ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY >

2017 , Vol. 1 >Issue 1: 15 - 18

DOI: https://doi.org/10.37015/AUDT.2017.170003

Case Reports

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

  • Luo, MD Xianghong ,
  • Zhang, MD Qian ,
  • Yan, MD Qing ,
  • Wang, MD Jufang ,
  • Dong, MD Qingqing ,
  • Li, MD Zhaojun
Expand
  • 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 date: 2017-10-07

  Revised date: 2020-10-27

  Online published: 2018-07-23

Fold

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

Cite this article

Luo, MD Xianghong , Zhang, MD Qian , Yan, MD Qing , Wang, MD Jufang , Dong, MD Qingqing , Li, MD Zhaojun . Diagnosis with Echocardiography for Rare Cases of Anomalous Left Main Coronary Artery: Two Case Reports and Important Lessons Learned[J]. ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY, 2017 , 1(1) : 15 -18 . DOI: 10.37015/AUDT.2017.170003

References

[1] Villa AD, Sammut E, Nair A, Rajani R, Bonamini R, Chiribiri A. Coronary artery anomalies overview: The normal and the abnormal. World J Radiol 2016 Jun 28; 8:537-555.
[2] Chen YA, Nguyen ET, Dennie C, Wald RM, Crean AM, Yoo SJ, et al. Computed tomography and magnetic resonance imaging of the coronary sinus: anatomic variants and congenital anomalies. Insights Imaging 2014 Oct; 5:547-557.
[3] Tsoutsinos A, Mitropoulos F, Trapali C, Papagiannis J. Anomalous origin of the left coronary artery from the pulmonary artery associated with an accessory atrioventricular pathway and managed successfully with surgical and interventional electrophysiological treatment: a case report. J Med Case Rep 2011 Aug 16; 5:384.
[4] Graidis C, Dimitriadis D, Karasavvidis V, Dimitriadis G, Argyropoulou E, Economou F, et al. Prevalence and characteristics of coronary artery anomalies in an adult population undergoing multidetector-row computed tomography for the evaluation of coronary artery disease. BMC Cardiovasc Disord 2015 Oct 2; 15:112.
Options
Outlines

/

〈 〉

Content
For Authors
For Reviewers
Article Category
Publisher Policies
About
Top 10 Rankings

Share: WeChat

Copyright ©2018 Advanced Ultrasound in Diagnosis and Therapy

|

Creative Commons License Advanced Ultrasound in Diagnosis and Therapy (AUDT)  is licensed under a Creative Commons Attribution 4.0 International License.