Dynamic Contrast-Enhanced Ultrasonography in Diagnosis of Hepatic Tumors

對比劑超音波鑑別診斷肝腫瘤

吳蓉俐(Rong-Li Wu) ； 鄭乃源(Nai-Yuan Cheng) ； 楊靜如(Ching-Ju Yang) ； 陳韻正(Tom Yung-Cheng Chen) ； 陳潤秋(Ran-Chou Chen)

《Journal of Radiological Science》 36卷2期 (2011/06) Pp. 8-15

https://doi.org/10.6698/JRS.201106_3602.02

並列摘要

The objective of this study is to analyze the enhancement patterns of hepatic tumors in different vascular phases using dynamic contrast-enhanced ultrasonography (CEUS).We performed dynamic CEUS in consecutive patients, and included a total of 61 patients (M = 41 , F = 20) with 69 proven focal hepatic tumors in this study. The hepatic tumors included hepatocellular carcinoma (HCC, n = 49), metastases (n = 6), cholangiocarcinoma (n = 3), hemangioma (n = 9) and focal nodular hyperplasia (FNH, n = 2), Most of the patients with HCC had underlying diseases such as hepatitis B (n = 26) 01' C (n = 12). After intravenous administration of micro-bubble contrast agent, video recordings were made. Three phases: initial, vascular and delayed phases were recorded and analyzed, ANOVA was used for statistical analysis, P value less than 0.05 is considered statistically significant. Two radiologists who were blind to the final diagnosis of hepatic tumors reviewed the video respectively. Interobsever difference was analyzed by kappa test.In the vascular phase, the enhancement is mainly marginal for HCCs (36.7%), peripheral for hemangioma (88.9%), no-enhancement (50.0%) or marginal enhancement (50.0%) for metastasis, while all the FNH showed internal enhancement and all the cholangiocarcinomas show no enhancement. In the delayed phase, the enhancement pattern is mainly inhomogeneous (59.2%) for HCCs, isoechoic (66.7%) for hemangioma, and hypoechoic (66.7%) for both metastases and cholangiocarcinoma; while FNHs were either hypoechoic (50%) or hyperechoic (50%), The interobserver difference is good (k = 0.62, 0.75).CEUS is useful in characterizing various hepatic tumors and may sometimes help in suggesting accurate diagnoses.