Premium
Characterization of Early Hepatocellular Carcinoma and High‐Grade Dysplastic Nodules on Contrast‐Enhanced Ultrasound
Author(s) -
Fan Peili,
Xia Hansheng,
Ding Hong,
Dong Yi,
Chen Lingli,
Wang Wenping
Publication year - 2020
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.1002/jum.15288
Subject(s) - hccs , medicine , hepatocellular carcinoma , contrast enhanced ultrasound , cd34 , radiology , ultrasound , biopsy , pathology , carcinoma , genetics , stem cell , biology
Objectives To explore the enhancement features of early hepatocellular carcinoma (HCC, including well‐differentiated HCC and high‐grade dysplastic nodules with a focus of HCC) and high‐grade dysplastic nodules (HGDNs) on contrast‐enhanced ultrasound (CEUS), correlated with the histopathologic findings. Methods This retrospective study enrolled 81 patients with 85 pathologically confirmed hepatic lesions (69 early HCCs and 16 HGDNs). All of the hepatic lesions were examined by CEUS with SonoVue (Bracco SpA, Milan, Italy) before surgery or biopsy. The enhancement features of early HCCs and HGDNs were evaluated and compared with histopathologic findings. Results Thirty‐eight (55.1%) early HCCs showed arterial‐phase hyperenhancement (APHE). The major enhancement pattern of early HCCs was APHE without portal venous/late‐phase wash‐out (20 of 69 [29.0%]). Eight (11.6%) early HCCs manifested APHE. Wash‐out was observed in 30 (43.5%) early HCCs. Sixteen (23.2%) early HCCs showed very‐late wash‐out (>120 seconds). Wash‐out was not observed in all HGDNs. Of the 16 HGDNs, arterial‐phase isoenhancement without portal venous/late‐phase wash‐out was the major enhancement pattern (n = 7 [43.8%]). The degree of CD34 expression of sinusoidal endothelial cells was more diffuse in early HCCs than in HGDNs (56.5% versus 12.5%; P = .001). Arterial‐phase enhancement patterns of early HCCs on CEUS were correlated with the degree of CD34 expression ( P = .039). Conclusions Enhancement patterns were significantly different between early HCCs and HGDNs on CEUS. Diffuse CD34 expression of sinusoidal endothelial cells in early HCC was correlated with APHE on CEUS.