To classify hepatocellular carcinoma (HCC) based on the findings of digital subtraction imaging (DSI) and to compare DSI against other diagnostic imaging modalities to assess its reliability. DSI was performed in 58 patients with HCC (62 nodules) and tie enhancement pat-terns of blood flow in the tumor were assessed during the early phase, the portal phase, and the late phase. In addition, the findings obtained by DSI were compared with those obtained by helical CT, digital subtraction angiography (DSA), US angiogmphy, and CT during arterial portography (CTAP). Of the 62 nodules, blood flow was detected in 52 (83.9%) by early-phase US1, in 55 (88.7%) by helical CT, in 51 (82,3%) by DSA, and in 56 (90.3%) by US angiography. Early-phase DSI did not demonstrate hypervascular enhancement in 10 HCC nodules (16.1%). These included 7 nodules in which other diagnostic imaging modalities also failed to identity tumor blood vessels and 3 nodules located in deep regions or more from the body surface. With regard to these 7 nodules (11.3%) in which tumor vessels were not visualized during the early phase, late-phase DSI demonstrated relatively poor enhancement compared with normal hepatic parendryma. Such late-phase defects in tumor enhancement were observed in 59 nodules (95.1%). DSI demonstrated characteristic findings of HCC enhancement during the early phase, the portal phase, and the late phase, permitting classification of HCC to be performed.

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Background : The effect of scanning directions on three-dimensional echocardiographic vol-umes measured by freehand scanning transthoracic three-dimensional echocardiography (FS 3DE) have not been investigated. Methods : In the experimental study, we used 3D ultrasound calibration phantom, and col-lected a series of phantom tomograms by slowly tilting the probe (fan-like scanning) from four probe scanning directions (A-1, A-2, B-1, B2) of the 3D phantom. The 3D phantom volumes were calculated by using the multiplanar Simpson's (the average rotation) method. In the clinical study, we collected a series of left atrium (LA) tomograms by slowly fitting the probe (fan-like scanning) from the apical long-axis (lax), 2-chamber (2c) and 4-chamber (4c) position. 3D maximum and minimum LA volumes were calculated by using the average rotation method. Results:In the experimental study, the 3D phantom volumes were 69.0 ± 0.5ml (A-1). 67.6 ± 1.5ml (A-2), 66.7 ± 2.5ml (B-1) and 67.6 ± 1.6ml (B-2). There were no significant differences among 4 scanning directions. In the clinical study, maximum LA volumes were 54.7 ± 15.3ml Oax), 55.7 ± 14.9ml (2c), 55.2 ± 15.4ml (4c). Minimum IA volumes were 26.6 ± 12.3ml (lax), 26.9±13.4ml (2c), 25.1±14.3ml (4c). There were no significant differences among 3 scanning directions. Conclusions : FS-3DE provides accurate measurement of volumes without the effect of scan-ning directions of transducer in the experimental study and the clinical (LA volumes) study.

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