Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Kanagawa 232-0024, Japan.
Eur J Radiol. 2009 Dec;72(3):425-31. doi: 10.1016/j.ejrad.2008.09.003. Epub 2008 Oct 18.
We investigated clinical utility of contrast-enhanced three-dimensional ultrasound (CE 3D US) imaging with contrast medium Sonazoid for demonstrating characteristic enhancement of hepatocellular carcinoma (HCC).
Among 115 focal liver tumors undergoing CE 3D US imaging, 70 HCCs confirmed with contrast-enhanced multi-detector computed tomography, contrast-enhanced magnetic resonance imaging or histopathologic examination were retrospectively analyzed. CE 3D US imaging was performed using Autosweep 3D scan functionality in the early, middle and late phase, after bolus injection of 0.2 ml Sonazoid. The CE 3D tomographic images reconstructed in parallel slices and sonographic angiogram images were independently reviewed by two reviewers. Kappa values were used to assess inter-reviewers' agreement.
TUI images showed most of HCCs were detected with intratumoral vessels and early tumor enhancement in the early phase, expressed homogenous or heterogeneous tumor enhancement in the middle phase, and became hypoechoic or isoechoic in the late phase. The kappa values in the early, middle and late phase for inter-reviewer agreements regarding the characteristic enhancement of tumors were 0.817, 0.774, and 0.785. In addition, TUI images demonstrated satellite foci and tortuous tumor vessels in three orthogonal planes. Sonographic angiogram reconstructed by different rendering modes showed the vessels and tumor stain in spatial view. The spatial configuration of anatomic structures was revealed on basis of both TUI and sonographic angiogram images.
CE 3D US imaging, with spatial visualization, is clinically useful to exhibit the characteristic enhancement of HCC tumors objectively.
我们研究了对比增强三维超声（CE 3D US）成像与造影剂声诺维在显示肝细胞癌（HCC）特征性增强方面的临床应用价值。
在 115 个接受 CE 3D US 成像的局灶性肝肿瘤中，回顾性分析了经增强多排 CT、增强磁共振成像或组织病理学检查证实的 70 个 HCC。CE 3D US 成像使用 Autosweep 3D 扫描功能在早期、中期和晚期，在 SonoVue 0.2ml 团注后进行。平行切片重建的 CE 3D 断层图像和超声造影图像由两名审阅者独立审阅。Kappa 值用于评估审阅者之间的一致性。
TUI 图像显示大多数 HCC 在早期显示肿瘤内血管和早期肿瘤增强，在中期表现为均匀或不均匀的肿瘤增强，在晚期表现为低回声或等回声。肿瘤特征性增强的早期、中期和晚期审阅者之间的 Kappa 值分别为 0.817、0.774 和 0.785。此外，TUI 图像在三个正交平面上显示了卫星灶和扭曲的肿瘤血管。不同渲染模式重建的超声造影图像显示了空间内的血管和肿瘤染色。基于 TUI 和超声造影图像，可以显示解剖结构的空间结构。
CE 3D US 成像具有空间可视化功能，可客观地显示 HCC 肿瘤的特征性增强，具有临床应用价值。
