[The usefulness of percutaneous ethanol injection therapy under guidance with carbon dioxide contrast enhanced ultrasound sonography].

We evaluated the usefulness of percutaneous ethanol injection therapy (PEIT) under Carbon dioxide (CO2) contrast enhanced ultrasound sonography (CEUS) guidance during digital subtraction angiography (DSA) in 21 cases of hepatocellular carcinoma (HCC) with 28 nodules that could not be detected by plain (non-contrast enhanced) US (PUS). In all cases of HCC that could not be visualized by PUS, PEIT could be performed successfully under CEUS guidance. Tumor size was below 10 mm in most cases, in 2 cases tumor size was more than 20 mm. Tumor location was roughly divided into 5 areas: just below the diaphragm and it's vicinity, liver surface, edge of the liver, around the portal and hepatic vein, and around the inferior vena cave. The detection rate of the nodules that could not be visualized with PUS was 35.7% for CT and 32.1% for DSA. PEIT was performed 1-9 times for each lesion, 3.32 times on an average. The effectiveness of PEIT was judged by CT. All cases were confirmed as LDA. We concluded that the range of indication of PEIT can be expanded by this method.