Skip to main content
SpringerLink
Log in
Book cover

Liver Malignancies pp 47–70Cite as

Ultrasound and Doppler Ultrasound of Hepatocellular Carcinoma

  • Chapter

  • 291 Accesses

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

Abstract

Despite the advancements of CT and MR imaging, ultrasonography (US) has continued to improve and to develop as well as to have enormous applications, implications, and importance in diagnostic imaging of the liver. While gray-scale imaging has improved significantly, so that the definition of subtle lesions only a few millimeters in size is now possible, recent years have seen the most exciting advances in Doppler US technology. The development of power Doppler imaging has substantially improved perception of tumor vascularity. The introduction of US contrast media in combination with harmonic imaging has even further enlarged the potential uses of this technique. This article explores the most recent advances in gray-scale and Doppler US of the liver, with emphasis on their clinical applications for the study of hepatocellular carcinoma (HCC). US currently plays a fundamental role in the diagnostic and therapeutic management of patients with HCC.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Albrecht T, Urbank A, Mahler M, et al (1998) Prolungation and optimization of Doppler enhancement with a microbubbles US contrast agent by using continuous infusion: preliminary experience. Radiology 207:339–347

    CAS  PubMed  Google Scholar 

  • Arakawa M, Kage M, Sugihara S, Nakashima T, Suenaga M, Okuda K (1986) Emergence of malignant lesions within an adenomatous hyperplastic nodule in a cirrhotic liver. Observations in five cases. Gastroenterology 91:198–208

    CAS  PubMed  Google Scholar 

  • Bartolozzi C, Lencioni R, Caramella D, Palla A, Bassi AM, Di Candio G (1995) Small hepatocellular carcinoma: detection with US, CT, MR imaging, DSA and Lipiodol-CT. Acta Radiol 37:69–74

    Google Scholar 

  • Bartolozzi C, Lencioni R, Paolicchi A, Moretti M, Armillotta N, Pinto F (1997) Differentation of hepatocellular adenoma and focal nodular hyperplasia of the liver: comparison of power Doppler imaging and conventional color Doppler sonography. Eur Radiol 7:1410–1415

    Article  CAS  PubMed  Google Scholar 

  • Bartolozzi C, Lencioni R, Ricci P, et al (1998) Hepatocellular carcinoma treatment with percutaneous ethanol injection: evaluation with contrast-enhaced color Doppler US. Radiology 209:387–393

    CAS  PubMed  Google Scholar 

  • Beasley RP, Hwang LY, Lin CC, Chien CS (1981) Hepatocellular carcinoma and hepatitis B virus. Lancet 2:1129–1133

    CAS  Google Scholar 

  • Bolondi L, Gaiani S, Gebel M (1998) Portohepatic vascular pathology and liver disease: diagnosis and monitoring. Eur J Ultrasound 7:41–52

    Article  Google Scholar 

  • Boultbee J (1979) Gray scale ultrasound in hepatocellular carcinoma. Clin Radiol 30:547–552

    Article  CAS  PubMed  Google Scholar 

  • Bruix J, Calvet X, Costa J, et al (1989) Prevalence of antibodies to hepatitis C virus in Spanish patients with hepatocellular carcinoma and hepatic cirrhosis. Lancet 2:1004–1006

    Article  CAS  PubMed  Google Scholar 

  • Bude RO, Rubin JM (1996) Power Doppler sonography. Radiology 200: 21–23

    CAS  PubMed  Google Scholar 

  • Buscarini L, Fornari F, Canaletti R, et al (1991) Diagnostic aspects and follow up of 174 cases od hepatocellular carcinoma: second report. Oncology 48:26–30

    Article  CAS  PubMed  Google Scholar 

  • Buscarini L, Di Stasi M, Buscarini E, et al (1996) Clinical presentation, diagnostic work-up and therapeutic choices in two consecutive series of patient with hepatocellular carcinoma. Oncology 53:204–209

