Mei Q, Yu M, Chen Q. Clinical value of contrast-enhanced ultrasound in early diagnosis of small hepatocellular carcinoma (≤ 2 cm). World J Clin Cases 2022; 10(24): 8525-8534 [PMID: 36157793 DOI: 10.12998/wjcc.v10.i24.8525]
Corresponding Author of This Article
Qiong Chen, MSc, Chief Doctor, Department of Radiology, Shanghai Xuhui Dahua Hospital, No. 901 Old Humin Road, Xuhui District, Shanghai 200237, China. cq1444@sina.com
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Retrospective Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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Mei Q, Yu M, Chen Q. Clinical value of contrast-enhanced ultrasound in early diagnosis of small hepatocellular carcinoma (≤ 2 cm). World J Clin Cases 2022; 10(24): 8525-8534 [PMID: 36157793 DOI: 10.12998/wjcc.v10.i24.8525]
World J Clin Cases. Aug 26, 2022; 10(24): 8525-8534 Published online Aug 26, 2022. doi: 10.12998/wjcc.v10.i24.8525
Clinical value of contrast-enhanced ultrasound in early diagnosis of small hepatocellular carcinoma (≤ 2 cm)
Qi Mei, Mei Yu, Qiong Chen
Qi Mei, Mei Yu, Department of Ultrasound, Shanghai Xuhui Dahua Hospital, Shanghai 200237, China
Qiong Chen, Department of Radiology, Shanghai Xuhui Dahua Hospital, Shanghai 200237, China
Author contributions: Mei Q and Yu M contributed equally to this study; Chen Q designed the research study; Yu M performed the research; Yu M contributed new reagents and analytic tools; Mei Q analyzed the data and wrote the manuscript; all authors have read and approved the final manuscript.
Supported byNational Natural Science Foundation of China, No. 81571675; Academic Experience and Research Workshop Construction Project of Shanghai Famous TCM Doctors, No. JCZYGZS-008; and Clinical Study on Control and Clearance of Hepatitis B Surface Antigen by Traditional Chinese Medicine, No. 1340190290A.
Institutional review board statement: The study was reviewed and approved by the Dahua Hospital of Xuhui District Institutional Review Board (No. 201607).
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: Dr. Chen reports non-financial support from National Natural Science Foundation of China, personal fees from the Academic Experience and Research Workshop Construction Project of Shanghai Famous TCM Doctors, personal fees from the Clinical Study on Control and Clearance of Hepatitis B Surface Antigen by Traditional Chinese Medicine, during the conduct of the study.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at cq1444@sina.com.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qiong Chen, MSc, Chief Doctor, Department of Radiology, Shanghai Xuhui Dahua Hospital, No. 901 Old Humin Road, Xuhui District, Shanghai 200237, China. cq1444@sina.com
Received: February 19, 2022 Peer-review started: February 19, 2022 First decision: April 19, 2022 Revised: May 10, 2022 Accepted: July 16, 2022 Article in press: July 16, 2022 Published online: August 26, 2022 Processing time: 177 Days and 20.7 Hours
Abstract
BACKGROUND
Hepatocellular carcinoma (HCC) is the most common type of primary liver malignancy. Contrast-enhanced ultrasound (CEUS) uses contrast microbubbles during ultrasound, allowing the detection and characterization of malignant focal liver lesions with much higher diagnostic accuracy than conventional ultrasound; however, there are few reports focusing on the pattern of enhancement of CEUS for the diagnosis of HCC smaller than 2 cm.
AIM
To investigate the clinical value of CEUS in the early detection of small HCC with high risk factors.
METHODS
A total of 395 patients with 632 nodules at high risk of HCC, who underwent regular follow-up at Xuhui Dahua Hospital from January 2007 to December 2021, were retrospectively examined. Conventional ultrasonography combined with CEUS was adopted to analyze the echo, size, location, and enhancement characteristics of benign and malignant nodules, as well as the enhancement methods for HCC with different diameters.
RESULTS
The follow-up rate and duration were 92.15% (364/395) and 51.28 ± 45.09 mo, respectively. Conventional ultrasonography combined with CEUS revealed 65 (11.80%) nodules with a follow-up diagnosis of HCC, 19 (3.45%) dysplastic nodules, and 467 (84.75%) benign cirrhotic hyperplastic nodules. Among 65 cases of confirmed HCC, 40 (61.54%) were transformed from hypoechoic nodules, 9 (13.85%) from hyperechoic nodules, and the remaining 16 (24.62%) from isoechoic nodules. Significant differences in CEUS characteristics were found among cirrhotic nodules, dysplastic nodules, and HCC nodules at each phase. Significant differences in the enhancement mode were observed between nodules ≤ 1 cm and those 1–2 cm. The smaller the HCC nodule, the later the contrast agent began to flush and the longer the duration of contrast enhancement.
CONCLUSION
Conventional ultrasonography combined with CEUS could identify small HCC and help monitor patients with an early diagnosis of HCC. Significant differences in the enhancement mode are noted between nodules ≤ 1 cm and those 1–2 cm.
Core Tip: Conventional ultrasonography combined with contrast-enhanced ultrasound is a feasible way to identify small hepatocellular carcinoma (HCC) and help monitor patients with small HCC. There are significant differences between the liver nodules ≤ 1 cm and those in the range 1-2 cm regarding enhancement mode.
