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Ultrasound Evaluation in Patients at Risk for Hepatocellular Carcinoma


In the context of chronic liver disease (CLD), sonographic features of hepatic steatosis, cirrhosis, and portal hypertension are discussed and examples are provided. The impact of CLD and hepatocellular carcinoma (HCC) is introduced, providing the rationale for a robust HCC screening and surveillance program for at-risk patients. The American College of Radiology Liver Imaging Reporting and Data System algorithms for screening and surveillance by ultrasound and for the definitive diagnosis of HCC by contrast-enhanced ultrasound are explained, with imaging examples provided. Contrast-enhanced ultrasound technique, limitations, and pitfalls also are introduced.


Fetzer DT1, Rodgers SK2, Seow JH3, Dawkins AA4, Joshi G5, Gabriel H6, Kamaya A7.


Radiol Clin North Am. 2019 May;57(3):563-583. doi: 10.1016/j.rcl.2019.01.004. Epub 2019 Feb 14.

Author Information

  1. Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9316, USA. Electronic address:

  2. Abdominal Radiology, Department of Radiology, Sidney Kimmel Medical College, Thomas Jefferson University, Einstein Medical Center, 5501 Old York Road, Philadelphia, PA 19141, USA.

  3. Department of Radiology, Royal Perth Hospital, Wellington Street, Perth, Western Australia 6000, Australia.

  4. Department of Radiology, University of Kentucky, 800 Rose Street, Room HX-318A, Lexington, KY 40536-0293, USA.

  5. Department of Radiology and Imaging Sciences, Emory University Hospital Midtown, Emory University School of Medicine, 550 Peachtree Street Northeast, Atlanta, GA 30308, USA.

  6. Department of Radiology, Feinberg School of Medicine, Northwestern University, 676 North St. Clair Avenue, Suite 800, Chicago, IL 60611, USA.

  7. Department of Radiology, Stanford University Medical Center, 300 Pasteur Drive H1307, Stanford, CA 94305, USA.

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