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Three-dimensional Power Doppler Imaging in Depicting Vascularity in Hepatocellular Carcinoma

Departments of Medical Ultrasonics (H.-X.X., L.L., G.-J.L.), Hepatobiliary Surgery (M.-D.L.), and Interventional Radiology (H.-P.L., J.-P.L.), The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China.

Address correspondence and reprint requests to Ming-De Lu, MD, DMSc, Department of Hepatobiliary Surgery, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Rd 2, Guangzhou 510080, People’s Republic of China. E-mail: lumd{at}21cn.com.

Objective. To assess the ability of three-dimensional power Doppler imaging to depict vascularity in hepatocellular carcinoma. Methods. Forty-three patients with hepatocellular carcinomas were subjected to two- and three-dimensional power Doppler imaging, and 14 of them also underwent angiography. The delineated amounts of intratumoral Doppler signals were compared between 2 methods of power Doppler imaging in 43 patients. In the 14 patients who also underwent angiography, the patterns of blood supply depicted by 2 methods of power Doppler imaging were compared with that depicted by angiography, and the intratumoral vascularity on three-dimensional projection images and angiograms was also quantitatively assessed by calculating the vascularity-area ratio with graphics software. Results. In comparison with two-dimensional power Doppler imaging, three-dimensional power Doppler imaging was subjectively determined as showing more intratumoral Doppler signals in 32 (74.4%) of the 43 lesions. The accuracies in depicting vascular patterns were 64.3% (9 of 14) for three-dimensional projection images and 14.3% (2 of 14) for two-dimensional slices compared with the results of angiography. The vascularity-area ratios on three-dimensional power Doppler imaging projections and angiograms were 46.0% ± 25.6% and 48.5% ± 22.5% (mean ± SD), respectively (P > .05). Three-dimensional projection images correlated significantly with angiograms in quantifying the vascularity ( = 0.87; P < .001). Conclusions. A three-dimensional power Doppler projection image gives a better overall picture of vascular distribution than a two-dimensional slice and correlates with angiography significantly for delineating vascularity in hepatocellular carcinoma.

Abbreviations: HCC, hepatocellular carcinoma • PDI, power Doppler imaging • 3D, three-dimensional • 2D, two-dimensional • VAR, vascularity-area ratio

Key Words: hepatocellular carcinoma • liver • power Doppler imaging • three-dimensional sonography • vascularity

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