Multiparametric Ultrasound in the Diagnosis of Hepatocellular Carcinoma in Patients without Cirrhosis (Clinical Case)

Abstract

Purpose: To demonstrate the capabilities of a complex of multiparametric ultrasound and MRI with intravenous contrast in the detection and characterization of atypical hepatocellular carcinoma with the example of a clinical case of a middle-aged patient without liver cirrhosis.Material and methods: Comprehensive study of medical history, outpatient records, results of clinical, laboratory, instrumental and morphological methods with independent retrospective analysis of the histological preparation of focal liver lesion.Results: Diagnostic search data are presented in a 48-year-old patient with hepatocellular carcinoma without signs of liver cirrhosis. The diagnosis required 1.5 months of examination in gastroenterological department, repeated review of the histological preparation by morphologists. The disease debuted with weakness after physical exertion, which was noted during a planned multiparameter abdomen ultrasound examination. During the study, multiple focal formations with uneven fuzzy contours, an inhomogeneous structure were visualized. Stiffness of the parenchyma in focal liver lesion is 108.29 kPa due to 2D-SWE. Further tactics consisted of hospitalization with further laboratory examination and abdomen MRI with intravenous contrast enhancement. Considering the results of instrumental examination, the patient was prescribed a puncture aspiration biopsy of focal liver lesion under ultrasound control followed by morphological verification.Conclusion: The presented clinical observation demonstrates the need of use an integrated approach in instrumental imaging methods in the diagnosis of atypical hepatocellular carcinoma.