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OBJECTIVE To investigate the value of contrast material-enhanced power Doppler ultrasonography (US) in the demonstration and characterization of tumor vascularity in hepatocellular carcinoma (HCC). METHODS Twenty patients with HCC were prospectively evaluated with power Doppler US before and after injection of the contrast agent SH U 508 A. The grade and pattern of tumor vascularity at power Doppler US were analyzed, along with the degree of tumor staining at angiography. RESULTS Intra- and peritumoral flow signals were detected in 19 HCCs (95%) at unenhanced power Doppler US. After injection of contrast agent, flow signals increased in 19 lesions (95%). At contrast-enhanced power Doppler US, two tumors demonstrated grade 1 vascularity; four, grade 2; three, grade 3; and 11, grade 4. At angiography, two tumors demonstrated grade 1 staining; four, grade 2; eight, grade 3; and six, grade 4. The correlation between vascularity grades at contrast-enhanced power Doppler US and at angiography was statistically significant (P < .0001). Seventeen HCCs (85%) showed the intratumoral or basket pattern of vascularity at unenhanced power Doppler US; after injection of contrast material, 15 HCCs (75%) showed the mixed pattern. CONCLUSIONS Contrast-enhanced power Doppler US is superior to unenhanced power Doppler US in the demonstration and characterization of tumor vascularity in HCC.
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