IMAGING DIAGNOSIS OF SMALL HEPATOCELLULAR-CARCINOMA

To elucidate the detectability of small hepatocellular carcinoma by va rious imaging modalities, we performed digital subtraction angiography , computed tomographic arterioportography and carbon dioxide-enhanced ultrasonography. Of 76 patients with a small hepatocellular carcinoma of 2 cm or less in maximum diameter, 61 underwent digital subtraction angiography, computed tomographic arterioportography and enhanced ultr asonography at the same time. Concerning the 61 patients undergoing al l the procedures, the characteristics of hepatocellular carcinoma were found in 57.4% (35 of 61) by digital subtraction angiography, 75.4% ( 46 of 61) by computed tomographic arterioportography and 72.1% (44 of 61) by enhanced ultrasonography. Among them, four hepatocellular carci nomas were detected only by enhanced ultrasonography, three were diagn osed only by computed tomographic arterioportography and two were diag nosed by both of them. Except for six hemangioma nodules that were eas ily diagnosed only with angiography, four of 55 benign hepatic nodules (7.3%) showed false-positive findings suggestive of hepatocellular ca rcinoma with either computed tomographic arterioportography or enhance d ultrasonography. In conclusion, computed tomographic arterioportogra phy and enhanced ultrasonography could complementarily detect a small hepatocellular carcinoma more sensitively than digital subtraction ang iography.