Ultrasound‐guided treatments under low acoustic power contrast harmonic imaging for hepatocellular carcinomas undetected by B‐mode ultrasonography

• DOI: 10.1111/j.1478-3231.2008.01875.x
• Publication Date: 2009-04-07T14:23:36Z
• Authors: Hitoshi Maruyama; Masanori Takahashi; Hiroyuki Ishibashi; Hidehiro Okugawa; Shinichiro Okabe; Masaharu Yoshikawa; Osamu Yokosuka
• Keywords: Percutaneous ethanol injection; Mechanical index; Second-harmonic imaging microscopy

Abstract Background/Aims: The aim was to examine the efficacy of contrast‐enhanced ultrasound (US) with Sonazoid ™ demonstrate ultrasonically unrecognizable hypervascular hepatocellular carcinoma (HCC) and apply percutaneous US‐guided treatments. Methods: subjects this prospective study were 44 cirrhotic patients 55 lesions (12.7±4.5 mm) found by computed tomography but unrecognized non‐contrast US. Contrast‐enhanced US performed these hepatic after an intravenous injection (0.0075 ml/kg). sonograms in both early phase (for 1 min injection) late (5–10 after) taken harmonic imaging mode under a low mechanical index (0.24–0.3). Results: Fifty‐three demonstrated US, 52 positive enhancement negative phase. Percutaneous treatments successfully for 42 (ethanol 20 radiofrequency ablation 22) 32 reference findings. Six treated transarterial chemoembolization alone because they had more than three liver. In remaining seven six patients, diagnosed as non‐HCC lesions: five vascular abnormalities such arterioportal or arteriovenous communication other one benign lesion alcoholic liver disease. These HCC severe damage followed up without any treatment. Conclusions: As detectability improved , wider application may be possible.