Fei Xiang, Han Peng, Jiang Bo, Zhu Lianhua, Tian Wenshuo, Sang Maodong, Zhang Xirui, Zhu Yaqiong, Luo Yukun
Department of Ultrasound, The First Medical Centre, Chinese PLA General Hospital, Beijing, China.
Clinical Research Division of Ultrasound Imaging System, Shenzhen Mindray Bio-Medical Electronics Co., Ltd., Shenzhen, Guangdong, China.
J Clin Transl Hepatol. 2022 Feb 28;10(1):26-33. doi: 10.14218/JCTH.2020.00172. Epub 2021 Jul 5.
This study aimed to evaluate the diagnostic performance of high frame rate contrast-enhanced ultrasound (H-CEUS) of focal liver lesions (FLLs).
From July 2017 to June 2019, conventional contrast-enhanced ultrasound (C-CEUS) and H-CEUS were performed in 78 patients with 78 nodules. The characteristics of C-CEUS and H-CEUS in malignant and benign groups and the differences between different lesion sizes (1-3 cm, 3-5 cm, or >5 cm) of C-CEUS and H-CEUS were examined. The diagnostic performance of C-CEUS and H-CEUS was analyzed. The chi-square test or Fisher's exact test was used to assess inter-group differences. The receiver operating characteristic curve was plotted to determine the diagnostic performance of C-CEUS and H-CEUS.
There were significant differences in the enhancement area, fill-in direction and vascular architecture between C-CEUS and H-CEUS for both benign and malignant lesions (all =0.000-0.008), but there were no significant differences in washout results (=0.566 and =0.684, respectively). For lesions 1-3 cm in size, the enhancement area, fill-in direction, and vascular architecture on C-CEUS and H-CEUS were significantly different (all =0.000), unlike for lesions 3-5 cm or >5 cm in size. For differentiation of malignant from benign FLLs in the 1-3 cm group, H-CEUS showed sensitivity, specificity, accuracy, and positive and negative predictive values of 92.86%, 95.0%, 96.3%, 90.48% and 93.75%, respectively, which were higher than those for C-CEUS (75.0%, 70.0%, 77.78%, 66.67% and 72.91%, respectively).
H-CEUS provided more vascular information which could help differentiate malignant from benign FLLs, especially for lesions 1-3 cm in size.
本研究旨在评估高帧率对比增强超声（H-CEUS）对肝脏局灶性病变（FLLs）的诊断性能。
2017年7月至2019年6月，对78例患者的78个结节进行了常规对比增强超声（C-CEUS）和H-CEUS检查。研究了C-CEUS和H-CEUS在恶性和良性组中的特征，以及C-CEUS和H-CEUS不同病变大小（1-3 cm、3-5 cm或>5 cm）之间的差异。分析了C-CEUS和H-CEUS的诊断性能。采用卡方检验或Fisher精确检验评估组间差异。绘制受试者操作特征曲线以确定C-CEUS和H-CEUS的诊断性能。
C-CEUS和H-CEUS在良性和恶性病变的增强区域、填充方向和血管结构方面均存在显著差异（均P =0.000-0.008），但在消退结果方面无显著差异（分别为P =0.566和P =0.684）。对于大小为1-3 cm的病变，C-CEUS和H-CEUS的增强区域、填充方向和血管结构存在显著差异（均P =0.000），而对于大小为3-5 cm或>5 cm的病变则不然。对于1-3 cm组中FLLs的良恶性鉴别，H-CEUS的敏感性、特异性、准确性以及阳性和阴性预测值分别为92.86%、95.0%、96.3%、90.48%和93.75%，高于C-CEUS（分别为75.0%、70.0%、77.78%、66.67%和72.91%）。
H-CEUS提供了更多血管信息，有助于鉴别FLLs的良恶性，尤其是对于大小为1-3 cm的病变。
