Assessment of arterial tumor vascularity in small hepatocellular carcinoma. Comparison between color Doppler ultrasonography and radiographic imagings with contrast medium: dynamic CT, angiography, and CT hepatic arteriography

Hepatocellular carcinoma (HCC) is characterized by tumor vascularization fr om the hepatic artery. The objective of our work was to compare color Doppl er ultrasonography (CDU), including power Doppler ultrasonography (PDU) wit h radiographic imagings with contrast medium in regard to the detection of the arterial tumor vascularity of small hepatocellular carcinomas (HCC). We examined 42 small HCC lesions 2 cm or less in diameter in 37 patients for arterial tumor vascularity by conventional CDU, PDU, dynamic computed tomog raphy (dCT), digital subtraction angiography (DSA), and CT hepatic arteriog raphy (CTA). Color images were detected in 25 (59.5%) and 28 (66.7%) of the 42 lesions with conventional CDU and PDU, respectively, and tumor vascular ity was detected in 26 (61.9%) by dCT, 23 (54.8%) by DSA, and 79 (69.0%) by CTA. Tumor vascularity could be detected in 51.9% by PDU and CTA, more tha n by conventional CDU, dCT, and DSA (44.4, 44.4, and 33.3%, respectively) i n well-differentiated HCC, whereas the detection rates by these techniques were almost equal (86.7% by CDU, 93.3% by PDU, dCT, and DSA, 100% by CTA, r espectively) in moderately and poorly differentiated HCC. PDU is superior t o CDU, dCT and DSA and equal to CTA for the detection of tumor vascularity in small HCC, particularly in well-differentiated HCC. (C) 2000 Elsevier Sc ience Ireland Ltd. All rights reserved.