Department of Medical Ultrasonics, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
Eur Radiol. 2024 Jan;34(1):622-631. doi: 10.1007/s00330-023-10051-1. Epub 2023 Aug 11.
To compare contrast-enhanced ultrasound (CEUS) with microbubbles containing sulfur hexafluoride (SHF) and perfluorobutane (PFB) for the detection of colorectal liver metastasis (CRLM).
In this prospective study, conducted from September to November 2021, patients with colorectal cancer were consecutively recruited and underwent same-day ultrasound, SHF-CEUS, and PFB-CEUS. The reference standard was contrast-enhanced MRI and follow-up imaging. The size, depth, echogenicity, and calcification of each focal liver lesion were recorded. The number and conspicuity of CRLMs, based on washout appearance during the late phase (LP) (> 120 s)/Kupffer phase (KP), were evaluated offsite by two blinded readers.
Overall, 230 lesions (CRLMs, n = 219; benign lesions, n = 11) in 78 patients were evaluated. Lesion conspicuity (p = 0.344) and accuracy in the detection of CRLM were comparable for SHF- and PFB-CEUS (0.877 for SHF vs. 0.770 for PFB, p = 0.087). More CRLMs ≥ 10 mm were identified by LP contrast washout in SHF-CEUS than in KP PFB-CEUS (p < 0.001). More CRLMs < 10 mm were identified by KP washout in PFB-CEUS than in LP SHF-CEUS (p < 0.001). Conspicuity was better on PFB-CEUS than on SHF-CEUS (p = 0.027). In hyperechoic lesions, lesions located deeper than 80 mm, and calcified lesions, CRLM conspicuity on PFB-CEUS was inferior to that on SHF-CEUS (p < 0.05).
The overall accuracy of detection and conspicuity of washout in CRLMs were comparable between SHF and PFB-CEUS. PFB-CEUS has the advantage of identifying washout in small CRLMs. However, larger, hyperechogenic, deep-seated, or calcified lesions were better identified using SHF-CEUS.
Accuracy of detection and conspicuity of washout in CRLMs were comparable between SHF- and PFB-CEUS. PFB-CEUS has the advantage in detecting small CRLMs, whereas SHF-CEUS is better for detecting larger, hyperechogenic, deep-seated, or calcified lesions.
Contrast-enhanced ultrasound with sulfur hexafluoride in the late phase and perfluorobutane microbubbles in the Kupffer phase were comparable in terms of accuracy in the detection and conspicuity of colorectal liver metastases. Small colorectal liver metastases (< 10 mm) were more often identified in the Kupffer phase contrast-enhanced ultrasound imaging when using perfluorobutane microbubbles. Larger, hyperechogenic, deep-seated, or calcified lesions were better identified in the late phase contrast-enhanced ultrasound imaging (> 120 s) when using sulfur hexafluoride microbubbles.
比较含六氟化硫（SHF）和全氟丁烷（PFB）微泡的超声造影（CEUS）在检测结直肠癌肝转移（CRLM）中的应用。
这是一项前瞻性研究，于 2021 年 9 月至 11 月进行，连续招募结直肠癌患者，同日接受超声、SHF-CEUS 和 PFB-CEUS 检查。参考标准为增强 MRI 和随访影像学检查。记录每个局灶性肝病变的大小、深度、回声强度和钙化情况。两名盲法阅片者离线评估基于晚期（LP）（>120 s）/库普弗相位（KP）洗脱外观的 CRLM 的数量和显著性。
共评估了 78 例患者的 230 个病灶（CRLM，n=219；良性病变，n=11）。SHF-和 PFB-CEUS 的病变显著性（p=0.344）和 CRLM 检测的准确性相当（SHF 为 0.877，PFB 为 0.770，p=0.087）。与 KP PFB-CEUS 相比，SHF-CEUS 中 LP 对比洗脱更能识别出更多≥10mm 的 CRLM（p<0.001）。与 LP SHF-CEUS 相比，KP 洗脱时 PFB-CEUS 能识别出更多<10mm 的 CRLM（p<0.001）。PFB-CEUS 的病变显著性优于 SHF-CEUS（p=0.027）。在高回声病变、深度大于 80mm 的病变和钙化病变中，PFB-CEUS 检测 CRLM 的显著性低于 SHF-CEUS（p<0.05）。
SHF 和 PFB-CEUS 在检测 CRLM 的总体准确性和洗脱显著性方面相当。PFB-CEUS 具有识别小 CRLM 洗脱的优势。然而，SHF-CEUS 更适合检测较大、高回声、深部或钙化病变。
SHF-和 PFB-CEUS 在检测 CRLM 的准确性和洗脱显著性方面相当。PFB-CEUS 在检测小 CRLM 方面具有优势，而 SHF-CEUS 则更适合检测较大、高回声、深部或钙化病变。
含六氟化硫的超声造影的晚期相与含全氟丁烷微泡的库普弗相位在检测结直肠癌肝转移的准确性和显著性方面相当。使用全氟丁烷微泡时，在库普弗相位增强超声成像中更常发现小的结直肠癌肝转移（<10mm）。使用六氟化硫微泡时，在晚期增强超声成像中更易发现较大、高回声、深部或钙化病变。
