Small Liver Nodule Detection With a High-Frequency Transducer in Patients With Chronic Liver Disease

Abstract

We report 3 cases in which small liver lesions were revealed on sonography with the supplemental use of a high‐frequency transducer. In all 3 cases, the patients had cirrhosis or chronic liver disease. The lesions were not seen on computed tomography or magnetic resonance imaging. Sonography plays a pivotal role in surveillance for hepatocellular carcinoma and, with modern transducer technology, may be the first imaging modality to show an early small tumor. A more thorough search for focal liver lesions with adjunctive use of high‐frequency transducers may prolong the examination time but can improve surveillance for hepatocellular carcinoma.

Detection and characterization of small superficially located focal liver lesions by contrast-enhanced ultrasound with high frequency transducers

“…This technique fails to reliably differentiate between malignant and benign lesions [13,[25][26][27][28][29][30]. Some FLLs are particularly difficult to diagnose even by biopsy because of their small size (<10 mm) or superficial location (close to liver capsule) [12,15,26].…”

“…Several studies have attempted to evaluate the use of high frequency transducers (5-12 MHz) in the description of the liver surface and its implication for the presence of diffuse liver disease. Most of them focused on patients with liver cirrhosis [15,16,25,32] or small hepatic metastasis from a known extrahepatic primary malignancy [14]. Jung et al described 9 cases in which small liver lesions (4-15 mm) were detected during intraoperative ultrasound with high-frequency transducers.…”

“…Recently, there has been a growing interest in the supplemental use of high-frequency transducers to better evaluate and delineate small FLLs near the surface in cirrhotic livers; these lesions are invisible using lowfrequency transducers [15,24,25,31]. Several studies have attempted to evaluate the use of high frequency transducers (5-12 MHz) in the description of the liver surface and its implication for the presence of diffuse liver disease.…”

“…These transducers have been primarily used in transabdominal ultrasound examinations to improve the detection of liver surface nodularity [14][15][16] or for the detection of small FLLs as deep as 4 to 5 cm [17].…”

Patchy echogenicity of the liver in patients with chronic hepatitis B does not indicate poorer elasticity

“…These areas show the same enhancement pattern as the adjacent liver parenchyma on contrast-enhanced US, unlike discernible nodular space-occupying lesions. These echogenic patches are usually invisible or inadequately seen on computed tomography (CT) and/ or magnetic resonance imaging (MRI) (unenhanced and contrast-enhanced), and biopsy results usually show they are not tumors, dysplastic nodules, or regenerative nodules of the liver [9]. In patients with inactive HBV, CHB, or other CHB-related diseases, disease surveillance is important.…”