Diagnosis with Echocardiography for Rare Cases of Anomalous Left Main Coronary Artery: Two Case Reports and Important Lessons Learned

doi:10.37015/AUDT.2017.170003

Advanced Ultrasound in Diagnosis and Therapy ›› 2017, Vol. 1 ›› Issue (1): 15-18.doi: 10.37015/AUDT.2017.170003

• Case Reports • Previous Articles Next Articles

Diagnosis with Echocardiography for Rare Cases of Anomalous Left Main Coronary Artery: Two Case Reports and Important Lessons Learned

Xianghong Luo, MD^a, Qian Zhang, MD^a, Qing Yan, MD^a, Jufang Wang, MD^a, Qingqing Dong, MD^a, Zhaojun Li, MD^a^,^*()

^aDepartment of Echocardiography, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
^bDepartment of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Received:2017-10-07 Revised:2020-10-27 Online:2017-03-30 Published:2018-07-23
Contact: Zhaojun Li, MD, E-mail:lzj_1975@sina.com

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Abstract

Abstract:

Objective: To evaluate the clinical significance of contrast-enhanced ultrasound (CEUS) in the diagnosis of early hepatocellular carcinoma (HCC) in patients with liver cirrhosis and analyze the enhancement patterns of nodules.
Methods: One hundred seventy-six patients with a solitary tumor with size between 1.0 and 3.0cm were included in this study. The final diagnosis was confirmed by the histological results obtained from ultrasound-guided biopsy. According to the size, tumors were classified into the (1.0-2.0cm) group and the (2.0-3.0cm) group. The ROC curve was used to evaluate the clinical significance of CEUS in the diagnosis of early HCC with different size.
Results: A total of 176 nodules, including 127 HCC and 49 non-HCC were enrolled in this study. 85.8% (109/127) of HCC were hypervascular during arterial phase of CEUS. The proportions of hypervascular tumors of the1.0-2.0cm group and the 2.0-3.0cm group were 81.0% and 90.0%, respectively. 72.4% of HCC in the 1.0-2.0cm group showed hypervascularity in arterial phase and contrast wash-out in portal of delayed phase, while 88.4% of HCC in the 2.0-3.0cm group presented the aforementioned enhancement pattern (P = 0.022). 16 of 58 HCC with size of 1.0-2.0cm did not meet the image diagnosis criteria recommend by guideline.
Conclusion: CEUS are useful for the differential diagnosis of early HCC and dysplastic nodules in liver cirrhosis. Compared with the tumors with size of 2.0-3.0cm, fewer tumors with size of 1.0-2.0cm show enhancement patterns meeting the image diagnosis criteria. Thus, early HCC may be described by hypervascularity in arterial phase without wash-out in later phase.

Key words: Contrast enhanced ultrasound; liver cirrhosis; hepatocellular carcinoma; dysplastic nodules

Xianghong Luo, MD, Qian Zhang, MD, Qing Yan, MD, Jufang Wang, MD, Qingqing Dong, MD, Zhaojun Li, MD. Diagnosis with Echocardiography for Rare Cases of Anomalous Left Main Coronary Artery: Two Case Reports and Important Lessons Learned. Advanced Ultrasound in Diagnosis and Therapy, 2017, 1(1): 15-18.

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Diagnosis with Echocardiography for Rare Cases of Anomalous Left Main Coronary Artery: Two Case Reports and Important Lessons Learned

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