肝脏病变的动态对比超声诊断（CEUS）与新的高分辨率检查技术（HiFR）和灌注的治疗后控制。

Dynamic Contrast Ultrasound Diagnostics (CEUS) of Liver Lesions and Post-treatment Control with A New High-resolution Examination Technique (HiFR) and Perfusion.

机构信息

Institute of Diagnostic Radiology, Interdisciplinary Ultrasound Department, University Hospital Regensburg, Regensburg, Germany. .

Institute of Diagnostic Radiology, Interdisciplinary Ultrasound Department, University Hospital Regensburg, Regensburg, Germany.

出版信息

J Gastrointestin Liver Dis. 2024 Sep 29;33(3):362-371. doi: 10.15403/jgld-5589.

DOI:10.15403/jgld-5589

PMID:39348590

Abstract

BACKGROUND AND AIMS

To evaluate, if high frame rate (HiFR) contrast-enhanced ultrasound (CEUS) and external perfusion analysis (VueBox®)can give answers on liver tumour diagnostics.

METHODS

A multifrequency probe (C1-6 /Resona R9) and 1-2.4 ml ultrasound contrast medium were used for CEUS up to 5-6 min. Independent analysis of DICOM-CINE files was performed, correlated to follow-up, computed tomography, magnetic resonance imaging, or histopathology.

RESULTS

In 110 patients the difference between marginal peak enhancement (PE) of malignant and benign leasions was significant. In the peripheral area, the AUCs were lower in malignant lesions (144.8±139.3) than in benign lesions (123.6±119.8). The mean transit time (mTT) was shorter in malignant lesions in the center. In the liver parenchyma, however, the mTT was significantly longer in malignant lesions (141.6±107.9s) than in benign lesions (128.8±138.6 s). The rise time (RT) was significantly shorter central (66.5±30.9s) and peripheral (72.8±35.1s) in malignant lesions than in benign lesions (114.33±159.58s). The wash in rate (WiR) in benign lesions was 848.3±2,563.7 rU in the center. Wash-out rate (WoR) in the center, peripheral and in the liver parenchyma showed a significantly lower wash-out in the malignant lesions.

CONCLUSIONS

HiFR CEUS with perfusion analysis enables the assessment of focal, diffuse and post-interventional liver changes.

摘要

背景与目的

评估高帧率（HiFR）对比增强超声（CEUS）和外部灌注分析（VueBox®）是否能为肝脏肿瘤诊断提供答案。

方法

使用多频探头（C1-6/Resona R9）和 1-2.4ml 超声造影剂进行 CEUS 检查，持续 5-6 分钟。对 DICOM-CINE 文件进行独立分析，并与随访、计算机断层扫描、磁共振成像或组织病理学相关联。

结果

在 110 名患者中，恶性和良性病变的边缘峰值增强（PE）差异具有统计学意义。在周边区域，恶性病变的 AUC 较低（144.8±139.3），良性病变的 AUC 较高（123.6±119.8）。中心区域恶性病变的平均通过时间（mTT）较短。然而，在肝实质中，恶性病变的 mTT 显著长于良性病变（141.6±107.9s），良性病变的 mTT 显著短于恶性病变（128.8±138.6 s）。中心区域（66.5±30.9s）和周边区域（72.8±35.1s）的上升时间（RT）显著短于恶性病变（114.33±159.58s）。中心区域的洗入率（WiR）为 848.3±2,563.7 rU，良性病变的洗出率（WoR）在中心、周边和肝实质中均显示出恶性病变的洗出率明显较低。