Hepatocellular carcinoma: Spectrum of contrast-enhanced gray-scale harmonic sonography findings

O. Catalano, R. Lobianco, B. Cusati, A. Siani

Research output: Contribution to journalArticlepeer-review


Sonography (US) is the most commonly used tool in the assessment of patients with chronic liver disease. Nevertheless, small nodules can be overlooked. Moreover, even if the lesion is readily recognizable, difficulty persists in differentiating hepatocellular carcinoma (HCC) from pre-tumoral, dysplastic stages of nodule evolution. In addition, US is the main tool in guiding percutaneous ablation therapies for HCC and in evaluating patients after treatment, but changes are not specific and difficulties persist in recognizing residual tumor during and after the ablation procedure. Contrast-enhanced, gray-scale, harmonic US offers new possibilities in the imaging of liver tumors. The real-time, low-mechanical index technique employed in our institution allows a true dynamic assessment of the tumor during the various phases of contrast medium circulation. This pictorial essay focuses on typical and atypical appearances of HCC when imaged with contrast-specific, real-time US. Findings useful for lesion detection, differential diagnosis, posttreatment assessment, and follow-up especially are illustrated. The potential role of contrast-enhanced US in various clinical settings is emphasized.

Original languageEnglish
Pages (from-to)341-347
Number of pages7
JournalAbdominal Imaging
Issue number3
Publication statusPublished - May 2004


  • Liver, hepatocellular carcinoma
  • Liver, percutaneous ablation therapy
  • Liver, sonography
  • Sonography, contrast media
  • Sonography, technique

ASJC Scopus subject areas

  • Gastroenterology
  • Urology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology


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