豊田 秀徳, 多田 俊史, 熊田 卓

Hidenori TOYODA, Toshifumi TADA, Takashi KUMADA

大垣市民病院消化器内科

Department of Gastroenterology, Ogaki Municipal Hospital

キーワード :

【Backgrounds & Aims】
Pretreatment assessments of macroscopic and microscopic pathological features of hepatocellular carcinoma（HCC）are important for selecting treatment modality and evaluating prognosis. We evaluated the accuracy of imaging findings by contrast-enhanced ultrasonography（CEUS）with perfulbutane to assess pathological features of HCC based on the comparison with pathology on the resected HCC specimens.
【Methods】
A total of 147 resected HCC nodules were investigated. CEUS was performed in all cases preoperatively, and the abilities of CEUS findings to identify macroscopic single nodular HCC and microscopic well-differentiated HCC were evaluated by comparing with pathological findings of resected specimens.
【Results】
Among HCC nodules investigated, 68.7％were single nodule HCC and 35.4％were well-differentiated HCC. Single nodule type of HCC could be identified with 92.4％of sensitivity, 87.1％of specificity, and 90.9％of accuracy by combining the findings of the shape of enhancement during the late arterial phase and the shape of the post-vascular image. Well-differentiated HCC could be identified with 98.1％of sensitivity, 78.9％of specificity, and 85.7％of accuracy by combining the findings of vascularity pattern in the arterial phase and the presence of washout in portal venous phase. Of note, CEUS accurately identified single nodular HCC in all but one of 9 HCC nodules for which gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced MRI（EOB-MRI）failed to identify as a single nodule type.
【Conclusions】
CEUS with perfulbutane can acutely assess some pathological features of HCC. Combination of multiple image findings during different phases of CEUS can contribute to the accurate pretreatment evaluation of pathological features of HCC.