Department of Ultrasound, Zhongshan Hospital, Fudan University.
Biosci Trends. 2015 Apr;9(2):104-10. doi: 10.5582/bst.2015.01026.
This study aims to compare contrast enhanced ultrasound (CEUS) and contrast enhanced magnetic resonance imaging (CEMRI) for the detection and characterization of hepatic hemangiomas. Included in this retrospective study were 83 histopathologically confirmed lesions of hemangioma in 66 hospitalized patients who underwent both CEUS and CEMRI and received surgery. The enhancement patterns on CEUS and CEMRI in each lesion were compared and analyzed. In addition, data obtained by the two modalities were then compared with the pathological findings to determine their value in differential diagnosis of hepatic hemangiomas. CEUS diagnosed 78 lesions of hemangioma against 80 by CEMRI. There were no statistical significant differences in the diagnostic value between CEUS and CEMRI in terms of sensitivity (88.0% vs. 92.8%), specificity (99.0% vs. 99.4%), accuracy (97.3% vs. 98.4%), positive predictive value (93.6% vs. 96.3%), and negative predictive value (98.0% vs. 98.8%) (p > 0.05, all). In the arterial phase, the main enhancement pattern on both CEUS and CEMRI was peripheral nodular enhancement (73 vs. 76), but lesions with diffuse enhancement on CEUS outnumbered those on CEMRI (3 vs. 1) and lesions with circular enhancement on CEMRI outnumbered those on CEUS (3 vs. 2). In the portal venous phase and delayed phase, the main enhancement pattern was hyperechoic change on CEUS and hyperintense on CEMRI (66 vs. 65), some lesions presented isoechoic change (12 vs. 15). These results suggested CEUS, an equivalent to CEMRI, may have an added diagnostic value in hemangiomas.
本研究旨在比较超声造影(CEUS)和对比增强磁共振成像(CEMRI)在肝血管瘤的检测和特征描述中的应用。这项回顾性研究纳入了 66 名住院患者的 83 个经组织病理学证实的肝血管瘤病灶,这些患者均接受了 CEUS 和 CEMRI 检查,并接受了手术治疗。比较和分析了每个病灶在 CEUS 和 CEMRI 上的增强模式。此外,还将两种模态获得的数据与病理结果进行比较,以确定它们在肝血管瘤的鉴别诊断中的价值。CEUS 诊断出 78 个血管瘤病变,CEMRI 诊断出 80 个。在诊断效能方面,CEUS 和 CEMRI 的灵敏度(88.0% vs. 92.8%)、特异性(99.0% vs. 99.4%)、准确性(97.3% vs. 98.4%)、阳性预测值(93.6% vs. 96.3%)和阴性预测值(98.0% vs. 98.8%)均无统计学差异(p > 0.05,均)。在动脉期,CEUS 和 CEMRI 的主要增强模式均为边缘结节状增强(73 个 vs. 76 个),但 CEUS 上弥漫性增强的病变多于 CEMRI(3 个 vs. 1 个),而 CEMRI 上环形增强的病变多于 CEUS(3 个 vs. 2 个)。在门静脉期和延迟期,CEUS 的主要增强模式为高回声改变,CEMRI 的主要增强模式为高信号改变(66 个 vs. 65 个),部分病变表现为等回声改变(12 个 vs. 15 个)。这些结果表明,CEUS 与 CEMRI 具有同等的诊断价值,可能对血管瘤具有额外的诊断价值。