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, MDa, Qian Zhang, MDa, Qing Yan, MDa, Jufang Wang, MDa, Qingqing Dong, MDa, Zhaojun Li, MDa,*()   

  1. 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

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