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Journal of Gastroenterology

, Volume 44, Issue 7, pp 733–741 | Cite as

Usefulness of Sonazoid contrast-enhanced ultrasonography for hepatocellular carcinoma: comparison with pathological diagnosis and superparamagnetic iron oxide magnetic resonance images

  • Keiko Korenaga
  • Masaaki Korenaga
  • Matakazu Furukawa
  • Takahiro Yamasaki
  • Isao Sakaida
Original Article—Liver, Pancreas, and Biliary Tract

Abstract

Objective

We investigated the usefulness of Sonazoid contrast-enhanced ultrasonography (Sonazoid-CEUS) in the diagnosis of hepatocellular carcinoma (HCC). The examination was performed by comparing the images during the Kupffer phase of Sonazoid-CEUS with superparamagnetic iron oxide magnetic resonance (SPIO-MRI).

Methods

The subjects were 48 HCC nodules which were histologically diagnosed (well-differentiated HCC, n = 13; moderately differentiated HCC, n = 30; poorly differentiated HCC, n = 5). We performed Sonazoid-CEUS and SPIO-MRI on all subjects. In the Kupffer phase of Sonazoid-CEUS, the differences in the contrast agent uptake between the tumorous and non-tumorous areas were quantified as the Kupffer phase ratio and compared. In the SPIO-MRI, it was quantified as the SPIO-intensity index. We then compared these results with the histological differentiation of HCCs.

Results

The Kupffer phase ratio decreased as the HCCs became less differentiated (P < 0.0001; Kruskal–Wallis test). The SPIO-intensity index also decreased as HCCs became less differentiated (P < 0.0001). A positive correlation was found between the Kupffer phase ratio and the SPIO-MRI index (r = 0.839). In the Kupffer phase of Sonazoid-CEUS, all of the moderately and poorly differentiated HCCs appeared hypoechoic and were detected as a perfusion defect, whereas the majority (9 of 13 cases, 69.2%) of the well-differentiated HCCs had an isoechoic pattern. The Kupffer phase images of Sonazoid-CEUS and SPIO-MRI matched perfectly (100%) in all of the moderately and poorly differentiated HCCs.

Conclusion

Sonazoid-CEUS is useful for estimating histological grading of HCCs. It is a modality that could potentially replace SPIO-MRI.

Keywords

Sonazoid Contrast-enhanced ultrasonography Kupffer phase SPIO-MRI Hepatocellular carcinoma 

Notes

Acknowledgments

We thank Masahiro Saitoh and Ritsuko Fukushima, from Mochida Siemence systems Co., Ltd., for their helpful advice and expert technical assistance.

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Copyright information

© Springer 2009

Authors and Affiliations

  • Keiko Korenaga
    • 1
    • 3
  • Masaaki Korenaga
    • 1
  • Matakazu Furukawa
    • 2
  • Takahiro Yamasaki
    • 1
  • Isao Sakaida
    • 1
  1. 1.Department of Gastroenterology and Hepatology, Graduate School of MedicineYamaguchi UniversityUbeJapan
  2. 2.Department of Radiology, Graduate School of MedicineYamaguchi UniversityUbeJapan
  3. 3.Division of Hepatology and Pancreatology, Department of Internal MedicineKawasaki Medical CollegeKurashikiJapan

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