The ultrasound was carried out in 40 patients with the chronic hepatitis with the spleanic vein and portal vein dilation to determine the patients whether had the esophageal vein dilation or not. The technique utilized the pachymetry of the anterior septal of the esophageal and found the hepato fugal spectrum in the esophageal septal. From which the standards were compared and introduced in diagnosis of the esophageal vein dilation to contribute to diagnosis of cirrhosis with the increase of portal vein pressure
Ultrasonography ; Hepatitis, Chronic ; Diagnosis

PURPOSE: The aim of this study is to correlate the non-characteristic dual-phase CT imaging findings of hepato-cellular carcinoma with the observed characteristics of surgical specimens. MATERIALS AND METHODS: We studied four cases in which homogeneous low attenuation was observed during the arterial and delayed phases of dynamic CT scanning and in which hepatocellular carcinoma with coagulation necrosis above 95% was pathologically confirmed. We compared the findings of dual phase CT scanning, ultrasonography, angiography and Lipiodol CT scanning with the observed features of surgical specimens. RESULTS: Nodules were 30-50 (mean, 41) mm in size, and were round in three cases and oval in one. In all four cases, a low density lesion was observed during the arterial and delayed phases of dual-phase CT scanning. Ultrasonography demonstrated internal echo and the presence of a hypoechoic halo, implying that in all cases a capsule was present. At angiography and LiCT, minimal peripheral and central tumor staining or lipiodol up-take was observed. In all surgical specimens a complete capsule was visible, and histologic structures were mainly of the trabecular type, Edmondson grade II or III was recorded, and the mass had undergone extensive coagulation necrosis (above 95%). CONCLUSION: In cirrhotic liver which is hepatitis B-antigen positive, clear sonographic findings of internal echo and a capsule, rather than a simple cyst, indicate the possibility of hepatocellular carcinoma with extensive coagulation necrosis. This is so even if the arterial and delayed phases of dual-phase CT scanning indicate the presence of a low-density lesion, and in such cases additional work-up is therefore required.
Angiography ; Carcinoma, Hepatocellular* ; Diagnosis* ; Ethiodized Oil ; Hepatitis ; Liver ; Liver Neoplasms ; Necrosis* ; Tomography, X-Ray Computed ; Ultrasonography

Complete or partial agenesis of dorsal pancreas has been reported in a small number of pediatric and adult patients. A case of partial agenesis of dorsal pancreas was reported. This case was not associated with diabetes mellitus and pancreatic exocrine dysfunction, or abdominal pain. A 37-year-old man with chronic hepatitis B visited to our hospital due to further examination for chronic hepatitis B. Abdominal ultrasonography showed enlarged pancreatic head. Diagnosis was made by endoscopic retrograde cholangiopancreatography and computed tomography. Explor-laparotomy was not done.
Abdominal Pain ; Adult ; Cholangiopancreatography, Endoscopic Retrograde ; Diabetes Mellitus ; Diagnosis ; Head ; Hepatitis B, Chronic ; Humans ; Pancreas ; Ultrasonography

BACKGROUND: The optimal screening tools for hepat ocellular carcinoma are regular tests of alpha fetoprotein (aFP)and liver ultrasonography every 6 months in high risk group. To implement successful long-term project for reducing cancer-mortality,it is essential to know the reasons f or non-compliance among the high risk group. METHODS: A telephone survey was done a mong the hepatitis B surface antigen positive patient group who had not receiveda follow-up test of aFP and liver ultrasonography. This group was selected among the patients who had received health examinations from January,2002 to December,2002 at a university hospital center for health promotion, and the reasons for non-compliance were inquired. RESULTS: There were no stati stical di fferences i n educational level,economic status,age,and sex between the patient group who had taken appropriate follow-up tests and the group who had not. But there were statistically significant differences in the admission history and t ransf usi on hi st ory bet ween t he t wo groups. The reasons for non-compliance were as follows:1. ignorance to the significance of follow-up examination (41.7%),2.lack of time (27.8%),3.no specific signs of cancer (22.2%),4.high costs (5.6%),and 5.fear of discovering serious disease. CONCLUSION: It is important to have patients educated on the significance of screening and early diagnosis of hepatocellular carcinoma.
alpha-Fetoproteins ; Carcinoma, Hepatocellular* ; Compliance ; Early Diagnosis ; Follow-Up Studies ; Health Promotion ; Hepatitis B Surface Antigens* ; Hepatitis B* ; Hepatitis* ; Humans ; Liver ; Mass Screening* ; Telephone ; Ultrasonography

