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Contrast-Enhanced Harmonic Gray-Scale Sonographic–Histologic Correlation of the Therapeutic Effects of Transcatheter Arterial Chemoembolization in Patients with Hepatocellular Carcinoma

Manabu Morimoto1, Kazuhito Shirato1, Kazuya Sugimori1, Atsushi Kokawa1, Naohiko Tomita1, Toshifumi Saito1, Toshio Imada1, Noriko Tanaka2, Akinori Nozawa2, Kazushi Numata3 and Katsuaki Tanaka1

1 Gastroenterological Center, Yokohama City University Medical Center, 4-57, Urafune-cho, Minamai-ku, Yokohama, 232-0024 Japan.
2 Department of Pathology, Yokohama City University Medical Center, Yokohama, 232-0024 Japan.
3 Clinical Laboratory, Yokohama City University School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, 236-0004 Japan.



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  		Fig. 1A. —61-year-old man with Child-Pugh class A cirrhosis and hepatocellular carcinoma (maximal diameter, 31 mm) in superoanterior segment of right lobe of liver. Contrast-enhanced arterial phase wideband harmonic gray-scale sonogram obtained before treatment shows tumor and tumor margin (arrowheads). Note centrally tortuous intratumoral vessels (arrows).

 


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  		Fig. 2A. —69-year-old man with Child-Pugh class B cirrhosis and hepatocellular carcinoma (maximal diameter, 56 mm) in inferoposterior segment of right lobe of liver. Contrast-enhanced arterial phase wideband harmonic gray-scale sonogram obtained before treatment shows tumor and tumor margin (arrowheads). Note centrally tortuous intratumoral vessels (arrows).

 


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  		Fig. 1B. —61-year-old man with Child-Pugh class A cirrhosis and hepatocellular carcinoma (maximal diameter, 31 mm) in superoanterior segment of right lobe of liver. Contrast-enhanced portal phase wideband harmonic gray-scale sonogram obtained before treatment shows tumor and tumor margin (arrowheads). Note homogeneous hypervascular tumor enhancement.

 


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  		Fig. 2B. —69-year-old man with Child-Pugh class B cirrhosis and hepatocellular carcinoma (maximal diameter, 56 mm) in inferoposterior segment of right lobe of liver. Contrast-enhanced portal phase wideband harmonic gray-scale sonogram obtained before treatment shows tumor and tumor margin (arrowheads). Note that homogeneous tumor enhancement is almost same as that of liver parenchyma.

 


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  		Fig. 1C. —61-year-old man with Child-Pugh class A cirrhosis and hepatocellular carcinoma (maximal diameter, 31 mm) in superoanterior segment of right lobe of liver. On contrast-enhanced portal phase wideband harmonic gray-scale sonogram obtained after transcatheter arterial chemoembolization, enhancement in tumor has completely disappeared. Tumor appears as perfusion defect with ovoid or round shape and distinct margin (arrowheads). Enhancement of liver parenchyma is also seen.

 


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  		Fig. 2C. —69-year-old man with Child-Pugh class B cirrhosis and hepatocellular carcinoma (maximal diameter, 56 mm) in inferoposterior segment of right lobe of liver. Contrast-enhanced portal phase wideband harmonic gray-scale sonogram obtained after transcatheter arterial chemoembolization shows hypervascular area (arrows) persisting in tumor. Arrowheads point to margin of tumor. Enhancement of liver parenchyma is also seen.

 

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