Online Journal
IF値: 1.878(2021年)→1.8(2022年)


Journal of Medical Ultrasonics

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1991 - Vol.18

Vol.18 No.06

Original Article(原著)

(0574 - 0581)


The Ultrasonographic Findings and the Problems in Diagnosis of Small Hepatocellular Carcinoma

池田 弘1, 川野 示真子1, 横井 徹1, 石崎 正彦1, 藤井 守1, 小西 明美1, 井上 武紀1, 仁科 恭一郎1, 藤井 正子2, 小林 伊津美2, 文屋 千恵子2, 石坂 克己2, 平田 和文3

Hiroshi IKEDA1, Shimako KAWANO1, Toru YOKOI1, Masahiko ISHIZAKI1, Mamoru FUJII1, Akemi KONISHI1, Takemichi INOUE1, Kyouichirou NISHINA1, Masako FUJII2, Izumi KOBAYASHI2, Chieko BUNYA2, Katsumi ISHIZAKA2, Kazuhumi HIRATA3

1倉敷中央病院内科, 2倉敷中央病院超音波室, 3平田内科医院

1Department of Internal Medicine, Kurashiki Central Hospital, 2Laboratory of Ultrasonography, Kurashiki Central Hospital, 3Hirata Clinic

キーワード : Small liver cancer, Hyperechoic HCC, US-guided needle biopsy

In order to clarify the ultrasonographic and clinical features of a small hepatocellular carcinoma (HCC), 22 small HCC were examined retrospectively. The ratio of short/long in terms of the length of a tumor≥0.8 was observed in 86% of cases. However, other findings were rarely detected: marginal hypoechoic zone (18%), lateral shadow (0%), posterior echo enhancement (23%). This tendency was obvious in small HCC less than 1 cm in diameter. In contrast, the appearance of a low echoic area was often seen in hyperechoic HCC, which represents adenomatous hyperplasia (AH) or well differentiated HCC. The sensitivity of the angiography and computed tomography was 100% in a hypoechoic HCC measuring 1 to 2 cm. In contrast, most of hyperechoic HCC were angiographically undetected HCC. Therefore, a US-guided needle biopsy was useful for final diagnosis. Moreover, the growth of hyperechoic HCC was slower than that of hypoechoic HCC. Histologically, some cases of hyperechoic HCC were closely related to AH. These results suggest that the atypical clinical findings of hyperechoic HCC are due to its unique histological features.