Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China.
Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
Clin Hemorheol Microcirc. 2023;84(1):43-52. doi: 10.3233/CH-221682.
To explore the value of vascular architecture detected by micro vascular imaging (MVI) in preoperative diagnosis of focal liver lesions (FLLs).
In this retrospective study, patients with surgery and histopathologically proved or radiologically confirmed FLLs were included. Vascular architecture of FLLs were acquired by color Doppler flow imaging (CDFI) and MVI on LOGIQ™ E20 ultrasound machine (C1-6 convex array probes). Alder semiquantitative analysis (grade 0-3) and morphologic features of blood vessels (pattern a-f) were used to assess the blood flow within the FLLs. Interobserver agreement for evaluating blood flow of FLLs was analyzed. Using Adler's grading or morphologic patterns as diagnostic criteria for malignant FLLs, the diagnostic efficiency was analyzed and compared.
From October 2021 and February 2022, 50 patients diagnosed with 40 malignant FLLs and 10 benign FLLs were finally included. The Kappa value within two observers for evaluating the blood flow of FLLs was 0.78 for MVI and 0.55 for CDFI. According to Alder semiquantitative analysis, more high-level blood flow signals (grade 2-3) were detected by MVI than CDFI (P < 0.05). Based on high-level blood flow signals (grade 2-3) and hypervascular supply patterns (pattern e and f), the diagnostic accuracy for malignant FLLs were 76% and 68% for MVI, 56% and 38% for CDFI, respectively.
MVI is superior to CDFI in evaluating vascular architecture of FLLs. The high-level flow signals and hypervascular pattern detected by MVI have a useful and complementary value in preoperative non-invasive identification of malignant FLLs.
探讨微血管成像（MVI）检测到的血管结构在局灶性肝脏病变（FLL）术前诊断中的价值。
本回顾性研究纳入了经手术和组织病理学证实或影像学证实的 FLL 患者。使用 LOGIQ™ E20 超声仪（C1-6 凸阵探头）上的彩色多普勒血流成像（CDFI）和 MVI 获取 FLL 的血管结构。采用 Alder 半定量分析（0-3 级）和血管形态（a-f 型）评估 FLL 内的血流。分析评估 FLL 血流的观察者间一致性。使用 Alder 分级或形态学模式作为恶性 FLL 的诊断标准，分析并比较其诊断效率。
2021 年 10 月至 2022 年 2 月，最终纳入了 50 例患者，共 40 个恶性 FLL 和 10 个良性 FLL。两名观察者评估 FLL 血流的 Kappa 值，MVI 为 0.78，CDFI 为 0.55。根据 Alder 半定量分析，MVI 检测到的高血流信号（2-3 级）比 CDFI 多（P < 0.05）。基于高血流信号（2-3 级）和富血供模式（e 型和 f 型），MVI 对恶性 FLL 的诊断准确率为 76%，CDFI 为 56%。
MVI 比 CDFI 更能评估 FLL 的血管结构。MVI 检测到的高血流信号和富血供模式在术前无创识别恶性 FLL 方面具有有用且互补的价值。
