Department of Ultrasound, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, 200032, Shanghai, China; Shanghai Institute of Medical Imaging, No.180 Fenglin Road, 200032, Shanghai, China.
Department of Pathology, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, 200032, Shanghai, China.
Eur J Radiol. 2020 Nov;132:109341. doi: 10.1016/j.ejrad.2020.109341. Epub 2020 Oct 8.
To analyze the correlation between enhancement patterns of small hepatic carcinomas (HCCs; ≤ 30 mm) on contrast-enhanced ultrasound (CEUS) and the clinicopathologic characteristics.
The retrospective study included 346 inpatients (288 males and 58 females) with 372 pathologically confirmed small HCCs between January 2017 and December 2018. All patients underwent CEUS examination before pathological examination. Statistical analysis was used to determine the correlation between enhancement patterns of small HCCs on CEUS and clinicopathologic characteristics including serum alpha-feto-protein level, protein induced by vitamin K absence or antagonist-II (PIVKA-II) level, primary or recurrent HCC condition, tumor number, tumor differentiation, tumor size, liver background and microvascular invasion (MVI).
Three hundred forty-seven out of 372 (93.3 %) HCCs manifested arterial phase hyper-enhancement (APHE). The arterial enhancement patterns were correlated with the tumor differentiation (odds ratio = 10.336, P = 0.000). Moderately- or poorly-differentiated HCCs were more likely to display APHE than well-differentiated HCCs (96.2 % vs 58.6 %, P < 0.001). Two hundred ninety-five of 372 (79.3 %) HCCs showed washout in the portal venous/late phase. Washout was correlated with serum PIVKA-II level, tumor size, tumor differentiation, and MVI on univariate analysis (P < 0.05). Logistic regression analysis revealed that only tumor size was significantly associated with washout of small HCCs (odds ratio = 2.335, P = 0.006). Large HCCs (20-30 mm) displayed a higher proportion of washout compared with that of HCCs ≤ 20 mm.
Enhancement patterns of small HCCs on CEUS were significantly correlated with tumor size and tumor differentiation among all clinicopathologic characteristics.
分析小肝细胞癌（HCC；≤30mm）在超声造影（CEUS）增强模式与临床病理特征之间的相关性。
本回顾性研究纳入了 2017 年 1 月至 2018 年 12 月期间经病理检查证实的 346 例小 HCC 住院患者（288 名男性，58 名女性）。所有患者均在病理检查前接受 CEUS 检查。采用统计学分析确定 CEUS 对小 HCC 增强模式与包括血清甲胎蛋白水平、维生素 K 拮抗剂-II 诱导蛋白（PIVKA-II）水平、原发性或复发性 HCC 状况、肿瘤数量、肿瘤分化、肿瘤大小、肝脏背景和微血管侵犯（MVI）在内的临床病理特征之间的相关性。
372 个 HCC 中有 347 个（93.3%）表现为动脉期高增强（APHE）。动脉增强模式与肿瘤分化相关（比值比=10.336，P=0.000）。中-低分化 HCC 比高分化 HCC 更有可能表现为 APHE（96.2%比 58.6%，P<0.001）。372 个 HCC 中有 295 个（79.3%）在门静脉/晚期出现洗脱。单因素分析显示，洗脱与血清 PIVKA-II 水平、肿瘤大小、肿瘤分化和 MVI 相关（P<0.05）。Logistic 回归分析显示，只有肿瘤大小与小 HCC 的洗脱显著相关（比值比=2.335，P=0.006）。与 HCCs≤20mm 相比，20-30mm 的 HCCs 洗脱的比例更高。
CEUS 中小 HCC 的增强模式与所有临床病理特征中的肿瘤大小和肿瘤分化显著相关。
