New lesions detected by intraoperative ultrasound during liver resection for hepatocellular carcinoma

During liver resection for hepatocellular carcinoma (HCC), it is not uncomm on for examinations by intraoperative ultrasound (IOUS) to detect small new lesions that were not found by preoperative examinations. Although a diffe rential diagnosis is critical, it has not yet been established if IOUS is u seful for this purpose with such small lesions. A total of 90 new lesions d etected by IOUS in 79 liver resections were analysed. IOUS was performed on all of these cases and the features were recorded, The histologic characte ristics of these 90 new Lesions were checked by needle biopsy and their rel ations to the clinical data were analyzed. The IOUS pattern of the lesion w as hypoechoic in 36 cases, hyperechoic in 49 and mosaic in 5. A total of 24 HCC lesions were detected and the incidences of malignancy for each type w ere 30.6%, 18.4% and 80.0%, respectively. Multiple regression analysis reve aled that the IOUS features of the new lesions were the only significant fa ctors in predicting the histology, IOUS should be mandatory in liver resect ion for HCC because it is useful for finding new lesions and might contribu te to prediction of the histologic features. (C) 2001 World Federation for Ultrasound in Medicine & Biology.