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DOI: 10.1055/s-0028-1109745
© Georg Thieme Verlag KG Stuttgart · New York
Correlation between SonoVue Enhancement in CEUS, HCC Differentiation and HCC Diameter: Analysis of 130 Patients with Hepatocellular Carcinoma (HCC)
Korrelation zwischen histologischem Differenzierungsgrad und Größe des hepatozellulären Karzinoms und der SonoVue-Aufnahme in CEUS: Analyse von 130 Patienten mit hepatozellulärem Karzinom (HCC)Publikationsverlauf
received: 19.11.2008
accepted: 1.8.2009
Publikationsdatum:
07. Dezember 2009 (online)
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Zusammenfassung
Ziel: Ziel der Studie war es, zu prüfen, ob es eine Korrelation zwischen dem histologischen Differenzierungsgrad und der Größe eines hepatozellulären Karzinoms einerseits und der SonoVue-Aufnahme im HCC andererseits gibt. Material und Methoden: In einer prospektiven Studie wurden 130 Patienten (72 Männer, 58 Frauen, 62 ± 10 Jahre) mit HCC untersucht, bei denen das HCC im sonografischen B-Bild nachweisbar war. Nach Injektion von 1,2 – 2,4 ml SonoVue i. v., wurde die Kontrastmittelaufnahme in der HCC-Raumforderung kontinuierlich bis zu 5 min in „low MI”-Technik untersucht. Ergebnisse:Bei Analyse der Gesamtgruppe war bei 72 % der HCC-Herde eine frühe arterielle Hypervaskularisation nachweisbar ohne Korrelation zur Größe oder zum histologischen Differenzierungsgrad. Bei der Analyse der G 1-Subgruppe fand sich hingegen eine signifikante Korrelation zwischen Durchmesser des HCC und der arteriellen Hypervaskularisation: Während bei 95 % der G 1-HCC’s > 3 cm eine arterielle Hypervaskularisation nachweisbar war, war bei den G 1-HCC’s < 3 cm eine Hypervaskularisation nur bei 43 % der Fälle nachweisbar (p < 0,001). Im Gegensatz dazu war bei den histologisch geringer differenzierten HCC’s (alle außer G 1) eine arterielle Hypervaskularisation bei 69 % der HCC’s < 3 cm und bei 72 % der HCC’s > 3 cm nachweisbar. In der Spätphase war in der G 1-Subgruppe eine echoarme Kontrastmittelaussparung bei 95 % der G 1-HCC’s > 3 cm, aber nur bei 64 % der G 1-HCC’s < 3 cm (p < 0,001). Im Gegensatz dazu fand sich bei den weniger differenzierten HCC-Herden (ohne G 1) eine Kontrastmittelaussparung bei 91 % (HCC > 3 cm) und in 82 % (HCC < 3 cm) der Fälle ohne Korrelation zur HCC-Größe. Schlussfolgerung: In gut differenzierten HCC’s (G1) korrelieren sowohl die arterielle Hypervaskularisation als auch die Kontrastmittelaussparung in der Spätphase mit dem HCC-Durchmesser.
Abstract
Purpose: The aim of the study was to characterize SonoVue enhancement in hepatocellular carcinoma in correlation to both lesion diameter and histological differentiation of the lesion. Materials and Methods: In a prospective study 130 patients (72 male, 58 female, 62 ± 10 years) with HCC lesions detected by B-mode sonography were examined. After injection of 1.2 – 2.4 ml SonoVue, HCC lesions were examined continuously for up to 5 min using ”low MI” sonography. Results: Arterial hypervascularization was found in 72 % of the HCC lesions without correlation to the lesion diameter or histological grading, when analyzed for the total group. However, the analysis of the G 1 subgroup showed significant correlation between lesion diameter and arterial hypervascularization. Arterial hypervascularization was found in 95 % of the G 1 lesions > 3 cm but in only 43 % of the G 1 lesions < 3 cm (p < 0.001). In contrast, analysis of the remaining HCC lesions (without G 1) showed arterial hypervascularization in 69 % of the lesions < 3 cm and in 72 % of the lesions > 3 cm (n. s.) without correlation to the diameter. In the late phase in the G 1 subgroup, hypoechoic demarcation was found in 95 % of the G 1 lesions > 3 cm, but in only 64 % of the G 1 lesions < 3 cm (p < 0.001). In contrast, in the less differentiated HCC lesions (without G 1), hypoechoic demarcation was found in 91 % (HCC > 3 cm) and in 82 % (HCC < 3 cm) of the lesions (n. s.). Conclusion: In well-differentiated HCCs (G1) hyperechoic enhancement in the arterial phase and hypoechoic demarcation in the late phase correlate to the diameter.
Key words
abdomen - contrast agents - ultrasound
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Prof. Dr. Alexandra von Herbay
Internal Medicine, University of Tuebingen
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