    Article  CAS  PubMed  Google Scholar 

  • Calliada F, Campani R, Bottinelli O, Bozzini A, Sommaruga MG (1998) Ultrasound contrast agents: basic principles. Eur J Radial 27(5):157–160

    Article  Google Scholar 

  • Calvet X, Bruix J, Bru C, et al (1990) Natural history of hepatocellular carcinoma in Spain. Five year’s experience in 249 cases. J Hepatol 10:311–317

    Article  CAS  PubMed  Google Scholar 

  • Campani R, Bottinelli O, Calliada F, Coscia D (1998) The latest in ultrasound: three-dimensional imaging. Eur J Radiol 27(5):183–187

    Article  Google Scholar 

  • Catalano O, Cusati B, Esposito M, Trivellini V, Lobianco R, Siani A (1998) The correlation between Doppler echography with a contrast medium and CT in the study of a hepatocarcinoma submitted to chemoembolization. Radiol Med (Torino) 95:608–613

    CAS  Google Scholar 

  • Choi BI, Park JH, Kim BH, Kim SH, Han MC, Kim CW (1989a) Small hepatocellular carcinoma: detection with sonography, computed tomography (CT), angiography and Lipiodol-CT. Br J Radiol 62:897–903

    Article  CAS  Google Scholar 

  • Choi BI, Kim CW, Ham MC, et al (1989b) Sonographic characteristics of small hepatocellular carcinoma. Gastrointest Radiol 14:255–261

    Article  CAS  Google Scholar 

  • Choi BI, Takayasu K, Han MC (1993) Small hepatocellular carcinomas and associated nodular lesion of the liver. Paythology, pathogenesis, and imaging findings. AIR 160:1177–1187

    CAS  Google Scholar 

  • Choi BI, Kim TK, Han JK, et al (1996) Power versus conventional color Doppler sonography: comparison in the depiction of vasculature in liver tumors. Radiology 200:55–58

    CAS  PubMed  Google Scholar 

  • Colombo M, De Franchis R, Del Ninno E, et al (1991) Hepatocellular carcinoma in Italian patient with cirrhosis. N Engl J Med 325:675–680

    Article  CAS  Google Scholar 

  • Cottone M, Maceno MP, Maringhini A, et al (1983) Ultrasound in the diagnosis of hepatocellular carcinoma associated with cirrhosis. Radiology 147:517–519

    CAS  PubMed  Google Scholar 

  • Cottone M, Vordone R, Fusco G, et al (1989) Asymptomatic hepatocellular carcinoma in Child’s A cirrhosis. A comparison of natural history and surgical treatment. Gastroenterology 96:1566–1571

    CAS  PubMed  Google Scholar 

  • Dodd GD, Miller WJ, Baron RL, Skoinick ML, Campbell WL (1992) Detection of malignant tumors in end-stage cirrhotic livers: efficacy of sonography as a screening technique. AJR 159:727–733

    PubMed  Google Scholar 

  • Dodd GD, Memel BS, Baron RL, Eichner L, Santiguida LA (1995) Portal vein thrombosis in patient with cirrhosis: does sonographic detection of intrathrombus flow alllow differentiation of benign and malignant thrombus? AJR 165:573–577

    PubMed  Google Scholar 

  • Ebara M, Ohto M, Shinagawa T, et al (1986) Natural history of minute hepatocellular carcinoma smaller than three centimeters complicating cirrhosis. A study in 22 patients. Gastroenterology 90:289–298

    CAS  PubMed  Google Scholar 

  • Edmondson HA, Steiner PA (1954) Primary carcinoma of the liver. Cancer 7:462–471

    Article  CAS  PubMed  Google Scholar 

  • Forsberg F, Merton DA, Liu JB, Needleman L, Goldberg BB (1998) Clinical applications of ultrasound contrast agents. Ultrasonics 36:695–701

    Article  CAS  PubMed  Google Scholar 

  • Freeman MP, Vick CW, Taylor KJW, Carithers RL, Brewer WH (1986) Regenerating nodules in cirrhosis: appearance with anatomic correlation. AIR 146:533–536

