Contrast-enhanced ultrasonography: a recent application for the diagnosis and treatment of hepatocellular carcinoma.

Hepatocellular carcinoma has a decisive influence on the prognosis of cirrhotic patients, and the use of imaging modalities is essential for the screening, diagnosis and treatment of hepatocellular carcinoma. Ultrasound plays a major role among them, because it provides real-time and non-invasive observation by a simple and easy technique. In addition, ultrasound-guided needle puncture methods are frequently required for the diagnosis and/or treatment process of hepatocellular carcinoma. The development of digital technology has led to the detectability of blood flow by color Doppler ultrasound, and the sensitivity for tumor vascularity has shown remarkable improvement with the introduction of microbubble contrast agents. Moreover, near real-time three-dimensional ultrasound images are now available. These advancements in the ultrasound field have led to rapid progress in hepatocellular carcinoma management, and continuing advances are expected. This article reviews the current application of contrast-enhanced ultrasound for hepatocellular carcinoma in clinical practice.