Document Detail


Usefulness of contrast-enhanced ultrasonography with dynamic flow imaging to evaluate therapeutic effects for hepatocellular carcinoma.
MedLine Citation:
PMID:  14696421     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: To examine the usefulness of dynamic flow imaging in identifying the therapeutic effects for hepatocellular carcinoma, we performed contrast-enhanced ultrasonography with Levovist. METHODOLOGY: Tumor vascularity of 48 hepatocellular carcinoma nodules in 27 patients infected with hepatitis C virus was assessed before and after radiofrequency ablation therapy by dynamic flow imaging with a wide-band power Doppler technology. RESULTS: All patients showed hypervascular enhancement of hepatocellular carcinoma on contrast-enhanced ultrasonography and/or dynamic computed tomography. The dynamic flow was obtained as vascular and perfusion images of hepatic tumors. The diameters of tumors were 1.1-2.0 cm in 12 nodules, 2.1-3.0 cm in 28, and 3.1-5.0 cm in 8, respectively. We were able to assess the tumor vascularities in 45 of 48 nodules before radiofrequency ablation by the dynamic flow. Three nodules showed insufficient dynamic flow which was located approximately 9 cm in depth from the body surface. The dynamic flow study for the therapeutic efficacy indicated that the tumor vessels disappeared in 43 of the 45 visible nodules. The tumor vascularities were noted in the remaining 2 nodules, and they were successfully retreated by radiofrequency ablation. The frequencies detecting positive enhancement in pretreatment and post-treatment were almost equivalent between vascular phase of dynamic flow on ultrasonography and early phase on helical dynamic computed tomography, although 5 nodules gave different findings; 2 were positive only on ultrasonography, and 3 were positive only on computed tomography. A major complication of radiofrequency ablation procedure was noted in only one case associated with intestinal edema, but it was cured by medical treatment. CONCLUSIONS: The results indicated that contrast-enhanced dynamic flow imaging on ultrasonography is a reliable tool to evaluate intratumoral vascularity both before and after radiofrequency ablation treatment in patients with hepatocellular carcinoma.
Authors:
Naoki Hotta; Tsuneaki Tagaya; Tadashi Maeno; Tetsuya Ishikawa; Akihiko Okumura; Yoshitaka Fukuzawa; Shinichi Kakumu
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  50     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2003 Nov-Dec
Date Detail:
Created Date:  2003-12-30     Completed Date:  2004-06-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  1867-71     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Division of Gastroenterology, Research Center for Infectious Disease, Aichi Medical University School of Medicine, 21 Karimata Yazako, Nagakute-cho, Aichi-gun, Aichi-ken 480-1195, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Blood Flow Velocity / physiology
Carcinoma, Hepatocellular / blood supply,  therapy*,  ultrasonography*
Contrast Media / administration & dosage
Female
Hepatitis C, Chronic / complications*,  ultrasonography*
Humans
Hyperthermia, Induced*
Image Enhancement*
Image Processing, Computer-Assisted*
Liver Neoplasms / blood supply,  therapy*,  ultrasonography*
Male
Middle Aged
Polysaccharides / diagnostic use
Regional Blood Flow / physiology
Sensitivity and Specificity
Treatment Outcome
Ultrasonography, Doppler, Duplex*
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Polysaccharides; 127279-08-7/SHU 508

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