Early hemodynamics of hepatocellular carcinoma using contrast-enhanced ultrasound with Sonazoid: focus on the pure arterial and early portal phases

DOI Web Site 参考文献23件
  • Saito Akiko
    Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan.
  • Yamamoto Masakazu
    Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
  • Katagiri Satoshi
    Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
  • Yamashita Shingo
    Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
  • Nakano Masayuki
    Tokyo Central Pathology Laboratory Co., LTD, Tokyo, Japan.
  • Morizane Toshio
    Japan Council for Quality Health Care, Tokyo, Japan.

この論文をさがす

抄録

<p>To clarify the early hemodynamics of hepatocellular carcinoma (HCC), we defined the early portal phase of contrast-enhanced ultrasound (CEUS) and examined the reliability of this modality for determining HCC differentiation. Starting in 2007, we performed Sonazoid CEUS in 146 pathologically confirmed hepatic nodules; 118 HCC (8 poorly [Pd], 73 moderately [Md] and 37 well-differentiated [Wd]) and 28 benign nodules. We focused on the pure arterial and early portal phases up to 45 seconds after Sonazoid injection, and then the subsequent phase up to 30 minutes. We calculated covariance-adjusted sensitivities for nodule enhancement combinations of these three phases. Nodule enhancements were divided into hypo, iso and hyper. A positive predictive value of 100% was obtained for the following patterns: iso-iso-hypo, hypo-iso-iso, and hypo-hypo-hypo for Wd, hyper-iso-hypo and hyper-hypo-hypo for Md, hypo-hyper-hypo for Pd, and hyper-hyper-hyper for benign nodules. In Wd HCC (early HCC), there were seven enhancement patterns, thought to be characterized by various hemodynamic changes from early to advanced HCC. Two patterns allowing a diagnosis of Wd HCC were hypo in the pure arterial phase. Subsequent iso-enhancement in the early portal phase indicated a portal blood supply. Decreased enhancement in the early portal phase allows a diagnosis of Md HCC. However, gradual enhancement observed from the pure arterial to the early portal phase allows a diagnosis of Pd HCC. Therefore, even in the early portal phase, hemodynamic changes were visible not only in Wd but also in Md and Pd HCC. In conclusion, with division of the early phase hemodynamics into pure arterial and early portal phases, CEUS can provide information useful for determining the likely degree of HCC differentiation and for distinguishing early stage HCC from benign nodules.</p>

収録刊行物

  • Global Health & Medicine

    Global Health & Medicine 2 (5), 319-327, 2020-10-31

    国立研究開発法人 国立国際医療研究センター

参考文献 (23)*注記

もっと見る

キーワード

詳細情報 詳細情報について

問題の指摘

ページトップへ