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Assessment of Vascularity in Hepatic Tumors

Comparison of Power Doppler Sonography and Intraarterial CO₂-Enhanced Sonography

¹ Department of Radiology, Taipei Municipal Jen-Ai Hospital, 10, Sec. 4, Jen-Ai Rd., 106, Taipei, Taiwan.
² Department of Radiology, School of Medicine, Taipei Medical University, Taipei, Taiwan.
³ Department of Gastroenterology, Taipei Municipal Jen-Ai Hospital, Taipei, Taiwan.

OBJECTIVE. The purpose of the study was to compare power Doppler sonography with intraarterial CO₂-enhanced sonography for revealing vascularity in treated and untreated hepatic tumors.

SUBJECTS AND METHODS. Fifty-five patients with 93 liver tumors were prospectively examined with power Doppler sonography and CO₂-enhanced sonography. These tumors included 29 hepatocellular carcinomas in patients with no previous treatment, 26 treated hepatocellular carcinomas, and 38 hemangiomas. The vascular depiction of power Doppler sonography was compared with that obtained in the early phase of CO₂-enhanced sonography. The results of angiography were also recorded for comparison.

RESULTS. In the hepatocellular carcinomas, power Doppler sonography was the same as CO₂-enhanced sonography in 18 (62%) of 29 tumors, was inferior to CO₂-enhanced sonography in nine (31%) of 29 tumors, and was superior to CO₂-enhanced sonography in two (7%) of 29 tumors. In the treated hepatocellular carcinomas, power Doppler sonography was the same as CO₂-enhanced sonography in 15 (58%) of 26 tumors and was inferior in 11 (42%) of 26 tumors. In hemangiomas, the same vascularity was found in both studies in 15 (39%) of 38 tumors, CO₂-enhanced sonography was superior in 22 (58%) of 38 tumors, and power Doppler sonography was superior in one (3%) of 38 tumors. As a whole, 45% of the 93 tumors showed better vascular depiction on CO₂-enhanced sonography. However, 19.4% of tumors were hypovascular using power Doppler sonography but hypervascular using CO₂-enhanced sonography.

CONCLUSION. Power Doppler sonography is a useful technique for screening hepatic tumor vascularity. CO₂-enhanced sonography is superior to power Doppler sonography in depicting tumor vascularity in treated hepatocellular carcinomas and in hemangiomas, especially small hemangiomas.

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