Patterns of contrast enhancement of tuberculous lymph nodes demonstrated by computed tomography.

The purpose of this study was to evaluate the contrast-enhanced CT characteristics of pathologic thoraco-abdominal lymph nodes in 38 patients infected with Mycobacterium tuberculosis (30 without AIDS and eight with AIDS). Unenhanced scans of chest, abdomen and pelvis were also done in all cases. The CT attenuation values and the enhancement characteristics of the largest node or group of lymph nodes were evaluated in a dynamic sequence over a period of 10 min. On unenhanced CT the nodes were of low attenuation (less than 30 HU) in 18 cases and of soft tissue attenuation (greater than 35 HU) in 20 cases. Four post-contrast patterns of enhancement were found: (i) peripheral rim enhancement (n = 22); (ii) inhomogeneous enhancement (n = 8); (iii) homogeneous enhancement (n = 6); and (iv) homogeneous nonenhancing nodes (n = 2). Increase of attenuation and obliteration of perinodal fat was found in 13 cases, most of them with the peripheral rim enhancement pattern. Seven cases had a combination of enhancing patterns in the same nodal group. The central enhancement was usually moderate (mean, 30 HU) but was marked (greater than 60 HU) in three patients with the homogeneous enhancement pattern. Neither the nodal attenuation values nor the patterns of enhancement are characteristic of tuberculosis, however adenopathy showing peripheral rim-enhancement with relative low attenuation centres can suggest a diagnosis of tuberculosis in the appropriate clinical setting.     

恶性淋巴瘤胸部CT表现

目的：了解恶性淋巴瘤的胸部ＣＴ表现以指导疾病的分期与治疗。材料和方法：对经病理证实的１００例恶性淋巴瘤中７８例胸部ＣＴ异常的表现作回顾性分析。结论：恶性淋巴瘤在胸部ＣＴ中可见纵隔淋巴结、肺、胸膜及心包等各种异常表现。常规胸部ＣＴ检查有利于精确分期，制定治疗计划及判断疗效。     

成人纵隔淋巴结结核与恶性淋巴瘤的MSCT对照研究

目的:探讨纵隔淋巴结结核与淋巴瘤的优势解剖分布及其MSCT表现.方法:纵隔淋巴结结核和淋巴瘤各30例行MSCT检查,按病变部位记录其大小、形态、密度、数量、有无坏死和融合、强化程度和方式、对纵隔血管有无侵犯和包埋等征象,并进行对比分析.结果:本组结果显示结核(10R,n=8;10L,n=9)比淋巴瘤(均为1例)更易累及10R和10L区淋巴结,而在其它纵隔解剖区分布上两者无明显差异.90%淋巴结结核呈环形强化(其中14.6%伴有分隔样强化,5.6%伴有小结节样强化),5%为均匀强化,5%无明显强化.91.8%淋巴瘤呈均匀强化,8.2%呈较均匀强化合并有部分坏死.同一部位多个淋巴结结核相对独立,即使粘连,也仍可分辨其单个淋巴结边界;淋巴瘤的肿大淋巴结常融合成块并侵犯纵隔结构.结论:纵隔淋巴结结核与纵隔淋巴瘤具有一定的优势解剖分布,根据两者的MSCT表现和强化特点可资鉴别.     

CT findings in Kikuchi disease: analysis of 96 cases

BACKGROUND AND PURPOSE: Although CT findings of Kikuchi disease (KD), or histiocytic necrotizing lymphadenitis, are reported in several case reports, large-scale analysis of the disease has not been undertaken. We characterized the clinical and CT findings in a large group of patients with KD. METHODS: Between 1990 and 2002, 96 patients (68 women, 28 men; mean age, 24.4 years) underwent biopsy of the cervical lymph nodes and had histologically proved KD at our institution. We reviewed their clinical and CT findings and recorded the total number of affected nodes; location and size of the lymph nodes; and characteristic findings including necrosis, perinodal infiltration, and contrast enhancement. RESULTS: We identified 1196 affected lymph nodes (12.5 nodes per patient). The affected lymph nodes were 0.5-3.5 cm (mean, 1.62 cm). Perinodal infiltration was found in 78 patients (81.3%). Eighty (83.3%) had homogeneous nodal contrast enhancement. Nine patients (9.4%) had lymph nodes with a focal low attenuation, and seven (7.3%) had ring-shaped lymph nodes. Unilateral and bilateral cervical lymph nodes were affected in 76 and 20 patients, respectively. Lymph nodes were mainly located at levels II (IIA, 174 nodes; IIB, 254 nodes), III (222 nodes), IV (160 nodes), and V (VA 126 nodes, VB 130 nodes). Follow-up CT in 32 patients showed complete resolution in 14 and partially improved lymphadenopathy in 18. CONCLUSION: Awareness of the various CT appearances of KD and follow-up CT may be helpful for more accurate diagnosis of the disease.     

