LIVER WITH HYPOECHOIC NODULAR PATTERN AS A RISK FACTOR FOR HEPATOCELLULAR-CARCINOMA

Background/Aims: Ultrasonography should be used for screening of hepat ocellular carcinoma, but there are few reports on the relationship bet ween liver ultrasonographic findings and the development of hepatocell ular carcinoma (HCC). Using prospective follow-up studies, we examined the role of liver with a hypoechoic nodular pattern as a high-risk fa ctor in HCC. Methods: The study was performed by follow-up on 593 pati ents with chronic liver disease recorded at our hospital. The ultrason ographic pattern of the liver parenchyma was classified either as a sm all or large hypoechoic nodular pattern or as a nonnodular pattern. Pa tients were followed up from the time of initial ultrasonographic exam ination (1985-1987) until January 1, 1991. Results: During the follow- up period (average, 4.2 years, range, 0.3-6.0 years), 62 patients were found to have HCC (12%). Patients whose livers showed small or large hypoechoic nodular pattern had a significantly higher risk of HCC than did patients whose livers showed a nonnodular pattern (rate ratios we re 14.0 and 20.0, respectively, adjusted for age, sex, hepatitis virus markers, ICG R15, alpha-fetoprotein concentration, and ultrasonograph ic pattern of the liver). Conclusions: Liver showing a hypoechoic nodu lar pattern is a major risk factor in HCC.