Sonographic appearances of small hepatic nodules without tumor stain on contrast-enhanced computed tomography and angiography

Authors

  • Masahiko Iwasaki MD,

    Corresponding author
    1. Department of Internal Medicine, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa-shi, Chiba 277, Japan
    • Department of Internal Medicine, Tanaka Nokyo Hospital, 110, Wakashiba, Kashiwa-shi, Chiba 277, Japan
    Search for more papers by this author
  • Jyunji Furuse MD,

    1. Department of Internal Medicine, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa-shi, Chiba 277, Japan
    Search for more papers by this author
  • Masahiro Yoshino MD,

    1. Department of Internal Medicine, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa-shi, Chiba 277, Japan
    Search for more papers by this author
  • Munemasa Ryu MD,

    1. Department of Surgery, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa-shi, Chiba 277, Japan
    Search for more papers by this author
  • Noriyuki Moriyama MD,

    1. Department of Radiology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa-shi, Chiba 277, Japan
    Search for more papers by this author
  • Kiyoshi Mukai MD

    1. Pathology Division, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa-shi, Chiba 277, Japan
    Search for more papers by this author

Abstract

Purpose

We report the sonographic appearances and pathologic findings for hepatic nodules 2 cm or smaller that were detected by sonography but that did not produce a tumor stain on constrast-enhanced helical CT or digital subtraction angiography.

Methods

Sixty-six nodules 2 cm or less were found by sonography in 39 patients. Sonographically guided needle biopsies were done on all lesions.

Results

Twenty-seven nodules were benign nodules, 9 were borderline lesions, and 30 were hepatocellular carcinomas. Benign nodules were significantly smaller than hepatocellular carcinomas (mean size, 1.0 cm versus 1.4 cm, respectively; p <0.00001). Nodules 1 cm or smaller were more likely to be diagnosed as benign nodules (68%) than as either of the other types (32%; p = 0.01). A significantly greater percentage of hepatocellular carcinomas showed a heterogeneous pattern (64%) on sonography compared with benign nodules (25%) and borderline lesions (11%; p = 0.04). In nodules 1 cm or smaller, a homogeneous pattern (68%) was more common than a heterogeneous pattern (32%; p = 0.01).

Conclusions

The nature of small hepatic nodules cannot be determined with sonography. Thus, biopsy remains the only technique for obtaining a definitive diagnosis. © 1998 John Wiley & Sons, Inc. J Clin Ultrasound 26:303–307, 1998.

Ancillary