MSCT对纵隔淋巴结结核和纵隔淋巴结转移瘤诊断价值

目的 探讨多层螺旋CT(MSCT)对纵隔淋巴结结核和纵隔淋巴结转移瘤的诊断价值.方法 选取50例纵隔淋巴结结核及26例纵隔淋巴结转移瘤的MSCT影像资料,记录病变分布、大小、密度、融合、强化方式、邻近组织受累情况,进行对比分析.结果 成人纵隔淋巴结结核比转移瘤更易累及4R、2R、7区淋巴结.前者病灶直径在1～4 cm之...     

腹腔及腹膜后间隙淋巴结结核的多层螺旋CT强化特征

目的研究腹腔及腹膜后间隙淋巴结结核的多层螺旋CT强化特征,以提高该疾病的影像诊断水平。方法收集本院经临床病理证实的腹部淋巴结结核19例,在多层螺旋CT强化图像上,观察受累淋巴结的大小、形态、密度、强化类型、优势解剖分布以及淋巴结外器官病变的强化特征。结果94.7%淋巴结结核呈典型的环状强化,仅5.3%增大的淋巴结呈均匀强化。腹部淋巴结结核常优势地累及肠系膜(73.7%)、门腔间隙(63.2%)、肝十二指肠韧带(57.9%)、肝胃韧带(47.4%)和腹主动脉周围上部淋巴结(47.4%)。9例(47.4%)脾增大,其中5例(26.3%)脾内有多发低密度灶,病灶周边强化;6例(31.5%)腹腔积液;3例(15.8%)大网膜、肠系膜和壁层腹膜广泛结节样增厚。结论结核累及腹腔及腹膜后间隙淋巴结的多层螺旋CT强化具有一定特征。     

Computed tomography of neck lymph nodes involved with malignant lymphoma: comparison with ultrasound.

CT images of 24 patients with head and neck lymphoma were retrospectively reviewed, compared with ultrasonograms, and compared with CT images of 13 patients with lymph node metastases. In nine (38%) of 24 patients, some lymph nodes with lymphomatous involvement showed a spotty or linear pattern of contrast enhancement. In two of these nine patients, a dendritic pattern of contrast enhancement between multiple enlarged lymph nodes was observed. The same pattern appeared as spotty, linear, or dendritic hyperechoic areas on the ultrasonogram. None of 13 patients with lymph node metastases showed a spotty, linear, or dendritic pattern of contrast enhancement. Ten of 13 (77%) showed ring-like contrast enhancement on CE-CT images. The spotty or linear contrast enhancement in enlarged lymph nodes and the dendritic contrast enhancement in confluent lymph nodes could be useful CT findings in diagnosing nodal involvement with malignant lymphoma.     

Computed tomography for preoperative evaluations of lung cancer

Computed tomography was evaluated for its accuracy in diagnosing mediastinal node metastases, direct chest wall invasion, and direct mediastinal invasion by lung cancer among 61 patients who subsequently underwent surgery. Using 15-mm diameter or larger mediastinal lymph nodes as the criterion for metastasis, the sensitivity was 36% (8/22); the specificity was 92% (34/37). The accuracy for direct chest wall invasion was relatively high, with a sensitivity of 100% (7/7) and a specificity of 92% (22/24). Direct mediastinal invasion had a sensitivity of 67% (4/6) and a specificity of 91% (10/11). These results suggest that the ability of computed tomography to diagnose mediastinal lymph node metastasis when such nodal size is used as a criterion is limited.     

