Sonographic Findings of Hepatocellular Carcinoma Detected in Ultrasound Surveillance of Cirrhotic Patients
Nittaya Chamadol MD*, Kulyada Somsap MD*, Vallop Laopaiboon MD*, Wattana Sukeepaisarnjaroen MD**
Affiliation : * Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand ** Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Background : Hepatocellular carcinoma (HCC) is associated with high mortality. Patients with hepatitis B or C viral
cirrhosis have an increased risk of developing HCC. Ultrasound is the most widely used screening method, and is
recommended by many guidelines.
Objective : To study the sonographic findings of HCC detected in ultrasound surveillance of cirrhotic patients.
Material and Method: Retrospective assessment of ultrasound findings of all nodules that were diagnosed HCC by either
dynamic imaging (CT or MRI) or biopsy between October 2008 and July 2011. Nodules were classified based on echogenicity
and other sonographic characteristics.
Results : Of 92 nodules, 42 (45.7%) were hyperechoic, 29 (31.5%) hypoechoic, 20 (21.7%) heterogeneous echoic and 1
(1.1%) isoechoic. Heteroechoic nodules were more common among nodules over 3.0 cm (p = 0.0037) while hypoechoic
nodules tended to be the smaller ones. About half (48/92) of the nodules had a hypoechoic halo and occurred significantly
more commonly among hyperechoic and heteroechoic nodules (p<0.001). Posterior enhancement was found in 54 nodules
(58.7%), also more common in nodules >3.0 cm (p = 018). Lateral shadowing occurred in 40 nodules (43.5%).
Conclusion : The sonographic findings of HCC nodules in the present studies varied, but the prevalence of hyperechoic
nodules was higher than in most of other studies. The authors emphasize the necessity of performing dynamic imaging for
any nodule detected in a cirrhotic liver in order to exclude their neoplastic nature, no matter what it may look like.
Keywords : Sonographic finding, HCC surveillance
