Hepatocellular carcinoma: US evolution in the early stage.

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Abstract
To study the sonographic evolution of hepatocellular carcinoma (HCC) in its early stage, 26 HCC in 24 patients were observed regularly with real-time ultrasound for a period of 90-691 days. In the beginning, 21 tumors were hypoechoic, 2 isoechoic and 3 diffusely hyperechoic. On follow-up, 2 of the 21 initially hypoechoic HCC remained the same echodensity, 12 increased in internal echoes but were still hypoechoic, 1 became isoechoic, 4 changed to hyperechoic and the remaining 2 shifted from hypoechoic to isoechoic and then to hyperechoic. The 2 initially isoechoic HCC also gained echogenicity and became hyperechoic. By contrast, the 3 initially hyperechoic HCC kept the same echo patterns. The acquired hyperechoic HCC were inhomogeneous in echodensity and larger in size whereas the 3 originally hyperechoic HCC were homogeneous and smaller. Most small HCC apparently evolve progressively from hypoechoic to isoechoic and then to inhomogeneously hyperechoic patterns as they grow; a few HCC have diffusely higher echogenicity from the beginning and retain the same features thereafter.