    CAS  Google Scholar 

  • Fujimoto M, Moriyasu F, Nishikawa K, et al (1994) Color Doppler sonography of hepatic tumors with a galactose-based contrast agent. Correlation with angiographic findings. AIR 163:1099–1104

    CAS  Google Scholar 

  • Garbagnati F, Spreafico D, Marchianò A, Salvetti M, Segura C, Piragine G (1991) Staging of hepatocellular carcinoma by ultrasonography, computed tomography, and angiography: the role of CT combined with arterial pertography. Gastrointest Radiol 16:225–228

    Article  CAS  PubMed  Google Scholar 

  • Hayashi N, Yamamoto K, Tamaki N, et al (1987) Metastatic nodules of hepatocellular carcinoma: detection with angiography, CT, and US. Radiology 165:61–63

    CAS  PubMed  Google Scholar 

  • Honda H, Onitsuka H, Murakami J, et al (1992) Characteristic findings of hepatocellular carcinoma: an evaluation with compatative study of US, CT, and MRI. Gastrointest Radiol 17:245–249

    Article  CAS  PubMed  Google Scholar 

  • Ikeda K, Saitoh S, Koida I, et al (1994) Imaging diagnosis of small hepatocellular carcinoma. Hepatology 20:82–87

    Article  CAS  PubMed  Google Scholar 

  • Jackson VP, Martin-Simmerman P, Becker GJ, Holden RW (1983) Real-time ultrasonographic demonstration of vascular invasion by hepatocellular carcinoma. I Ultrasound Med 2:277–280

    CAS  Google Scholar 

  • Kabayashi K, Sugimoto T, Makino H, et a1 (1985) Screening methods for early detection of hepatocellular carcinoma. Hepatology 5:1100–1105

    Article  Google Scholar 

  • Kamin PD, Bernardino ME, Green B (1979) Ultrasound manifestations of hepatocellular carcinoma. Radiology 131:459–461

    CAS  PubMed  Google Scholar 

  • Kanno T, Kurioka N, Kim S, et al (1989) Implications of hypoechoic lesions in small hepatocellular carcinoma. Gastroenterol Jpn 24:528–534

    CAS  PubMed  Google Scholar 

  • Kawasaki H, Sakaguchi S, Irisa T, Hirayama C (1978) Value of B-scan ultrasonography in the diagnosis of lives cancer. Am I Gastroenter 69:436–442

    CAS  Google Scholar 

  • Kim AY, Choi BI, Han JK et al (1998) Hepatocellular carcinoma: power Doppler US with a contrast-agent-preliminary results. Radiology 209:135–140

    CAS  PubMed  Google Scholar 

  • Laudy JA, Janssen MM, Struyk PC, Stijnen T, Wallenberg HC, Wladimiroff JW (1998) Fetal liver volume measurement by three-dimensional ultrasonography: a preliminary study. Ultrasound Obstet Gynecol 12:93–96

    Article  CAS  PubMed  Google Scholar 

  • Lencioni R, Caramella D, Bartolozzi C, Di Coscio G (1994) Long term follow-up study of adenomatous hyperplasia in liver cirrhosis. Ital J Gastroenterol 26:163–168

    CAS  PubMed  Google Scholar 

  • Lencioni R, Caramella D, Sanguinetti F, Battolla L, Falaschi F, Bartolozzi C (1995) Portal vein thrombosis after percutaneous ethanol injection for hepatocellular carcinoma: value of color Doppler sonography in distinguishing chemical and tumor thrombi. AIR 164:1125–1130

    CAS  Google Scholar 

  • Lencioni R, Mascalchi M, Caramella D, Bartolozzi C (1996a) Small hepatocellular carcinoma: differentiation from adenomatous hyperplasia with color doppler US and dynamic Gd-DTPA-enhanced MR imaging. Abdom Imaging 21: 41–48

    Article  CAS  Google Scholar 

  • Lencioni R, Pinto F, Armillotta N, Bartolozzi C (1996b) Assessment of tumor vascularity in hepatocellular carcinoma: comparison of power Doppler US and color Doppler US. Radiology 201:353–358

