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.