Abdominal tuberculous lymphadenopathy: MRI features

The aim of this study was to describe the MRI features of abdominal tuberculous lymphadenopathy. MRI studies of 13 patients with abdominal tuberculous lymphadenopathy were reviewed with regard to anatomic distribution and size. Signal intensities, in relation to abdominal wall muscle, on unenhanced T1- and T2-weighted images and patterns of contrast enhancement of lymphadenopathy were evaluated in each patient. In each patient, the largest lymph node with the same imaging characteristic was evaluated. The upper paraaortic region was the most common site of involvement (n=12 patients), followed by the lesser omentum (n=10 patients), the anterior pararenal space (n=9 patients), the lower paraaortic area (n=8 patients), the small bowel mesentery (n=6 patients), the greater omentum (n=2 patients) and the originating site of the inferior mesenteric artery (n=2 patients). The mean lymph node size was 1.8 cm (range 0.5–5 cm). The overall mean lymph node number per patient was 16 (range 2–50). A total of 41 lymph nodes were evaluated in 13 patients. On T2-weighted images, 40 lesions were hyperintense and one lesion was isointense. Nine hyperintense lesions showed a hypointense peripheral rim and seven internal heterogeneïty. Perinodal T2-hyperintensity was present in 23 lesions. The latter finding was valid for all patients. On T1-weighted images, 30 lesions were hypointense and 11 isointense. Nine hypointense lesions demonstrated a hyperintense peripheral rim, and six were heterogeneous. Contrast-enhanced fat-suppressed T1-weighted images demonstrated predominant peripheral enhancement in 28 lesions: (1) peripheral uniform, thin (n=19); (2) thick irregular, complete (n=3); and (3) conglomerate group of nodes showing peripheral and central areas of rim enhancement (n=6). Heterogeneous and homogeneous enhancement was present in ten and three lesions, respectively. Combinations of enhancing patterns in the same nodal group and different nodal groups were seen in eight and nine patients, respectively. Abdominal tuberculous lymphadenopathy may show a variety of signal intensities and patterns of contrast enhancement on MRI. Lymphadenopathy, hypointense on T1-weighted, hyperintense on T2-weighted images with perinodal hyperintensity, and predominant peripheral rimlike enhancement may suggest the diagnosis of tuberculosis.     

PET/CT与增强CT检测乳腺癌及其腋淋巴结转移的对照研究

目的探讨^18F-脱氧葡萄糖（FDG）PET／CT显像与螺旋CT增强扫描检测乳腺癌及其腋淋巴结转移的临床价值。方法27例乳腺肿块患者于同日行^18F—FDG PET／CT显像与CT增强扫描。患者俯卧于乳腺专用泡沫垫上接受检查，前者图像由3位核医学科医师采用目测法结合半定量法进行诊断，后者图像由3位影像科医师分析诊断；最后与病理检查结果对照。结果27例患者PET／CT与增强CT均发现31个乳腺肿块，病理检查证实其中21个为乳腺癌，10个为良性病变；发现腋淋巴结91个，共有66个转移（1例有双侧腋淋巴结转移）；PET／CT显像检测乳腺癌原发灶的灵敏度为80．95％，特异性为90％，阳性预测值为94．44％；检测淋巴结转移的灵敏度为89．39％，特异性为88％，阳性预测值为95．16％。增强CT检测乳腺癌原发灶的灵敏度为90．48％，特异性为60％，阳性预测值为82．61％；检测淋巴结转移的灵敏度为86．36％，特异性为52％，阳性预测值为82．61％。^18F—FDG PET／CT和增强CT对腋淋巴结状态的诊断与病理检查结果的列联系数分别为0．64和0．37；两者对乳腺癌及其腋淋巴结转移的诊断特异性差异有显著性（P〈0．05）；对直径〈2cm的病灶，^18F—FDG PET／CT诊断准确性明显高于增强CT（P〈0．05）。结论^18F—FDG PET／CT对诊断乳腺癌及其腋淋巴结转移的特异性均高于增强CT。     

Mediastinal evaluation in lung cancer

Findings of mediastinal imaging were compared with pathologic findings following thoracotomy and full nodal sampling in 50 patients with bronchogenic carcinoma. All patients underwent full nodal sampling and chest radiography, conventional tomography, CT, and Ga-67 radionuclide scanning. The highest sensitivity for mediastinal metastases noted was 54%, considering nodes greater than or equal to 1.0 cm abnormal at CT. The small size of some involved nodes precluded sensitivity from reaching 100%. Using differing size criteria for nodal abnormality at CT (greater than or equal to 1.0 cm, greater than or equal to 1.5 cm, greater than or equal to 2.0 cm abnormal) sensitivity decreased as specificity increased. The highest specificity noted was 97% with CT, considering nodes greater than or equal to 2.0 cm abnormal. Ga-67 scanning did not offer additional information when compared with that of other studies. The predictive value of considering mediastinal lymph nodes greater than or equal to 1.0 cm abnormal at CT was 35%. Reasons for this include reactive nodes proximal to obstructions and prior granulomatous disease. In 13 peripheral T1N0 cancers (determined by chest radiography) no additional information was gained with any other imaging technique. The utility of CT in peripheral T2 cancers and central cancers is not clear.     