    CAS  Google Scholar 

  • Lencioni R, Cioni D, Donati F, Bartolozzi C (1999) Contrast-enhancement pattern in harmonic power Doppler imaging: value in characterization of hepatic tumors. Radiographics (in press)

    Google Scholar 

  • Mathieu D, Guinet C, Bouklia-Hassane A, Vasile N (1988) Hepatic vein involvement in hepatocellular carcinoma. Gastrointest Radiol 13:55–60

    Article  CAS  PubMed  Google Scholar 

  • Matsui O, Kadoya M, Kameyana T, et a1 (1991) Benign and malignant nodules in cirrhotic livers. Distinction based Ultrasound and Doppler Ultrasound of Hepatocellular Carcinoma 69 on blood supply. Radiology 178:493–497

    CAS  PubMed  Google Scholar 

  • Melato M, Laurino L, Much E, Valente M, Okuda K (1989) Relationship between cirrhosis, liver cancer, and hepatic metastases. An autopsy study. Cancer 64:455–459

    Article  CAS  PubMed  Google Scholar 

  • Nino-Murcia M, Rails PW, Jeffrey RB, et al (1992) Color flow Doppler characterization of focal hepatic lesions. AIR 159:1195–1197

    CAS  Google Scholar 

  • Numata K, Tanaka K, Mitsui K, Morimoto M, Inoue S, Yonezawa H (1993) Flow characteristics of hepatic tumors at color Doppler sonography: correlation with arteriographic findings. AIR 160:515–521

    CAS  Google Scholar 

  • Numata K, Tanaka K, Kiba T, et al (1997) Use of hepatic tumor index on color Doppler sonography for differentiating large hepatic tumors. AIR 168:991–995

    CAS  Google Scholar 

  • Ohnishi K, Nomura F(1989) Ultrasonic Doppler studies of hepatocellular carcinoma and comparison with other hepatic focal lesions. Gastroenterology 97:1489–1497

    CAS  PubMed  Google Scholar 

  • Oka H, Kurioka M, Kim K, et al (1990) Prospective study of early detection of hepatocellular carcinoma in patients with cirrhosis. Hepatology 12:680–687

    Article  CAS  PubMed  Google Scholar 

  • Okuda K (1986) Early recognition of hepatocellular carcinoma. Hepatology 6:729–738

    Article  CAS  PubMed  Google Scholar 

  • Okuda K, Musha H, Yoshida T, et al (1975) Demonstration of growing casts of hepatocellular carcinoma in the portal vein by celiac angiography: the tread and streaks sign. Radiology 117:303–309

    CAS  PubMed  Google Scholar 

  • Okuda K, Musha H, Nakajima J, et al (1977) Clinicopathologic features of encapsulated hepatocellular carcinoma: a study of 26 cases. Cancer 40:1240–1245

    Article  CAS  PubMed  Google Scholar 

  • Okuda K, Ohtsuki T, Obata H, et al (1985) Natural history of hepatocellular carcinoma and prognosis in relation to treatment: study of 850 patients. Cancer 56:918–928

    Article  CAS  PubMed  Google Scholar 

  • Pateron D, Gonne N, Trinchet J, et al (1994) Prospective study of screening of hepatocellular carcinoma in caucasian patients with cirrhosis. J Hepatol 20:65–71

    Article  CAS  PubMed  Google Scholar 

  • Reinhold C, Hammers L, Taylor CR, Quedes-Case CL, Holland CK, Taylor KJW (1995) Characterization of focal hepatic lesions with duplex sonography: findings in 198 patients. AJR 164:1131–1135

    CAS  PubMed  Google Scholar 

  • Ricca Rosellini S, Arienti V, Nanni O, et al (1992) Hepatocellular carcinoma. Prognostic factors and survival analysis in 135 italian patients. J Hepatol 16:66–72

    Google Scholar 

  • Ros PR, Murphy BJ, Buck IL, Olmedilla G, Goodman Z (1990) Encapsulated hepatocellular carcinoma: radiologic findings and pathologic correlation. Gastrointest Radiol 15:233–237

