Figure 4

Examples of focal lesions identified by ICE in patients with liver cirrhosis. Without contrast medium for ultrasound, these tumors, which were highly suspect for hepatocellular carcinoma, could not be differentiated from regenerative nodules. The ultrasound device was introduced into the right or middle hepatic vein and the parenchyma surrounding the vessel was inspected over 360 degrees by turning the ultrasound catheter clock- and anti-clockwise. The ultrasound pattern of these lesions was homogeneous (A, B and C) or heterogeneous (D, E and F). No vascular invasion was identified in this study.