Contrast-enhanced 3D ultrasonography in minute hepatocellular carcinoma.

Purpose: The study aimed to clarify whether contrast-enhanced (CE) three-dimensional (3D) ultrasonography (US) can depict characteristic hyperstain and washout patterns in minute nodules ≤10 mm of hepatocellular carcinoma (minute HCC), and whether it serves as a potent diagnostic modality.

Methods: CE 3D US was carried out to depict hyperstain and washout of a solitary nodule ≤10 mm in patients with liver cirrhosis. When both patterns were depicted with success, CE computed tomography (CT) and CE magnetic resonance imaging (MRI) were also carried out as part of a comparative study, and then a histological specimen was obtained by needle biopsy. The final diagnosis was based on the histopathological findings and a follow-up on the growth of nodules.

Results: All 12 minute nodules exhibiting hyperstain and washout showed evidence of HCC when examined by CE 3D US. The CE CT and CE MRI examinations could depict both of these patterns, characteristic of HCC, in most of the nodules but rather less successfully than CE 3D US.

Conclusion: CE 3D US can depict hyperstain and washout patterns in minute HCC and serves as a potent modality for diagnosis.