European Radiology

, Volume 14, Issue 6, pp 1092–1099 | Cite as

Evaluation of hepatocellular carcinoma using SonoVue, a second generation ultrasound contrast agent: correlation with cellular differentiation

  • Carlos Nicolau
  • Violeta Catalá
  • Ramón Vilana
  • Rosa Gilabert
  • Luis Bianchi
  • Manel Solé
  • Mario Pagés
  • Concepció Brú


The appearance of hepatocellular carcinoma (HCC) with contrast-enhanced ultrasound (CEUS) in the vascular phase is described and evaluated as to whether the enhancement pattern correlates with the degree of cellular differentiation. One hundred four HCCs were prospectively evaluated with CEUS using coherent-contrast imaging (CCI) and SonoVue with a low mechanical index (<0.2). The enhancement of HCCs in the vascular phase was analyzed according to the degree of pathological differentiation obtained by fine-needle biopsy. In the arterial phase, all HCCs except for four well differentiated ones (96.2%) showed enhancement (P<0.05). Histological differentiation of hypoechoic lesions in the early portal phase (7 HCCs; 16%) significantly differed from hyperechoic (1 HCC; 1%) or isoechoic lesions (87 HCCs; 83.6%) (P<0.05), with a significant probability of a worse differentiation in hypoechoic lesions. Histological differentiation of isoechoic lesions in the late phase (30 HCCs; 28.8%) significantly differed from hypoechoic lesions (74 HCCs; 71.2%) (P<0.05), with a significant probability of a better differentiation in isoechoic lesions. CEUS using CCI and SonoVue revealed enhancement in the arterial phase in >95% of HCCs, with a few well-differentiated cases not being diagnosed due to the absence of enhancement. Echogenicity in the portal and late phases correlated with cellular differentiation.


Hepatocellular carcinoma Ultrasound, harmonic study Contrast coherent imaging Ultrasound, contrast media 


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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Carlos Nicolau
    • 1
  • Violeta Catalá
    • 1
  • Ramón Vilana
    • 1
  • Rosa Gilabert
    • 1
  • Luis Bianchi
    • 1
  • Manel Solé
    • 2
  • Mario Pagés
    • 1
  • Concepció Brú
    • 1
  1. 1.Diagnosis Imaging CenterHospital ClinicBarcelonaSpain
  2. 2.Department of PathologyHospital ClinicBarcelonaSpain

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