    Article  CAS  PubMed  Google Scholar 

  • Rubin JM, Bude RO, Carson PL, Bree RL, Adler RS (1994) Power Doppler US: A potentiallly useful alternative to mean frequency-based color Doppler US. Radiology 190:853–856

    CAS  PubMed  Google Scholar 

  • Sakaguchi S, Tohara K, Oka Y (1992) Ultrasonographic diagnosis of hepatocellular carcinoma. In: Tobe T, Kameda H, Okudaira M, et al (eds) Primary liver cancer in Japan. Springer-Verlag, Tokyo, p 115

    Google Scholar 

  • Schwarz K, Chen X, Steinmetz S, Phillips D (1997) Harmonic imaging with Levovist.J Am Soc Echocardiogr 10:1–10

    Article  CAS  PubMed  Google Scholar 

  • Shankar P, Dala Krishna P, Newhouse VL (1998) Advantages of subharmonic over second harmonic backscatter for contrast-to-tissue echo enhancement. Ultrasound Med Biol 24:395–399

    Article  CAS  PubMed  Google Scholar 

  • Sheu JC, Chen DS, Sung JL, et al (1985a) Hepatocellular carcinoma: US evolution in the early stage. Radiology 155:463–467

    CAS  Google Scholar 

  • Sheu IC, Sung IL, Chen DS, et al (1985b) Growth rate of asymptomatic hepatocellular carcinoma and its clinical implications. Gastroenterology 89:259–266

    CAS  Google Scholar 

  • Shimamoto K, Sakuma S, Ishigaki T, Makino M (1987) Intratumoral blood flow: evaluation with color Doppler echography. Radiology 165:683–685

    CAS  PubMed  Google Scholar 

  • Shimamoto K, Sakuma S, Ishigaki T, et al (1992) Hepatocellular carcinoma: evaluation with color Doppler US and MR imaging. Radiology 182:149–153

    CAS  PubMed  Google Scholar 

  • Shinagawa T, Ohto M, Kimura K, et al (1984) Diagnosis and clinical features of small hepatocellular carcinoma with emphasis on the utility of realtime ultrasonography. A study of 51 patients. Gastroenterology 86:495–502

    CAS  PubMed  Google Scholar 

  • Subramanyam BR, Balthazar EJ, Hilton S, Lefleur RS, Horii SC, Raghavendra BN (1984) Hepatocellular carcinoma with venous invasion. Sonographic-angiographic correlation. Radiology 150:793–796

    CAS  PubMed  Google Scholar 

  • Takano S, Yokosuka O, Imazeki F, et al (1995) Incidence of hepatocellular carcinoma in chronic hepatitis B and C. A prospective study of 251 patients. Hepatology 21:650–655

    Article  CAS  PubMed  Google Scholar 

  • Takayasu K, Moriyama N, Muramatsu Y, et al (1990) The diagnosis of small hepatocellular carcinomas: efficacy of various imaging procedures in 100 patients. AJR 155:49–54

    CAS  PubMed  Google Scholar 

  • Tanaka S, Kitamura T, Imaoka S, Sasaki Y, Taniguchi H, Ishiguro S (1983) Hepatocellular carcinoma: sonographic and histologic correlation. AIR 140:701–707

    CAS  Google Scholar 

  • Tanaka S, Kitamura T, Ahshima A, et al (1986) Diagnostic accuracy of ultrasonography for hepatocellular carcinoma. Cancer 58:344–347

    Article  CAS  PubMed  Google Scholar 

  • Tanaka S, Kitamura T, Nakanishi K, Okuda S, Kojima I, Fujimoto I (1989) Recent advances in ultrasonographic diagnosis of hepatocellular carcinoma. Cancer 63:1313–1317

    Article  CAS  PubMed  Google Scholar 

  • Tanaka S, Kitamura T, Nakanishi K, et al (1990a) Effectiveness of periodic checkup by ultrasonography for the early diagnosis of hepatocellular carcinoma. Cancer 66:2210–2214

