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Objective To investigate the relationship between hemodynamic parameters from quantitative analysis of contrast-enhanced ultrasonography (CEUS) on hepatocellular carcinoma (HCC) and pathological tumor differentiated grades. Methods Seventy-seven HCC lesions were examinated and off-line analyzed with dynamic images. Quantitative parameters such as slope of decrease to half of peak (SD), increased signal intensity (ISI), area under the curve (AUC) and blood flow coefficient (BF) were acquired, and the standardized values (sISI, sAUC and sBF) included the ratio of parameters from tumor to those from hepatic parenchyma. These quantitative parameters were correlated with tumor grades according to Edmonson criteria. Results There was significant difference (P＜0.05) of SD, AUC and BF, as well as standardized values (sISI, sAUC and sBF) between different grades of HCC. AUC, BF, sISI, sAUC and sBF were negative correlated with differentiated grades, respectively (P＜0.05). Well-differentiated HCC had significantly higher perfusion values than HCC of other grades (P＜0.05). Conclusion Quantitative analysis of CEUS can assess differentiation of HCC indirectly, and might reveal biological behavior of malignant tumors.
RESUMO
Objective To investigate the feasibility of contrast-enhanced ultrasonography(CEUS) in quantitative assessment of angiogenesis in patients with hepatocellular carcinoma(HCC).Methods Thirtythree patients with HCCs confirmed by pathology underwent CEUS in one week preoperatively.The presets and contrast dosage were fixed in all the studies.The new quantitative software with GAMMA fitting technique was used to analyze the dynamic images offline.The quantitative parameters such as baseline intensity,increased signal intensity(ASI),decent curvature(a2),up slope rate(a3),arrive time(AT), time to peak(TTP), accelerate time(ACT),peak intensity(PI),and area under curve(AREA) were calculated.The pathological specimen was stained with CD34 antibady and microvessel density (MVD) was calculated automatically.The correlation between parameters of CEUS and MVD was analyzed statistically.Results The parameters of ASI, a2, a3, AT, TTP, PI and ACT in the tumor were significantly different from those in liver parenehyma ( P＜0.01 ).The value of a2 in the tumor was correlated with MVD, the standardized ASI and AREA were correlated with MVD (P＜0.05).Conclusions The quantitative analysis with CEUS reflects the microvascular perfusion flow objectively.It provides a noninvasive imaging method to assess the angiogenesis in HCCs.