Department of Radiology, Thomas Jefferson University, 132 South 10th St, 796E Main Building, Philadelphia, PA, 19107, USA.
Department of Radiology, Northwestern University, Chicago, IL, USA.
Abdom Radiol (NY). 2021 Aug;46(8):3579-3595. doi: 10.1007/s00261-021-03059-y. Epub 2021 Apr 7.
Hepatocellular carcinoma (HCC) is a global problem constituting the second leading cause of cancer deaths worldwide, thereby necessitating an accurate and cost-effective solution for managing care. Ultrasound is well poised to address this need due to its low cost, portability, safety, and excellent temporal resolution. The role of ultrasound for HCC screening has been well established and supported by multiple international guidelines. Similarly, contrast-enhanced ultrasound (CEUS) can be used for the characterization of focal liver lesions in high-risk populations, and standardized criteria for CEUS have been established by the American College of Radiology Liver Imaging Reporting & Data System (LI-RADS). Following HCC identification, CEUS can also be highly beneficial in treatment planning, delivery, and monitoring HCC response to locoregional therapies. Specific advantages of CEUS include providing real-time treatment guidance and improved diagnostic performance for the detection of residual tumor viability or recurrence, thereby identifying patients in need of retreatment substantially earlier than contrast-enhanced CT and MRI. This review provides a primer on ultrasound and CEUS for the screening and characterization of HCC, with an emphasis on assessing tumor response to locoregional therapies.
肝细胞癌（HCC）是一个全球性问题，构成了全球癌症死亡的第二大主要原因，因此需要一种准确且具有成本效益的解决方案来管理护理。由于其成本低、便携性、安全性和出色的时间分辨率，超声非常适合满足这一需求。超声在 HCC 筛查中的作用已得到广泛认可，并得到多个国际指南的支持。同样，对比增强超声（CEUS）可用于高危人群中局灶性肝病变的特征描述，并且美国放射学院肝脏成像报告和数据系统（LI-RADS）已经为 CEUS 制定了标准化标准。在识别 HCC 后，CEUS 还可以在治疗计划、实施和监测 HCC 对局部区域治疗的反应方面提供很大的帮助。CEUS 的特定优势包括提供实时治疗指导和提高检测残留肿瘤活力或复发的诊断性能，从而能够更早地识别出需要再次治疗的患者，这比对比增强 CT 和 MRI 要早得多。本综述提供了超声和 CEUS 在 HCC 筛查和特征描述方面的基础知识，重点介绍了评估局部区域治疗后肿瘤反应的情况。
