Abstract: Objective To compare the diagnostic value of contrast- enhanced ultrasound (CEUS) and contrastenhanced helical computed tomography (CECT) for hepatocellular carcinoma (HCC) with liver cirrhosis. Methods Two hundreds and forty-one focal liver lesions in 207 patients with Hepatitis B virus (HBV) cirrhosis were detected with CEUS and CECT, respectively. Pathological results were used as "gold standard" to compare the two methods. Diagnostic results of the two methods were compared with pathological results. Differences were assessed using the McNemar test, and the Kappa test was used for consistency evaluation. Results (1) For 113 liver lesions that were ≤ 2 cm, the number of HCC lesions was 63, and the number of benign lesions was 50. There were no significant differences in results of CEUS and CECT compared with that of the "gold standard" of McNemar test results (P = 0.824, P = 0.082). Consistency of the Kappa test results of CEUS and CECT in comparison with the "gold standard" was general (Kappa = 0.643, Kappa = 0.421). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of HCC diagnosed by CEUS were higher than those of CECT. The rate of arterial enhancement was better for CEUS [87.30% (55/63)] than that for CECT [69.84% (44/63), χ2 = 5.704, P = 0.017]. (2) For 128 liver lesions that were > 2 cm, the number of HCC lesions was 77, and the number of benign lesions was 51. There were no significant differences in the diagnostic results between McNemar test and CEUS and CECT tests (P = 0.481, P = 0.167). Consistency of the Kappa test results of CEUS and CECT and "gold standard" was general (Kappa = 0.710, Kappa = 0.697). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of HCC were not different between two diagnostic methods. The rate of arterial enhancement was 89.61% (69/77) for CEUS and 85.71% (66/77) for CECT, and there was no significant difference between the two groups (χ2 = 0.540, P = 0.462). Conclusion For HCC ≤ 2 cm, the diagnostic performance of CEUS is better than that of CECT. For HCC > 2 cm, the diagnostic performance is similar for the two diagnostic methods.

Key words: carcinoma, hepatocellular, liver cirrhosis, contrast-enhanced ultrasound, contrast-enhanced helical CT