Discrepancy of contrast-enhanced ultrasonographic pattern with two contrast agents in steatohepatitic subtype hepatocellular carcinoma: A case report

Radiology Case Reports

article

Jiang Bo¹  Kong BeiNing¹  Fei Xiang¹  Wan XinKun¹  Luo YuKun¹ 

[1] Department of ultrasound, The First Medical Centre, Chinese PLA General Hospital

关键词: Hepatocellular carcinoma;    Contrast-enhanced ultrasound;    Ultrasound contrast agent;    Case report;   

DOI  :  10.1016/j.radcr.2022.03.010

学科分类：生物化学工程

来源: University of Washington * Department of Radiology

【 摘 要 】

Contrast-enhanced ultrasound (CEUS) is one of the important imaging modalities for diagnosis of hepatocellular carcinoma (HCC). Sonovue and Sonazoid are the third-generation of ultrasound contrast agents that have been commercialized and widely used in clinical applications. This study introduces the imaging differences between these two agents in vascular phases for the first time. A 54-year-old man clinical suspected liver cancer. He had chronic hepatitis B for more than 20 years. The result of alpha-fetoprotein was 36.45μg/L (normal< 20μg/L). The imaging pattern of CEUS with Sonovue was “fast-in and fast-out” performance, while the pattern of “fast-out” was absent after portal phase with Sonazoid, even in Kupffer phase. The lesion was diagnosed as lipid-rich HCC by contrast-enhanced MRI. After liver resection , pathology revealed that it was hepatocellular carcinoma contained poor-differentiated steatohepatitis subtype and moderate-differentiated microtrabecular subtype. The imaging difference mainly existed in the part of steatohepatitis subtype. Steatohepatitis subtype HCC can be showed as “fast-in and no wash-out” characteristic in Sonazoid CEUS. Though the mechanism remains not fully clarified, this different enhancing pattern may provide a potential for the supplement of the guidelines and differential of steatohepatitis subtype HCC.

【 授权许可】

CC BY|CC BY-NC-ND