ABSTRACT
With the recent progress in imaging modalities, detection of small, nodular hepatic
lesions has become much easier; however, differential diagnosis still remains difficult.
Nevertheless, a combination of tomographic imaging techniques and angiography, such
as ultrasound (US) angiography, CT arteriography (CTA), and CT during arterial portography
(CTAP) has contributed considerably to the differentiation of overt (advanced) hepatocellular
carcinoma (HCC) from benign or premalignant/borderline lesions. With such techniques,
estimation of the grade of malignancy is also possible. Recently, noninvasive ultrasonographic
vascular imaging techniques have been developed, such as color Doppler, power Doppler,
and enhanced Doppler imaging. In particular, gray-scale contrast second harmonic imaging
may prove useful in the management of HCC and will replace some of the roles of magnetic
resonance imaging (MRI) and CT in the near future; ultrasonographic visualization
of the vascularity of viable cancer cells is essential for the US-guided interventional
therapy of HCC.
KEY WORDS
hepatocellular carcinoma - imaging diagnosis - intranodular hemodynamic imaging
