Hepatocellular carcinoma: Power Doppler US with a contrast agent - Preliminary results

PURPOSE: To investigate the value of contrast material-enhanced power Doppler ultrasonography (US) in the demonstration and characterization of tumor vascularity in hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Twenty patients with HCC were prospectively evaluated with power Doppler US before and after injection of the contrast agent SH U 508 A. The grade and pattern of tumor vascularity at power Doppler US were analyzed, along with the degree of tumor staining at angiography. RESULTS: Intra- and peritumoral flow signals were detected in 19 HCCs (95%) at unenhanced power Doppler US. After injection of contrast agent, flow signals increased in 19 lesions (95%). At contrast-enhanced power Doppler US, two tumors demonstrated grade 1 vascularity; four grade 2; three, grade 3; and 11, grade 4. At angiography, two tumors demonstrated grade 1 staining; four grade 2; eight, grade 3; six, grade 4. The correlation between vascularity grades at contrast-enhanced power Doppler US and at angiography was statistically significant (P < .0001). Seventeen HCCs (85%) showed the intratumoral or basket pattern of vascularity at unenhanced power Doppler US; after injection of contrast material, 15 HCCs (75%) showed the mixed pattern. CONCLUSION: Contrast- enhanced power Doppler US is superior to unenhanced power Doppler US in the demonstration and characterization of tumor vascularity in HCC.