Background
Methods
Patient population and clinical information
US scan
CEUS image analysis
CT scan
Categorization of enhancement patterns at CT
Statistical analysis
Results
Clinicopathologic features
Number (%) | Mean ± SD | Median (range) | |
---|---|---|---|
Age (year) | 52.8 ± 10.4 | 51.5 (28–74) | |
Male/female | 40/5 | ||
AFP (ng/ml) | 680.8 ± 1700.2 | 68.6 (1.02–9675) | |
≤ 20 | 17 (37.8) | ||
21–200 | 15 (33.3) | ||
> 200 | 13 (28.9) | ||
Underling liver disease | |||
Cirrhosis | 30 (66.7) | ||
Chronic hepatitis B | 4 (8.9) | ||
Chronic hepatitis C | |||
Alcoholic | 3 (6.7) | ||
Chronic hepatitis B and alcoholic | 5 (11.1) | ||
No evidence of chronic liver disease | 3 (6.7) | ||
Nodule size (cm) | 5.3 ± 3.2 | 4.5 (1.5–13.8) | |
< 5 cm | 24 (53.3) | ||
5–10 cm | 15 (33.3) | ||
> 10 cm | 6 (13.3) | ||
Number of nodules | |||
Single | 38 (84.4) | ||
Two | 6 (13.3) | ||
More than three | 1 (2.2) | ||
Location of nodules | |||
Left lobe | 8 (17.8) | ||
Right lobe | 31 (68.9) | ||
Both left and right lobe | 3 (6.7) | ||
Caudate lobe | 3 (6.7) | ||
Echogenicity of nodules | |||
Hypoechoic | 23 (51.1) | ||
Isoechoic | 2 (4.4) | ||
Hyperechoic | 12 (26.7) | ||
Mixed | 8 (17.8) |
Radiological features
Enhancement appearance | Number % |
---|---|
Arterial phase | |
Peripheral hyperenhancement | 9 (20.0) |
Heterogeneous hyperenhancemen | 22 (48.9) |
Homogeneous hyperenhancement | 13 (28.9) |
Hypoenhancement | 1 (0.2) |
Isoenhancement | 0 (0) |
Portal phase | |
Peripheral hyperenhancement | |
Heterogeneous hyperenhancement | 1 (0.2) |
Homogeneous hyperenhancement | 0 (0) |
Slight hypoenhancement | 17 (37.8) |
Marked hypoenhancement | 25 (55.6) |
Isoenhancement | 2 (0.4) |
Delayed phase | |
Peripheral hyperenhancement | |
Heterogeneous hyperenhancement | 1 (0.2) |
Homogeneous hyperenhancement | |
Slight hypoenhancement | 8 (17.8) |
Marked hypoenhancement | 35 (77.8) |
Isoenhancement | 1 (0.2) |
Emergence of-washout | |
< 60 seconds | 28 (62.2) |
60–120 seconds | 13 (28.9) |
> 120 seconds | 2 (4.4) |
No washout | 2 (4.4) |
Arterial phase | Portal phase | Delayed phase | |
---|---|---|---|
Peripherally hyperdense No.(%) | 12 (27.9) | 13 (30.2) | 7 (16.3) |
Partially hyperdense No.(%) | 24 (55.8) | 5 (11.6) | 6 (13.9) |
Globally hyperdense No.(%) | 2 (0.5) | ||
Isodense No.(%) | 1 (0.2) | ||
Hypodense No.(%) | 5 (11.6) | 25 (58.1) | 29 (67.4) |
Correlations of AFP and CA19-9 levels with enhancement patterns on CEUS and CT
CEUS pattern (n = 45) | CT pattern (n = 43) | |||||
---|---|---|---|---|---|---|
CC | HCC | indeterminate | CC | HCC | indeterminate | |
AFP normal | 10 | 7 | 5 | 9 | 3 | |
AFP elevated | 14 | 12 | 2 | 8 | 16 | 2 |
CEUS pattern (n = 45) | CT pattern (n = 43) | |||||
---|---|---|---|---|---|---|
CC | HCC | indeterminate | CC | HCC | indeterminate | |
CA19-9 normal | 19 | 14 | 2 | 11 | 17 | 5 |
CA19-9 elevated | 5 | 5 | 2 | 8 |