ĐẶC ĐIỂM HÌNH ẢNH VÀ GIÁ TRỊ CỦA SIÊU ÂM DOPPLER TRONG CHẨN ĐOÁN UNG THƯ BIỂU MÔ TẾ BÀO GAN TẠI THÀNH PHỐ CẦN THƠ NĂM 2023 – 2025

Abstract

Background: Hepatocellular carcinoma (HCC) represents a major public health issue in Vietnam, with the majority of cases being diagnosed at an advanced stage, thereby reducing treatment efficacy and increasing mortality rates. Doppler ultrasound plays a critical role in evaluating tumor perfusion, contributing to early diagnosis and disease monitoring. Objective: To describe the imaging characteristics and determine the diagnostic value of Doppler ultrasound in hepatocellular carcinoma. Materials and methods: A cross-sectional descriptive study was conducted on 69 patients in Can Tho City with hepatic masses detected by ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI), and with complete medical records. Results: Among 69 patients, 52 were definitively diagnosed with HCC. The mean age in the HCC group was 60.25 ± 12.05 years, with a male-to-female ratio of 2.47:1. On B-mode ultrasound, tumor echogenicity was variable, with hypoechoic (50.0%) and hyperechoic (32.7%) patterns being the most common. Doppler ultrasound showed that both vascular proliferation and arterial waveform increased with tumor size. The predominant vascular distribution patterns were basket pattern (40.4%) and intratumoral penetrating vessels (38.5%). The mean peak systolic velocity (PSV) of intratumoral arteries was 83.9 cm/s, and the mean resistive index (RI) was 0.71. However, RI tended to decrease as tumor size increased. Doppler ultrasound demonstrated a sensitivity of 90.4%, specificity of 88.2%, positive predictive value (PPV) of 95.9%, negative predictive value (NPV) of 75%, and an overall diagnostic accuracy of 89.9% in detecting HCC. Conclusion: Doppler ultrasound has high sensitivity and specificity in the diagnosis of hepatocellular carcinoma. Common imaging features include hypoechoic lesions on B-mode, basket or penetrating vascular patterns on Doppler imaging, and elevated PSV and RI values in intratumoral arteries.