Ultrasonic doppler studies of hepatocellular carcinoma and comparison with other hepatic focal lesions

One hundred fifty-four liver lesions, including 63 hepatocellular carcinomas, were studied to determine the value of duplex ultrasound in the diagnosis of small hepatocellular carcinomas. Arterial Doppler signals were obtained either within the body of the tumor, at its periphery, or in both locations, from 28 of 37 hepatocellular carcinomas ≤3 cm in diameter and from all 26 hepatocellular carcinomas with a diameter >3 cm. Arterial Doppler signals were obtained at the periphery of 5 of 7 cholangiocarcinomas, 4 of 11 liver metastatic tumors, and 5 of 23 hemangiomas. No such signals were obtained from 29 regenerative nodules, 10 hepatic pseudotumors, and 11 liver cysts. The mean peak systolic frequency seen in hepatocellular carcinoma (1.2 kHz) was significantly greater than in cholangiocarcinoma (0.6 kHz), metastatic tumors (0.5 kHz), or hemangiomas (0.3 kHz). A peak systolic frequency of >3 kHz was found in 6 of 8 hepatocellular carcinomas ≥4 cm in diameter with angiographically proven arterioportal shunting, whereas the value in other hepatocellular carcinomas or other hepatic focal lesions was