Radiological imaging plays a crucial role in the diagnosis of hepatocellular carcinoma (HCC) as the noninvasive diagnosis of HCC in high-risk patients by typical imaging findings alone is widely adopted in major practice guidelines for HCC. While imaging techniques have markedly improved in detecting small liver lesions, they often detect incidental benign liver lesions and non-hepatocellular malignancy that can be misdiagnosed as HCC. The most common mimicker of HCC in cirrhotic liver is nontumorous arterioportal shunts that are seen as focal hypervascular liver lesions on dynamic contrast-enhanced cross-sectional imaging. Rapidly enhancing hemangiomas can be easily misdiagnosed as HCC especially on MR imaging with liver-specific contrast agent. Focal inflammatory liver lesions mimic HCC by demonstrating arterial-phase hypervascularity and subsequent washout on dynamic contrast-enhanced imaging. It is important to recognize the suggestive imaging findings for intrahepatic cholangiocarcinoma (CC) as the management of CC is largely different from that of HCC. There are other benign mimickers of HCC such as angiomyolipomas and focal nodular hyperplasia-like nodules. Recognition of their typical imaging findings can reduce false-positive HCC diagnosis.
Carcinoma, Hepatocellular/*diagnosis/radiography ; Diagnosis, Differential ; Hemangioma/complications/radiography/ultrasonography ; Hepatitis B/complications ; Humans ; Inflammation/radiography/ultrasonography ; Liver/radiography/ultrasonography ; Liver Cirrhosis/complications/radiography ; Liver Neoplasms/*diagnosis/radiography ; Magnetic Resonance Imaging ; Non-alcoholic Fatty Liver Disease/radiography/ultrasonography

Biliary atresia (BA) is very difficult to distinguish from neonatal hepatitis (NH) and its prognosis depends on the age at the time of Kasai operation. Therefore early differentiation between these two conditions is very important. Although various clinical and laboratory tests have been reported to differentiate between them, they are still of limited value. From 1980 to 1999, forty-five infants were referred to our pediatric surgical unit for operation for suspected BA. Eight patients underwent Kasai operation immediately because late diagnosis. These were excluded from the study. The clinical history, physical findings, radiologic and laboratory examinations of 37 cases were analyzed retrospectively. The average age of BA (n=20) was 55.1+/-6.7 days, and that of NH (n=17) was 55.8+/-5.6 days. The sex ratio of BA was 13:7, and that of NH was 14:3. All the patients had obstructive jaundice and acholic stool except 4 BA and 6 NH patients. Acholic stool with yellow component was more frequent in NH. Onset of jaundice was within 2 weeks after birth in 85% of BA, and in 65% of NH. The onset of acholic stool was within 2 weeks after birth in 60% of BA, and in 23.5% of NH. The duration of jaundice and acholic stool of BA were 50.9+/-6.6 days and 41.3+/-8.4 days and those of NH were 40.1+/-3.1 days and 26.6+/-5.4 days respectively. The ultrasonogram and hepatobiliary scan were useful, but not a definitively reliable method for the differentiation of these two diseases. There was no difference in laboratory data. Seventeen cases had NH among 45 referred cases for Kasai operation with the clinical impression of BA, and 4 cases of 17 NH cases needed to be explored to rule out BA. In conclusion, false positive rate of clinical impression of BA was 37.8%, and negative exploration rate was 8.9%. Therefore, careful clinical observation for 1-2 weeks by an experienced pediatric surgeon was very important to avoid unnecessary operation to rule out NH up to the age of 8 - 10 weeks, so long as the stool had yellow component.
Biliary Atresia* ; Delayed Diagnosis ; Diagnosis, Differential ; Hepatitis ; Humans ; Infant ; Jaundice ; Jaundice, Obstructive ; Parturition ; Prognosis ; Retrospective Studies ; Sex Ratio ; Ultrasonography

OBJECTIVESTo explore the relation of ultrasonic findings to pathological features in cases of chronic viral hepatitis B and C.

METHODSThe ultrasonic and pathological findings were analyzed in 130 patients with chronic viral hepatitis B and 106 with chronic viral hepatitis C.