Nasopharyngeal carcinoma: treatment of neck node recurrence by radiotherapy.

The records of 91 nasopharyngeal carcinoma patients who were treated with external radiotherapy for recurrent neck node disease were reviewed. All patients had received prior radiotherapy for cervical nodal disease or prophylactic neck irradiation. The node size (product of the greatest perpendicular diameters) at the time of treatment for nodal relapse ranged from 1cm2 to 35cm2 (median 2.25cm2). The radiation dose ranged from 823 RETs to 1949 RETs (median 1520 RETs). The recurrent node size and radiation dose were found significant prognostic factors for local control. The local tumour control for nodes 4cm2 or smaller was 51% at five years, for nodes greater than 4cm2 was 16% at 18 months (p = 0.01). The overall 5 year survival was 19.7%. Radiation dose greater than 1600 RETs was significantly associated with better survival for patients with recurrent nodes measured 4cm2 or smaller, but higher radiation dose did not improve the survival of patients with recurrent nodes greater than 4cm2. Because of the dilemma of suboptimal control resulting from inadequate radiation dose when compared with surgical treatment, and possible radiation complication from higher dose, surgery should be the treatment of choice for neck node recurrence after primary radiotherapy for nasopharyngeal carcinoma.     

Nodal metastases of nasopharyngeal carcinoma: patterns of disease on MRI and FDG PET

The patterns of nodal spread of nasopharyngeal carcinoma (NPC) have an important influence on treatment planning, but have not yet been fully addressed. We prospectively used MRI and FDG PET to document the patterns of nodal spread in NPC. One hundred and one patients with newly diagnosed NPC were studied with MRI and FDG PET. On MRI, nodes were considered as metastatic according to criteria regarding size, the presence of nodal necrosis, and extracapsular spread. FDG PET images were interpreted visually, and nodes were considered metastatic if they showed prominent FDG uptake against the background. Nodal metastases were found in 89 of our 101 patients. Analysis of the distributions of nodal metastases in these 89 patients showed that retropharyngeal nodes were less frequently involved than cervical nodes (82.0% vs 95.5%). The vast majority of cervical nodal metastases were to the internal jugular chain, including nodes at levels II, III, and IV, with decreasing incidences of 95.5%, 60.7%, and 34.8%, respectively. Level V nodal involvement was found in 27% of patients. Supraclavicular fossa nodal metastases were not uncommon and occurred in 22.5% of patients. Skip metastases in the lower-level nodes or supraclavicular fossa nodes occurred in 7.9% of patients. Mediastinal and abdominal metastatic adenopathy was present in 4.5% and 3.4% of patients, respectively, and was associated with advanced nodal metastasis in the supraclavicular fossa. Level VI (2.2%), level VII (1.1%), submandibular (2.2%), and parotid (3.4%) nodal metastases were uncommon and were always associated with advanced ipsilateral nodal metastases of the neck. We conclude that the combined use of FDG PET and MRI can comprehensively depict the pattern of nodal metastasis in NPC patients. Nodal metastases principally affected level II nodes, from which lymphatic spread extended down in an orderly manner to involve level III, level IV, and the supraclavicular fossa nodes, or extended posteriorly to involve level V nodes. The frequency of skip metastases was 7.9%. Distant spread to mediastinal or abdominal nodes was found in 3–5% of patients, usually in association with supraclavicular nodal metastases.     

Detection of lymph nodes in pelvic malignancies with computed tomography and magnetic resonance imaging

Thirty patients with prostate or bladder cancer underwent CT and MRI for nodal staging. CT detected 189 nodes, and MRI detected 271 nodes. This difference was statistically significant in the external iliac (CT/MRI=73/87 nodes), obturator (CT/MRI=48/75 nodes), and internal iliac (CT/MRI=24/46 nodes) nodal chains. Based on size, the number of nodes detected by CT and MRI were as follows: 1–5 mm, CT/MRI=91/166; 6–10 mm, CT/MRI=91/98; >10 mm, CT/MRI=7/7 nodes. MRI detected significantly more lymph nodes in the size range of 1–5 mm.     

