Value of contrast-enhanced color Doppler sonography in diagnosing hepatocellular carcinoma with special attention to the "color-filled pattern"

Abstract

Purpose: The purpose of this study is to evaluate the effectiveness of contrast-enhanced color Doppler sonography in the diagnosis of hepatocellular carcinoma (HCC), with special attention to the value of a "color-filled pattern."

Methods: Contrast enhancement with Levovist was performed on 30 liver tumors, including 21 HCCs, as part of phase II and III clinical trials. Detection of a "feeding artery" or a "color-filled pattern" with color Doppler sonography was interpreted as a positive finding for HCC. Angiography was also performed.

Results: A feeding artery was detected in 9 HCCs before contrast enhancement and 20 HCCs after. A color-filled pattern was seen in 14 HCCs after enhancement. A feeding artery was seen in only 1 non-HCC tumor, and a color-filled pattern was not seen in any non-HCC. The sensitivity and specificity of a feeding artery for the diagnosis of HCC were 95% and 89%, values similar to those of hepatic angiography. The sensitivity and specificity of a color-filled pattern were 67% and 100%, respectively.

Conclusions: Contrast enhancement increases the detectability of a feeding artery and improves the sensitivity of color Doppler sonography for diagnosing HCC. A color-filled pattern is a highly specific finding in the diagnosis of HCC.