RESULTSIn patients with hepatitis B, the ultrasonic echo was thicker and more intensive and uneven cords were found. These findings were closely related to the pathological findings (P less than 0.001). In those with hepatitis C, the ultrasonic echo was slight and dense, which was also closely related to the pathological findings (P less than 0.001). In the patients complicated with fatty liver, the ultrasonic findings were also different (P less than 0.001).

CONCLUSIONUltrasonography is helpful for differential diagnosis of hepatitis B and hepatitis C.

Adult ; Diagnosis, Differential ; Female ; Hepatitis B, Chronic ; diagnostic imaging ; pathology ; Hepatitis C, Chronic ; diagnostic imaging ; pathology ; Humans ; Liver ; diagnostic imaging ; pathology ; Male ; Ultrasonography

Spontaneous regression of hepatocellular carcinoma (HCC) is extremely rare, and dozens of cases have been reported in the literature. In this report, we present a case of pathologically confirmed HCC that partially regressed without medical intervention. A 54-year-old Korean male with chronic hepatitis B had a hepatic mass detected by abdominal ultrasonography during a routine visit. A clinical diagnosis of HCC was made after measuring serum alpha-fetoprotein levels followed by dynamic computed tomography and magnetic resonance imaging. The patient delayed surgical resection; however, after 5 months, the size of the HCC decreased from 3.2 to 1.0 cm in diameter without any treatment. At that time the mass was surgically resected. Histopathology confirmed that the hepatic mass was consistent with partially regressed HCC and showed more intra- and peri-tumoral lymphocytes consisting of greater CD4+ T cell infiltration than what is normally seen in resected HCC.
alpha-Fetoproteins ; Carcinoma, Hepatocellular* ; Diagnosis ; Hepatitis B, Chronic ; Humans ; Lymphocytes ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Regression, Spontaneous ; Ultrasonography

Spontaneous regression of hepatocellular carcinoma (HCC) is extremely rare, and dozens of cases have been reported in the literature. In this report, we present a case of pathologically confirmed HCC that partially regressed without medical intervention. A 54-year-old Korean male with chronic hepatitis B had a hepatic mass detected by abdominal ultrasonography during a routine visit. A clinical diagnosis of HCC was made after measuring serum alpha-fetoprotein levels followed by dynamic computed tomography and magnetic resonance imaging. The patient delayed surgical resection; however, after 5 months, the size of the HCC decreased from 3.2 to 1.0 cm in diameter without any treatment. At that time the mass was surgically resected. Histopathology confirmed that the hepatic mass was consistent with partially regressed HCC and showed more intra- and peri-tumoral lymphocytes consisting of greater CD4+ T cell infiltration than what is normally seen in resected HCC.
alpha-Fetoproteins ; Carcinoma, Hepatocellular* ; Diagnosis ; Hepatitis B, Chronic ; Humans ; Lymphocytes ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Regression, Spontaneous ; Ultrasonography

Hepatocellular carcinoma (HCC) is the third most common cause of cancer related death worldwide. Prognosis and treatment options largely depend on tumor stage at diagnosis, with curative treatments only available if detected at an early stage. However, two thirds of patients with HCC are diagnosed at a late stage and not eligible for cure. Therefore several liver professional societies recommend HCC surveillance using abdominal ultrasound with or without alpha fetoprotein in at-risk populations, including patients with cirrhosis and subsets of those with chronic hepatitis B. Available data suggest HCC surveillance can significantly improve early tumor detection, curative treatment eligibility, and overall survival. However, the potential benefits of HCC surveillance must be considered in light a shifting HCC demographic from a viral-mediated cancer to an increasing proportion of patients having non-alcoholic steatohepatitis, which has been shown to limit ultrasound sensitivity and may mitigate observed benefits. Further, benefits of HCC surveillance must be weighed against potential physical, financial and psychological harms. Continued data for both benefits and harms of HCC surveillance in contemporary populations are necessary. In the interim, providers should continue to strive for high quality HCC surveillance in at-risk patients.
alpha-Fetoproteins ; Carcinoma, Hepatocellular ; Diagnosis ; Fatty Liver ; Fibrosis ; Hepatitis B, Chronic ; Humans ; Liver ; Liver Neoplasms ; Mass Screening ; Prognosis ; Ultrasonography