Clinical application on diagnosis in high-risk subjects with micro-hepatocellular carcinoma by ultrasonic contrast

Objective To evaluate the diagnostic performance of ultrasound contrast in diagnosing and monitoring hepatocellular carcinoma (HCC) in high-risk subjects. Methods Baseline ultrasound and/or other imaging examination were performed on 57 cases with small focal liver lesions or the serum levels of α-fetoprotein was significant higher but without any nodule on atlas. All cases chosen from HBV carriers,patients had chronic hepatitis B,C,and cirrhosis. Ultrasound contrast examination was carried out with Sonovue and CnTI techniques. Abnormal filling nodules were observed,the characeristics of phases and enhancement patterns were analysed. The diagnostic outcomes were calculated by using histologic results as the reference standard. Results Of 57 cases,all diameters of small focal liver lesions were ≤2.0 cm,25 were micro-hepatocellular carcinoma. According to the diagnostic criteria of baseline ultrasound,the rate of correct diagnosis of HCC was 40.0% (10/25). Therefore,the diagnostic accuracy of ultrasound contrast was 84.0% (21/25 ). There was significant difference between baseline ultrasound and ultrasound contrast in the diagnostic confidence of small hepatic nodules. Conclusions Ultrasound contrast significantly improves the diagnostic performance in characterization of small HCCs,which provides a new way for monitoring high-risk subjects and diagnosing micro-hepatocellular carcinoma.