Introduction. On ultrasound, hepatocellular carcinoma presents with nodular
or multinodular lesions of different size and echostructure, sometimes with
a surrounding halo, and lateral acoustic shadows or posterior acoustic
enhancement. The aim of this study was to determine the incidence of
posterior acoustic enhancement in hepatocellular carcinoma. Material and
Methods. This retrospective study included 120 patients with pathologically
verified hepatocellular carcinoma who had undergone ultrasound examination
(using real time ultrasounds from different manufacturers, with 3.5 and 5
MHz probes). Ultrasound imaging focused on the size and appearance of the
focal lesions, i. e. echostructure and presence or absence of posterior
acoustic enhancement as areas of increased echogenicity behind the lesion.
Results. Posterior acoustic enhancement was observed in 47.3% of all nodular
hepatocellular carcinomas, whereas this ultrasound phenomenon was
statistically significantly more common in the group of tumors from 3 to 5
cm in size. In the group of multinodular tumors, posterior acoustic
enhancement was found in 70% of cases. Conclusion. The presence of posterior
acoustic enhancement in the detection of focal hepatic lesions may be a
significant finding in the diagnosis of hepatocellular carcinoma, especially
in patients at risk for developing hepatocellular carcinoma (cirrhosis and
chronic liver disease), as well as in monitoring interval growth in size of
focal lesions using this ultrasound phenomenon.
Significance of posterior acoustic enhancement ultrasonographic findings in the diagnosis of hepatocellular carcinoma