    Article  CAS  Google Scholar 

  • Tanaka S, Kitamura T, Fujita M, et al (1990b) Color Doppler flow imaging of liver tumors. AIR 143:509–514

    Google Scholar 

  • Tanaka S, Kitamura T, Fujita M, et al (1992) Small hepatocellular carcinoma. Differentation from adenomatous hyper-plastic nodule with color Doppler flow imaging. Radiology 182:161–165

    CAS  PubMed  Google Scholar 

  • Tanaka S, Kitamura T, Fujita M, Yoshioka F (1998) Value of contrast-enhanced color Doppler sonography in diagnosing hepatocellular carcinoma with special attention to the „color-filled pattern“.J Clin Ultrasound 26:207–212

    Article  CAS  PubMed  Google Scholar 

  • Tano S, Ueno N, Toliyama T, et al (1997) Possibility of differentiating small hyperechoic liver tumors using contrast-enhanced color Doppler ultrasonography: a preliminary study. Clin Radiol 52:41–45

    Article  CAS  PubMed  Google Scholar 

  • Taylor KJW, Ramos I, Morse SS, et al (1987) Focal liver masses. Differential diagnosis with pulsed Doppler US. Radiology 164:643–647

    CAS  PubMed  Google Scholar 

  • Thomas J, Rubin DN (1998) Tissue harmonic imaging: why does it work? J Am Soc Echocardiogr 11:803–808

    Article  CAS  PubMed  Google Scholar 

  • Trevisani F, D’Intino PE, Caraceni P, et al (1995) Etiologic factors and clinical presentation of hepatocellular carcinoma. Differences between cirrhotic and noncirrhotic Italian patient. Cancer 75:2220–2232

    Article  CAS  PubMed  Google Scholar 

  • Wernecke K, Henke L, Vassallo P, et al (1992) Pathologic explanation for hypoechoic halo seen on sonograms of malignant liver tumors: an in vitro correlative study. AIR 159:1011–1016

    CAS  Google Scholar 

  • Yashura K, Kimuram K, Ohto M, et a1 (1988) Pulsed Doppler in the diagnosis of small liver tumors. Br J Radiology 61:898–902

    Article  Google Scholar 

  • Yoshida T, Matsue H, Okazaki MD, Yoshino M (1987) Ultrasonographic differentiation of hepatocellular carcinoma from metastatic liver cancer. J Clin Ultrasound 15:431–437

    Article  CAS  PubMed  Google Scholar 

  • Yoshikawa J, Matsui O, Takashima T, et al (1988) Fatty metamorphosis in hepatocellular carcinoma: radiologic features in 10 cases. AJR 151:717–720

    CAS  PubMed  Google Scholar 

  • Yuki K, Hirohashi S, Sakamoto M, Kanai T, Shimosato Y (1990) Growth and spread of hepatocellular carcinoma. A review of 240 consecutive autopsy cases. Cancer 66:21742179

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Diagnostic and Interventional Radiology, Department of Oncology, University of Pisa, Via Roma 67, I-56125, Pisa, Italy

    R. Lencioni MD

  2. Department of Radiology, Hôpital Beaujon, 100 Bd. du Général Leclerc, I-92118, Clichy, France

    Y. Menu MD (Professor and Chairman)

Authors
  1. R. Lencioni MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Y. Menu MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Division of Diagnostic and Interventional Radiology, Department of Oncology, University of Pisa, Via Roma 67, I-56125, Pisa, Italy

    C. Bartolozzi MD (Professor and Chairman) & R. Lencioni MD (Professor and Chairman) & 

Rights and permissions

Reprints and permissions

Copyright information

© 1999 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Lencioni, R., Menu, Y. (1999). Ultrasound and Doppler Ultrasound of Hepatocellular Carcinoma. In: Bartolozzi, C., Lencioni, R. (eds) Liver Malignancies. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-58641-5_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-58641-5_5

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-63679-0

  • Online ISBN: 978-3-642-58641-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation