Detection of hepatocellular carcinomas and dysplastic nodules in cirrhoticliver - Accuracy of ultrasonography in transplant patients

The purpose of this study was to assess the usefulness of ultrasonography i n the detection of hepatocellular carcinomas and dysplastic nodules in pati ents with liver cirrhosis. Pretransplantation sonograms in 52 patients with liver cirrhosis who underwent orthotopic liver transplantation were evalua ted retrospectively. The numbers of hepatocellular carcinomas and dysplasti c nodules were assessed in the explanted liver specimens and compared with pretransplantation ultrasonographic results. Eighteen hepatocellular carcin omas in 16 patients and 20 dysplastic nodules in 11 patients were present i n the explanted livers. The size of hepatocellular carcinomas ranged from 0 .6 to 5.0 cm (mean, 2.1 cm) in diameter, and that of dysplastic: nodules ra nged from 0.5 to 1.7 cm (mean, 1.0 cm) in diameter. Pretransplantation ultr asonography enabled detection of 6 of 18 hepatocellular carcinoma and 0 of 20 dysplastic nodule lesions; lesion detection sensitivity for hepatocellul ar carcinomas and dysplastic nodules was 33% and 0%, respectively. Patient sensitivity and specificity for hepatocellular carcinomas were 38% (6 of 16 ) and 92% (33 of 36), and those for dysplastic: nodules were 0% and 95% (39 of 41), respectively. On the basis of our results, ultrasonography is inse nsitive for detection of hepatocellular carcinomas and dysplastic nodules i n patients with advanced liver cirrhosis.