Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China.
Department of Radiology, University Medical Center Regensburg, Regensburg, Germany.
Clin Hemorheol Microcirc. 2021;77(4):461-469. doi: 10.3233/CH-201085.
To investigate the clinical value of dynamic contrast enhanced ultrasound (D-CEUS) in predicting the microvascular invasion (MVI) of hepatocellular carcinoma (HCC).
In this retrospective study, 16 patients with surgery and histopathologically proved HCC lesions were included. Patients were classified according to the presence of MVI: MVI positive group (n = 6) and MVI negative group (n = 10). Contrast enhanced ultrasound (CEUS) examinations were performed within a week before surgery. Dynamic analysis was performed by VueBox® software (Bracco, Italy). Three regions of interests (ROIs) were set in the center of HCC lesions, at the margin of HCC lesions and in the surrounding liver parenchyma accordingly. Time intensity curves (TICs) were generated and quantitative perfusion parameters including WiR (wash-in rate), WoR (wash-out rate), WiAUC (wash-in area under the curve), WoAUC (wash-out area under the curve) and WiPi (wash-in perfusion index) were obtained and analyzed.
All of HCC lesions showed arterial hyperenhancement (100 %) and at the late phase as hypoenhancement (75%) in CEUS. Among all CEUS quantitative parameters, the WiAUC and WoAUC were higher in MVI positive group than in MVI negative group in the center HCC lesions (P < 0.05), WiAUC, WoAUC and WiPI were higher in MVI positive group than in MVI negative group at the margin of HCC lesions. WiR and WoR were significant higher in MVI positive group.
D-CEUS with quantitative perfusion analysis has potential clinical value in predicting the existence of MVI in HCC lesions.
探讨动态对比增强超声（D-CEUS）预测肝细胞癌（HCC）微血管侵犯（MVI）的临床价值。
本回顾性研究纳入了 16 例经手术和组织病理学证实的 HCC 病变患者。根据 MVI 的存在情况对患者进行分类：MVI 阳性组（n = 6）和 MVI 阴性组（n = 10）。所有患者均在术前一周内行超声造影（CEUS）检查。采用 VueBox®软件（意大利 Bracco）进行动态分析。在 HCC 病变的中心、边缘和周围肝实质分别设置三个感兴趣区（ROI）。生成时间强度曲线（TIC），并获得和分析定量灌注参数，包括 WiR（灌注上升率）、WoR（灌注下降率）、WiAUC（灌注上升曲线下面积）、WoAUC（灌注下降曲线下面积）和 WiPi（灌注指数）。
CEUS 示所有 HCC 病变均表现为动脉期高增强（100%），晚期呈低增强（75%）。在所有 CEUS 定量参数中，MVI 阳性组 HCC 病变中心的 WiAUC 和 WoAUC 均高于 MVI 阴性组（P < 0.05），MVI 阳性组 HCC 病变边缘的 WiAUC、WoAUC 和 WiPI 均高于 MVI 阴性组。MVI 阳性组 WiR 和 WoR 明显升高。
D-CEUS 定量灌注分析对预测 HCC 病变中 MVI 的存在具有潜在的临床价值。