Enhancement patterns of intrahepatic cholangiocarcinoma: comparison between contrast-enhanced ultrasound and contrast-enhanced CT

The aim of this study was to compare the enhancement pattern of intrahepatic cholangiocarcinoma (ICC) on contrast-enhanced ultrasound (CEUS) with that on contrast-enhanced computed tomography (CECT). 40 pathologically proven ICC lesions in 40 patients were evaluated retrospectively with both CEUS and CECT. The enhancement level and pattern in the dynamic phases on both CEUS and CECT were analysed. The diagnostic results of CEUS and CECT before pathological examination were also recorded. During arterial phases, the number of lesions that appeared as (i) peripheral irregular rim-like hyperenhancement, (ii) diffuse heterogeneous hyperenhancement, (iii) diffuse homogeneous hyperenhancement and (iv) diffuse heterogeneous hypoenhancement were 19 (47.5%), 9 (22.5%), 5 (12.5%) and 7 (17.5%), respectively, on CEUS, and 22 (55.0%), 3 (7.5%), 2 (5.0%) and 13 (32.5%), respectively, on CECT (p = 0.125). In the portal phase, the number of lesions showing hyperenhancement and hypoenhancement were 1 (2.5%) and 39 (97.5%), respectively, on CEUS, and 15 (37.5%) and 25 (62.5%) on CECT (p = 0.0001). CEUS made a correct diagnosis in 32 (80.0%) lesions before pathological examination; CECT made a correct diagnosis in 27 (67.5%) lesions (p = 0.18). In conclusion, the enhancement patterns of ICC on CEUS were consistent with those on CECT in the arterial phase, whereas in the portal phase ICC faded out more obviously on CEUS than on CECT. CEUS had the same accuracy as CECT in diagnosing ICCs, and so can be used as a new modality for the characterization of ICC.     

Peripheral T-cell lymphoma in the neck: CT findings of lymph node involvement

OBJECTIVE: To describe the CT findings of lymph nodes of the neck involved in peripheral T-cell lymphomas (PTCL). MATERIALS AND METHODS: Twenty-seven patients with pathologically proved PTCL with involvement of the lymph nodes of the neck were enrolled in this study. We retrospectively evaluated the lymph nodes on CT images with special attention to nodal necrosis, the margin, and enhancement patterns. RESULTS: In the 27 patients studied, nodal necrosis and ill-defined margin were seen in 11 (41%) and 19 (70%), respectively. Heterogeneous enhancement of enlarged lymph nodes was noted on CT images in 19 (70%) of 27 patients. Homogeneous enhancement without ill-defined margin and/or nodal necrosis was only seen in 6 of 27 patients (22%). CONCLUSION: Necrosis, an ill-defined margin, and heterogeneous enhancement of enlarged lymph nodes in the neck are relatively common CT features of PTCL. For patients with cervical lymph node enlargement, the presence of these findings may suggest high-grade non-Hodgkin's lymphoma, including PTCL.     

High-resolution MR imaging for nodal staging in rectal cancer: are there any criteria in addition to the size?

PURPOSE: MR staging of nodal metastases in patients with rectal cancer using criteria based on size, shape and signal intensity can be difficult, because > or =50% of the nodes are less than 5 mm in size. Therefore new MR criteria were evaluated to see whether it can improve the MR assessment of nodal metastases in rectal cancer patients. MATERIALS AND METHODS: Ninety-nine patients with primary rectal carcinoma underwent 1.5 T high-resolution MRI with a quadrature phased array coil. Among them, 75 patients who had undergone total mesorectal excision were enrolled in this study. An MR radiologist, blinded for the histological results, randomly recorded the characteristics of each detectable node (LN); common criteria such as short-axis diameter, the ratio of long- to short-axis diameter, and signal intensity on each sequence; new criteria such as the margin (smooth, lobulated, spiculated, indistinct), a homogenous or mottled heterogeneous appearance, gross enhancement and its pattern, the venous encasement, and the dirty perirectal fat signal. RESULTS: Among 75 patients, 22 (29%) were node-positive. All patients who did not have detectable LN on MR were node-free (n = 15). Presence of LNs > 4 mm was significantly higher in the node-positive group. Presence of LNs > 8 mm was seen only in the node-positive group. Presence of a spiculated border and an indistinct border shows sensitivities of 45 and 36%, and specificities of 100 and 100%, respectively. Presence of a mottled heterogeneic pattern shows a sensitivity of 50%, a specificity of 95%. The presence of these three features were strongly correlated with LN positivity (P < 0.001, respectively). Presence of a venous encasement (n = 4) and dirty perirectal fat signal (n = 3) were also significantly (P < 0.05, respectively) correlated with LN positivity. CONCLUSION: In addition to size, new criteria such as a spiculated or indistinct border and a mottled heterogeneous appearance could be useful to predict regional lymph node involvement in patients with rectal cancer.     

