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Loria et al. Hepatoma Res 2018;4:59 Hepatoma Research
DOI: 10.20517/2394-5079.2018.75

Review Open Access

Role of the contrast-enhanced ultrasoud in the
diagnosis of HCC in cirrhotic liver

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Francesco Loria , Antonello Parlati , Giuseppe Loria , Luciano Frosina , Giuseppe Crea , Salvatore
Basile , Caterina Alessio , Giuseppe Di Leo , Adele De Caridi , Vittorio Maschio , Nicola Zizzi , Orazio
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Trapuzzano , Salvatore Giuseppe Galea 1
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1 Deptartment of Radiology, Giovanni Paolo II Hospital, Lamezia Terme ZC 89015, Italy.
2 Deptartment of Radiology, Policlinico G. Martino University of Messina, Messina ZC 98100, Italy.
3 Deptartment of Radiology, Palmi Hospital, ASP RC, Palmi ZC 89015, Italy.
Correspondence to: Dr. Francesco Loria, Deptartment of Radiology, Giovanni Paolo II Hospital Lamezia Terme, Lamezia Terme ZC 89015,
Italy. E-mail: francescoloria956@alice.it
How to cite this article: Loria F, Parlati A, Loria G, Frosina L, Crea G, Basile S, Alessio C, Di Leo G, De Caridi A, Maschio V, Zizzi N,
Trapuzzano O, Galea SG. Role of the contrast-enhanced ultrasoud in the diagnosis of HCC in cirrhotic liver. Hepatoma Res 2018;4:59.
http://dx.doi.org/10.20517/2394-5079.2018.75
Received: 8 Jun 2018 First Decision: 1 Aug 2018 Revised: 28 Aug 2018 Accepted: 29 Aug 2018 Published: 28 Sep 2018
Science Editor: Guang-Wen Cao Copy Editor: Yuan-Li Wang Production Editor: Zhong-Yu Guo

Abstract
The development of second generation ultrasound (US) contrast-medium and specific imaging techniques with
dedicated softwares, allows to observe the liver perfusion in real time, becoming an useful and less invasive
method to describe precisely the vascularization of hepatic lesions. This significantly increased the ability of
US to detect and characterize focal liver lesions. The aim of this review article is to evaluate the role of contrast
enhancement US in the diagnosis of hepatocellular carcinoma in cirrhotic liver, with reference to the guidelines
of American Association for the Study of Liver Diseases, European Association for the Study of the Liver and
European Federation of Societies for Ultrasound in Medicine and Biology.

Keywords: Contrast-enhanced ultrasound, hepato-cellular carcinoma, cirrhotic liver

INTRODUCTION
Hepatocellular carcinoma (HCC) is the most common malignancy of the liver. Ultrasound (US) examination
and measurement of serum levels of alpha-fetoprotein (AFP) represent the most common screening method
for HCC .
[1]
However, the conventional grayscale US and Color-Power Doppler US show limited ability in characterizing

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