HUANG Zhe, ZHOU Pingping, WU Xiaobei, et al. Differential diagnosis of contrast-enhanced ultrasound in delayed phase clearance of hepatitis lesions and hepatocellular carcinoma. [J]. Journal of Clinical Ultrasound in Medicine 23(1):31-35(2021)
HUANG Zhe, ZHOU Pingping, WU Xiaobei, et al. Differential diagnosis of contrast-enhanced ultrasound in delayed phase clearance of hepatitis lesions and hepatocellular carcinoma. [J]. Journal of Clinical Ultrasound in Medicine 23(1):31-35(2021) DOI: 10.16245/j.cnki.issn1008-6978.2021.01.009.
Differential diagnosis of contrast-enhanced ultrasound in delayed phase clearance of hepatitis lesions and hepatocellular carcinoma
ObjectiveTo investigate the value of contrast-enhanced ultrasound and quantitative analysis in thedifferential diagnosis of delayed phase clearance of hepatitis lesions and hepatocellular carcinoma(HCC).MethodsThecontrast-enhanced ultrasound data of 38 patients(hepatitis lesion group
with a total of 38 lesions)who were confirmed bysurgery or biopsy and 66 HCC patients(hepatocellular carcinoma group
with a total of 66 lesions)were analyzed.The cut-offvalues of quantitative parameters of contrast-enhanced ultrasound in distinguishing hepatitis lesions from hepatocellularcarcinoma and their diagnostic efficacy were analyzed.ResultsThere were statistically significant differences between thehepatitis lesions group and the hepatocellular carcinoma group in gender
symptoms
serum carbohydrate antigen 125
alpha-fetoprotein(AFP) and hepatitis B virus infection history(all P<0.05). The proportion of irregular morphology and unclearboundary by contrast-enhanced ultrasound in the hepatitis focus group(23/38
30/38)were higher than those of the hepatocellularcarcinoma group(10/66
4/66)
and the differences were statistically significant(both P<0.01). There were 30 cases of lowenhancement and 8 cases of isoenhancement in the hepatitis lesion group
26 cases of low enhancement
34 cases ofisoenhancement and 6 cases of high enhancement in the hepatocellular carcinoma group.The difference between the two groupswas statistically significant(all P<0.01).Quantitative analysis showed that the area under the curve(AUC)of the time-intensity curve of the hepatitis lesion group was larger than that of the HCC group
and the fall time(FT)and mean transit time(MTT)were shorter than those of the HCC group.The differences were statistically significant(all P<0.05).The results of univariateanalysis showed that taken AUC>365.281
MTT<22 s
FT<35.5 s as cut-off value to distinguish hepatitis lesions fromhepatocellular carcinoma
the sensitivity and specificity were 100% and 68.2%
92.4% and 73.7%
100% and 60.5%
respectively.Logistic regression multivariate analysis showed that the coincidence rate of AUC>365.281 in diagnosing hepatitislesions as benign lesions was 100%.ConclusionContrast-enhanced ultrasound provides important information for thedifferential diagnosis of delayed phase clearance of hepatitis lesions and hepatocellular carcinoma
and quantitative analysis canobjectively show the blood perfusion characteristics of the lesion
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江苏省无锡市新吴区新瑞医院 上海交通大学医学院附属瑞金医院无锡分院超声科
Department of Ultrasound,Shanghai Jiao Tong University Affiliated First People’s Hospital
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