J Korean Soc Med Ultrasound.  2000 Dec;19(4):233-238.

Contrast-enhanced Harmonic Power Doppler Ultrasonography: Improved Depiction of Vascularity and Characterization of Flow Pattern in Hepatocellular Carcinoma

• Baek HC
• Yoon KH
• Kim CG
• Park KH
• Won JJ

Abstract

PURPOSE
To evaluate the value of contrast-enhanced harmonic power Doppler ultrasonography (PDUS) in depiction and characterization of tumoral vascularity in hepatocellular carcinoma (HCC).
MATERIALS AND METHODS
Thirty-three patients with HCC were prospectively evaluated with harmonic PDUS before and after injection of the contrast agent SH U 508A (2.5g, 300 mg/ml). Unenhanced and serial dynamic scans at 15, 30, 45, 60, 90, 120, 150, 180, 240, 300 seconds after injection of contrast agents were obtained using a tissue harmonic technique with power Doppler imaging. The tumoral vascularity was expressed as percentage of power Doppler area, which was measured quantitatively by a computerized program (Ultrasonic Imaging Tool; Soongsil University, Seoul, Korea). The grade (0, no signal; 1, less than 5%; 2, 5-25%; 3, more than 25%) and flow pattern (intratumoral, detour, basket, and mixed) of tumoral vascularity were analyzed. Peak time of contrast-enhancement was measured on each tumor.
RESULTS
After injection of contrast agent, tumoral flow signals increased in all lesions (100%). At unenhanced harmonic PDUS, flow signals were detected in 17 HCCs (52%); 15 tumors (46%) demonstrated grade 1 vascularity; and two (6%), grade 2. At contrast-enhanced harmonic PDUS, all tumors were detected vascularity; five (15%) were grade 1; eight (24%), grade 2; and 20 (61%), grade 3. Flow patterns were demonstated as follows at unenhanced harmonic PDUS; intratumoral pattern in 13 tumors (76%), detour in 2 (12%), and basket in 2 (12%). After injection of contrast agent, intratumoral pattern in 7 tumors (21%), detour 0 (0%), basket in 3 (9%) and mixed in 23 (70%) were demonstrated. Peak time of enhancement after injection of contrast agent was 30- 90 seconds in majority of the patients.
CONCLUSION
Contrast-enhanced harmonic PDUS would be valuable in depiction of vascularity and characterization of flow pattern in HCC.

MeSH Terms

Carcinoma, Hepatocellular*
Contrast Media
Humans
Liver Neoplasms
Prospective Studies
Seoul
Ultrasonography, Doppler*
Contrast Media