Use of power Doppler sonography for differential diagnosis of small hepatocellular carcinoma and adenomatous hyperplastic nodule.

Objective: To evaluate applicability of power Doppler sonography (PDS) in differential diagnosis of small hepatocellular carcinoma (SHCC) and adenomatous hyperplastic nodule (AHN).

Methods: Twenty-two cases of SHCC and 15 cases of AHN were investigated by PDS and the findings were compared with those of digital subtraction angiography (DSA).

Results: The rates of arterial and portal flow in an afferent tumor vessel were 86.4% and 40.9% in SHCCs, respectively. The rate of portal flow in an afferent tumor vessel was 60.0% in AHNs, while no arterial flow was detected (P < 0.01). In addition, PDS revealed a constant flow in an efferent tumor vessel (50.0%) continuing to a portal branch in 10 (45.5%) of the 22 SHCCs cases to a hepatic vein in 1 (4.5%) of the 22 SHCCs, but to nothing else in the AHNs (P < 0.01).

Conclusions: Power Doppler sonography is of value in distinguishing SHCC from AHN, and arterial afferent tumor vessels from constant flow efferent tumor vessels at PDS.