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Contrast-enhanced sonography versus biopsy for the differential diagnosis of thrombosis in hepatocellular carcinoma patients

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World Journal of Gastroenterology 2009年第18期15卷 2245-2251页

作者： Paolo Sorrentino Salvatore D'Angelo Luciano Tarantino Umberto Ferbo Alessandra Bracigliano Raffaela Vecchione Liver Unit Clinical and Experimental HepatologyDepartment of Internal MedicineS.G.Moscati Hospital83100 AvellinoItaly Department of Biomorphological Science University of Naples Federico Ⅱ80131 NaplesItaly Hepatology and Interventional Ultrasound Unit S.Giovanni di Dio HospitalASL 380027 FrattamaggioreNaplesItaly Institute of Pathology S.G.Moscati Hospital83100 AvellinoItaly

AIM:To clarify which method has accuracy:2nd gen-eration contrast-enhanced ultrasound or biopsy of portal vein thrombus in the differential diagnosis of portal vein ***:One hundred and eighty-six patients with hepatocellular carcinoma and portal vein thrombosis underwent in blinded fashion a 2nd generation contrast-enhanced ultrasound and biopsy of portal vein thrombus;both results were examined on the basis of the follow-up of patients compared to ***:One hundred and eight patients completed the *** thrombosis on 2nd generation contrast-enhanced ultrasound was characterised by progressive hypoenhancing of the thrombus;in malignant portal vein thrombosis there was a precocious homo-geneous enhancement of the *** follow-up there were 50 of 108 patients with benign thrombosis:all were correctly diagnosed by both *** were 58 of 108 patients with malignant thrombosis:amongst these,52 were correctly diagnosed by both methods,the remainder did not present malignant cells on portal vein thrombus biopsy and showed on 2nd generation contrast-enhanced ultrasound an inho-mogeneous enhancement pattern.A new biopsy during the follow-up,guided to the area of thrombus that showed up on 2nd generation contrast-enhanced ultra-sound,demonstrated an enhancing pattern indicating malignant ***:In patients with hepatocellular carcinoma complicated by portal vein thrombosis,2nd generation contrast-enhanced ultrasound of portal vein thrombus is very useful in assessing the benign or malignant nature of the *** biopsy of thrombus is usually accurate but presents some sampling errors,so,when pathological results are required,2nd generation contrast-enhanced ultrasound could guide the sampling needle to the correct area of the thrombus.

关键词： Hepatocellular carcinoma 2nd generationcontrast enhanced ultrasound Contrast enhancedsonography Malignant thrombosis portal vein biopsy

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