Chamadol Nittaya, Somsap Kulyada, Laopaiboon Vallop, Sukeepaisarnjaroen Wattana
Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
J Med Assoc Thai. 2013 Jul;96(7):829-38.
Hepatocellular carcinoma (HCC) is associated with high mortality. Patients with hepatitis B or C viral cirrhosis have an increased risk of developing HCC. Ultrasound is the most widely used screening method, and is recommended by many guidelines.
To study the sonographic findings ofHCC detected in ultrasound surveillance of cirrhotic patients.
Retrospective assessment of ultrasoundfindings of all nodules that were diagnosed HCC by either dynamic imaging (CTor MRI) or biopsy between October 2008 and July 2011. Nodules were classified based on echogenicity and other sonographic characteristics.
Of 92 nodules, 42 (45.7%) were hyperechoic, 29 (31.5%) hypoechoic, 20 (21.7%) heterogeneous echoic and 1 (1.1%) isoechoic. Heteroechoic nodules were more common among nodules over 3.0 cm (p = 0.0037) while hypoechoic nodules tended to be the smaller ones. About half (48/92) of the nodules had a hypoechoic halo and occurred significantly more commonly among hyperechoic and heteroechoic nodules (p< 0. 001). Posterior enhancement was found in 54 nodules (58. 7%0), also more common in nodules >3.0 cm (p = 018). Lateral shadowing occurred in 40 nodules (43.5%).
The sonographic findings of HCC nodules in the present studies varied, but the prevalence of hyperechoic nodules was higher than in most of other studies. The authors emphasize the necessity of performing dynamic imaging for any nodule detected in a cirrhotic liver in order to exclude their neoplastic nature, no matter what it may look like.
肝细胞癌（HCC）与高死亡率相关。乙型或丙型病毒性肝硬化患者发生HCC的风险增加。超声是应用最广泛的筛查方法，并且被许多指南推荐。
研究在肝硬化患者超声监测中检测到的HCC的超声表现。
回顾性评估2008年10月至2011年7月间通过动态成像（CT或MRI）或活检诊断为HCC的所有结节的超声表现。根据回声性和其他超声特征对结节进行分类。
92个结节中，42个（45.7%）为高回声，29个（31.5%）为低回声，20个（21.7%）为混合回声，1个（1.1%）为等回声。混合回声结节在直径大于3.0 cm的结节中更常见（p = 0.0037），而低回声结节往往较小。约一半（48/92）的结节有低回声晕，在高回声和混合回声结节中明显更常见（p<0.001）。54个结节（58.7%）发现后方增强，在直径>3.0 cm的结节中也更常见（p = 0.018）。40个结节（43.5%）出现侧方声影。
本研究中HCC结节的超声表现各异，但高回声结节的发生率高于大多数其他研究。作者强调，对于在肝硬化肝脏中检测到的任何结节，无论其外观如何，都有必要进行动态成像以排除其肿瘤性质。
