Han Dan, Wang Ting, Wang Ruiqi, Chen Jingyu, Tang Yi
Department of Ultrasound, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.
Diagnostics (Basel). 2023 Nov 14;13(22):3443. doi: 10.3390/diagnostics13223443.
We aimed to investigate the diagnostic utility of quantitative parameters of contrast-enhanced ultrasound (CEUS) for benign and malignant liver lesions in pediatric patients. This was a single-center retrospective analysis of children with liver lesions who underwent CEUS at our hospital between July 2019 and February 2023. The CEUS perfusion patterns for all lesions were qualitatively analyzed using histopathology, contrast-enhanced magnetic resonance imaging, contrast-enhanced computed tomography, or long-term clinical follow-up as reference standards. The CEUS images were quantitatively analyzed using SonoLiver software (TomTec Imaging Systems, Munich, Germany) to obtain data regarding quantitative parameters and dynamic vascular pattern (DVP) parametric images, including rise time (RT), time to peak (TTP), mean transit time (mTT), and maximum intensity (IMAX). Statistical analysis was carried out using Student's -test and receiver operating characteristic (ROC) curve analysis to evaluate the diagnostic value of quantitative parameters. A total of 53 pediatric cases were included in this study, and 88.57% (31/35) of malignant lesions exhibited hyper-enhancement with rapid washout patterns; the same proportion of DVP parametric images exhibited washout patterns. Conversely, 94.44% (17/18) of benign lesions showed hyper-enhancement with slow washout patterns, and the same proportion of DVP parametric images showed no-washout patterns. RT, TTP, and mTT were significantly shorter in the malignant group than in the benign group ( < 0.05), while IMAX showed no significant difference ( > 0.05). ROC analysis indicated that mTT < 113.34 had the highest diagnostic value, with an area under the curve of 0.82. CEUS quantitative analysis had an accuracy of 98.11%, while qualitative analysis had an accuracy of 92.45%, with no statistically significant difference ( > 0.05). Quantitative analysis of CEUS provides valuable assistance in differentiating benign and malignant liver lesions in children. Among all quantitative parameters, mTT holds promise as a potentially valuable tool for identifying liver tumors.
我们旨在研究超声造影（CEUS）定量参数对儿科患者肝脏良恶性病变的诊断效用。这是一项对2019年7月至2023年2月期间在我院接受CEUS检查的肝脏病变患儿进行的单中心回顾性分析。以组织病理学、磁共振造影成像、计算机断层造影或长期临床随访作为参考标准，对所有病变的CEUS灌注模式进行定性分析。使用SonoLiver软件（德国慕尼黑TomTec成像系统公司）对CEUS图像进行定量分析，以获取有关定量参数和动态血管模式（DVP）参数图像的数据，包括上升时间（RT）、达峰时间（TTP）、平均通过时间（mTT）和最大强度（IMAX）。采用Student's -检验和受试者操作特征（ROC）曲线分析进行统计分析，以评估定量参数的诊断价值。本研究共纳入53例儿科病例，88.57%（31/35）的恶性病变表现为快速廓清的高增强模式；相同比例的DVP参数图像表现为廓清模式。相反，94.44%（17/18）的良性病变表现为缓慢廓清的高增强模式，相同比例的DVP参数图像表现为无廓清模式。恶性组的RT、TTP和mTT显著短于良性组（<0.05），而IMAX无显著差异（>0.05）。ROC分析表明，mTT<113.34具有最高的诊断价值，曲线下面积为0.82。CEUS定量分析的准确率为98.11%，而定性分析的准确率为92.45%，差异无统计学意义（>0.05）。CEUS定量分析为鉴别儿童肝脏良恶性病变提供了有价值的帮助。在所有定量参数中，mTT有望成为识别肝脏肿瘤的潜在有价值工具。
