Color doppler flow imaging of hepatocellular carcinomas comparison with metastatic tumors and hemangiomas by three-step grading for color hues

The role of color Doppler imaging was evaluated in differentiating hepatocellular carcinomas (HCCs) from metastases and hemangiomas by the amount of tumoral color signals. Intratumoral and peritumoral color signals were analyzed by a three-step grading system (grade 1 to 3) in 51 patients (32 HCCs, seven metastases, and 12 hemangiomas). Correlation of grading scores for intratumoral and peritumoral color signals was evaluated with the size of the tumors as well. HCCs demonstrated a higher grade of intratumoral color signals than did metastases or hemangiomas in all (p< 0.05) and biopsy-proved lesions (p = 0.0084); there was no significant difference in the degree of peritumoral color signals in all (p> 0.05) or 17 biopsy-proved HCCs (p = 0.2078) from the other tumor groups. In addition, the grade of both intratumoral and peritumoral color signals was not related with the tumor size in all groups (p> 0.05). In conclusion, color Doppler imaging provided a valuable role in the diagnosis of HCCs based on the qualitative analysis of the intratumoral color signals.