs)(diameter is less than 3cm) were examined with real-time gray scale contrast enhanced ultrasound (CEUS)after an intravenous administration of SonoVue, to analyze perfusion pattern and enhancement phases of hepatic lesions on ultrasound. As a result of which, hepatic arteriovenous transit times (HAVTT) of twenty eight patients with focal hepatic lesions were analysed by use of visual examination. The relationship between contrast enhanced ultrasound manifestations of 62 SHCCs and its histopathologic grading, size, expression of AFP, field of the hepatic liver parenchyma, elementary disease of liver can also be analysized.Results: Regarding perfusion pattern and enhancement pattern of CEUS as the ultrasonic diagnostic criterion of SHCC, the accuracy,sensitivity, speciality, positive predictive value and negative predictive value were 92.5﹪,91.8﹪,92.9﹪,86.2﹪and 95.9﹪, respectively. HAVTT was shorter in malignant focal hepatic lesion group than in benign focal hepatic lesion group (P<0.01). The study about the correlation of contrast enhanced ultrasound manifestations with histopathologic grading of 62 SHCCs, size, expression of AFP, field of the hepatic liver parenchyma, elementary disease of liver showed that histopathologic grading, field of the hepatic liver parenchyma and elementary disease of liver were related with contrast enhanced ultrasound manifestations of SHCCs.Conclusion:CEUS combined with HAVTT can significantly improve the pre-diagnosis of SHCC. Sufficiently considering impacts on CEUS manifestations of SHCCs by histopathologic grading and field of the hepatic liver parenchyma favors diagnosis and differential diagnosis of SHCC. However, as several aspects of factors indulge in this group, the consequence of hepatic elementary disease on CEUS manifestations of SHCC asks for further data accumulation and research. |