Do hemodynamic studies of stage T1 lung cancer enable the prediction of hilar or mediastinal nodal metastasis?

OBJECTIVE: We aimed to identify CT enhancement characteristics that predict hilar or mediastinal nodal metastasis in patients with stage T1 lung cancer. SUBJECTS AND METHODS: Eighty-four patients (50 men and 34 women; age range, 39-80 years; mean age, 61 years) with stage T1 lung cancer underwent a hemodynamic and a conventional morphologic CT study before curative surgical resection. Peak enhancement (maximum attenuation over the entire time course), net enhancement (peak enhancement minus preenhancement attenuation), maximum enhancement ratio (MER), time to peak enhancement, slope of enhancement on dynamic studies, nodule size, presence of tumor necrosis or thickening of bronchovascular bundles, and marginal characteristics on morphologic studies were analyzed and correlated with the presence of histologically determined mediastinal or hilar nodal metastasis. RESULTS: Mediastinal or hilar nodal metastases were found at surgery in 26 (31%) of 84 patients: mediastinal nodes in 13 (15%) and hilar nodes in 19 (23%). Six (7%) had both mediastinal and hilar nodal metastasis. Peak enhancement, net enhancement, and MER were significantly associated (p = 0.001, 0.002, and 0.008, respectively) with the presence of mediastinal or hilar nodal metastasis. A peak attenuation of 110 H or greater and a net enhancement of 60 H or greater predicted nodal metastasis with accuracies of 73% (61/84 nodules) and 73% (61/84 nodules) and odd ratios of 4.98 and 5.94, respectively. CONCLUSION: Stage T1 lung cancers showing peak enhancement of 110 H or greater or net enhancement of 60 H or greater on dynamic CT indicate a high likelihood of hilar or mediastinal nodal metastasis.     

PET/CT in initial staging and therapy response assessment of early mediastinal lymphoma

Objective

To detect accuracy of PET/CT in the initial staging, response after the first line and end of treatment in early mediastinal lymphoma patients compared to contrast CT.

Materials and methods

We studied 50 patients with pathologically proven lymphoma with a mean age = 27.5. All patients were at early stage. All patients performed CT and PET/CT for initial staging, after the first course of chemotherapy (after 4–6 weeks) and at the end of treatment (after 2–4 months).

Results

PET/CT upstaged 5 cases. At first line of treatment, PET/CT and CECT were agreeable in 32% of cases. PET/CT showed 100% sensitivity, 96.7% specificity, 95% positive predictive value and 100% negative predictive value. At the end of treatment both methods showed a 46% agreement. PET/CT was statistically significant in the follow up of hilar and axillary lymph nodes. PET/CT showed 100% sensitivity and specificity; compared to 62.5% sensitivity and 97.6% specificity for CECT in detection of extra-nodal disease sites.

Conclusion

PET/CT proved higher sensitivity and specificity over CECT. The major strength of PET/CT over CECT was its higher ability for detection of extra-nodal sites of lymphoma and excluding active disease in residual nodal mass lesions on follow up.     

Enhancement pattern of hepatocellular carcinoma: comparison of real-time contrast-enhanced ultrasound and contrast-enhanced computed tomography

We compared the enhancement pattern of 98 hepatocellular carcinoma nodules in 92 patients on contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT). Contrast-enhanced ultrasound was performed with SonoVue and a low mechanical index method. In arterial phase, 98 nodules were hyperenhancing on CEUS and 94 on CECT. In portal phase, 82 nodules were hypoenhancing on CEUS and 83 on CECT. Peripheral thin-rim-like enhancement was exhibited in 30 nodules on CEUS and 31 on CECT. Intratumoral vessels were visualized in 94 nodules on CEUS and 36 on CECT.