Song Yi, Cheng Jingliang, Zhang Ruifang
Departments of Ultrasound, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Departments of Magnetic Resonance Imaging, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
J Ultrasound Med. 2018 May;37(5):1117-1128. doi: 10.1002/jum.14458. Epub 2017 Oct 24.
In this study, we investigated the vascular characteristics of liver tumors on 3-dimensional (3D) and 2-dimensional (2D) contrast-enhanced ultrasonography (CEUS). The clinical value of these CEUS methods in the diagnosis of benign and malignant liver tumors was evaluated and compared.
A total of 126 liver tumors were examined by conventional ultrasonography (US), 2D CEUS, and dynamic 3D CEUS (frequency range, 1-6 MHz; focusing ability, 2-25 cm in depth; mechanical index, 0.09). Dynamic 3D CEUS images were postprocessed with high-resolution intelligent tomographic technology. The sensitivity and specificity of the CEUS methods in differentiating benign and malignant liver tumors were compared, as were the vascular characteristics (including the number and spatial relationships of the tumor vessels, such as origin and continuity) of the tumors in the arterial phase.
The imaging methods did not significantly differ in their sensitivity and specificity for differentiating benign and malignant liver tumors (P > .05). Dynamic 3D CEUS was significantly better than 2D CEUS in revealing the vascular characteristics of the tumors (P < .05). The vascular morphologic characteristics of benign and malignant hepatic tumors in the arterial phase of dynamic 3D CEUS using intelligent tomographic technology differed significantly (P < .05).
Dynamic 3D CEUS of liver tumors provides a more intuitive and comprehensive view of the spatial relationships of their blood vessels, including their peripheral and internal distribution. The volume information obtained with dynamic 3D CEUS combined with intelligent tomographic technology can improve the US-based diagnosis of liver tumors and thus guide their treatment.
在本研究中，我们利用三维（3D）和二维（2D）对比增强超声（CEUS）研究了肝肿瘤的血管特征。评估并比较了这些CEUS方法在诊断良性和恶性肝肿瘤方面的临床价值。
对126个肝肿瘤进行了常规超声（US）、2D CEUS和动态3D CEUS检查（频率范围为1 - 6 MHz；聚焦能力为深度2 - 25 cm；机械指数为0.09）。动态3D CEUS图像采用高分辨率智能断层扫描技术进行后处理。比较了CEUS方法在鉴别良性和恶性肝肿瘤方面的敏感性和特异性，以及肿瘤在动脉期的血管特征（包括肿瘤血管的数量和空间关系，如起源和连续性）。
在鉴别良性和恶性肝肿瘤的敏感性和特异性方面，这些成像方法无显著差异（P > 0.05）。动态3D CEUS在显示肿瘤血管特征方面明显优于2D CEUS（P < 0.05）。使用智能断层扫描技术的动态3D CEUS动脉期良性和恶性肝肿瘤的血管形态特征差异显著（P < 0.05）。
肝肿瘤的动态3D CEUS能更直观、全面地显示其血管的空间关系，包括外周和内部分布。动态3D CEUS结合智能断层扫描技术获得的容积信息可改善基于超声的肝肿瘤诊断，从而指导其治疗。
