Color Doppler sonography in the differential diagnosis of common hepatic tumors

Background: Correlations between high-quality color Doppler sonography and angiography have been reported. In this study, the intention was to use color Doppler sonography for the differential diagnosis of common hepatic tumors. Materials and Methods: A total of 134 focal hepatic tumors in 94 consecutive patients were studied. Among them, there were 62 hepatocellular carcinomas in 45 patients, 19 metastatic liver cancers in 13 patients, and 53 hemangiomas in 36 patients. A Toshiba SSA-270A color Doppler machine equipped with a 3.75-MHz sector-array probe was used to study intratumoral arterial Doppler signals. Chi-square test with Yates' correction and Fisher's exact test were used for statistical analyses. Results: The detection rate of intratumoral arterial Doppler signals in hepatocellular carcinomas was 87% (47/54) for those tumors ? 2 cm in diameter and 13% (1/8) for those < 2 cm in diameter (p < 0.001). In metastatic liver cancers, the detection rate was 86% (6/7) for those > 5 cm in diameter, 50% (2/4) for those 3-5 cm, and 38% (3/8) for those from 2 cm to < 3 cm. Arterial Doppler signals were not shown in any of the 53 hemangiomas. The difference in the detection rate of intratumoral arterial Doppler signals was highly significant between malignant tumors and hemangiomas (73% vs 0%, p < 0.001). However, the difference between hepatocellular carcinoma and metastatic liver cancer was not statistically significant (77% vs 58%, p > 0.05). Conclusion: In hepatic tumors that are ? 3 cm in diameter, the presence of intratumoral arterial Doppler signals can be used to differentiate malignant tumors from hemangiomas. However, the role of Doppler sonography is limited in the differential diagnosis of hepatic tumors < 3 cm in diameter.